Comparative Effectiveness of Intracranial Pressure Monitoring on 6-Month Outcomes of Critically Ill Patients With Traumatic Brain Injury-Reference-Cited by-同舟云学术

Comparative Effectiveness of Intracranial Pressure Monitoring on 6-Month Outcomes of Critically Ill Patients With Traumatic Brain Injury

Published:2023-09-27 Issue:9 Volume:6 Page:e2334214
ISSN:2574-3805
Container-title:JAMA Network Open
language:en
Short-container-title:JAMA Netw Open

Author:

Nattino Giovanni¹,Gamberini Lorenzo²,Brissy Obou¹,Carrara Greta¹,Chesnut Randall³,Chiarini Valentina²,Chieregato Arturo⁴,Csomos Akos⁵,Fleming Joanne M.¹,Gradisek Primoz⁶⁷,Kaps Rafael⁸,Kyprianou Theodoros⁹¹⁰,Lazar Isaac¹¹,Lemeshow Stanley¹²,Mikaszewska-Sokolewicz Malgorzata¹³,Paci Giulia¹⁴,Rossi Carlotta¹,Temkin Nancy¹⁵,Xirouchaki Nektaria¹⁶,Giugni Aimone²,Bertolini Guido¹,Agostini Fulvio¹⁷,Ajmone-Cat Claudio¹⁷,Bassi Giovanni¹⁷,Bekos Vasileios¹⁷,Bellin Marzia¹⁷,Bocci Maria Grazia¹⁷,Bonato Valeria¹⁷,Bonato Alfeo¹⁷,Bonizzoli Manuela¹⁷,Bonucci Paola¹⁷,Bottazzi Andrea¹⁷,Calamai Italo¹⁷,Calicchio Giuseppe¹⁷,Carlin Fabrizia¹⁷,Casagli Sergio¹⁷,Castioni Carlo Alberto¹⁷,Ciceri Rita¹⁷,Cocciolo Francesco¹⁷,Crestan Ezio¹⁷,Csato Gabor¹⁷,Cseplo Peter¹⁷,Curto Francesco¹⁷,Dąbrowski Wojciech¹⁷,De Cristofaro Anna¹⁷,De Luca Alessandra¹⁷,Duda Izabela¹⁷,Duek Or¹⁷,Bakó Blanka Emoke¹⁷,Fagoni Nazzareno¹⁷,Fassini Paola¹⁷,Ferri Enrico¹⁷,Filekovic Suada¹⁷,Fiore Gilberto¹⁷,Gamberini Emiliano¹⁷,Gattari Diego¹⁷,Gianni Massimo¹⁷,Dessena Maria Giovanna¹⁷,Giuntini Romano¹⁷,Guido Stefania¹⁷,Gyulai Rita¹⁷,Hadash Amir¹⁷,Hribar Renata¹⁷,Ilia Stavroula¹⁷,Jankovic Vesna Novak¹⁷,Jurekovic Vlado¹⁷,Jereb Mateja¹⁷,Kapias Maciej¹⁷,Karadzic Dragica¹⁷,Kasnik Darja¹⁷,Vaggelis Volakakis¹⁷,Szaszi Adrienn Kitti¹⁷,Kompan Janez¹⁷,Kyriakides Eraclis¹⁷,Lagomarsino Silvia¹⁷,Lamborghini Sara¹⁷,Livigni Sergio¹⁷,Malacarne Paolo¹⁷,Martelli Maria¹⁷,Martin Marina Alessandra¹⁷,Martino Costanza¹⁷,Marudi Andrea¹⁷,Melis Martina¹⁷,Mengoli Francesca¹⁷,Mirkovic Tomislav¹⁷,Mizak Wiktoria¹⁷,Munari Marina¹⁷,Nardai Gabor¹⁷,Nascimben Ennio¹⁷,Natalini Giuseppe¹⁷,Negro Giancarlo¹⁷,Nemes Csaba¹⁷,Bernasconi Mara Olga¹⁷,Pagani Michele¹⁷,Parrini Vieri¹⁷,Partala Panagio¹⁷,Pastorelli Mauro¹⁷,Pellicioli Isabella¹⁷,Perino Bert Paolo¹⁷,Petrucci Nicola¹⁷,Piva Simone¹⁷,Poole Daniele¹⁷,Portolani Laila¹⁷,Radrizzani Danilo¹⁷,Rekas Anna¹⁷,Robak Paweł¹⁷,Rosano Antonio¹⁷,Ruggeri Patrizia¹⁷,Sacchi Marco¹⁷,Sárkány Ágnes¹⁷,Skoti Mara¹⁷,Skrt Alja¹⁷,Spagarino Ermanno¹⁷,Sulkowski Wiktor¹⁷,Szedlák Balázs¹⁷,Terzitta Marina¹⁷,Tinturini Rebecca¹⁷,Tofani Rossella¹⁷,Tselioti Paraskevi¹⁷,Vecchiarelli Ada¹⁷,Venturini Elisabetta¹⁷,Visconti Salvatore¹⁷,Zompanti Valeria¹⁷,Zoppellari Roberto¹⁷,

Affiliation:

1. Laboratory of Clinical Epidemiology, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Ranica, Bergamo, Italy

2. Anesthesia, Intensive Care and Prehospital Emergency, Maggiore Hospital, Bologna, Italy

3. Department of Neurological Surgery and School of Global Health, University of Washington, Seattle

4. Neurointensive Care Unit, Grande Ospedale Metropolitano Niguarda, Milan, Italy

5. Hungarian Army Medical Center, Budapest, Hungary

6. Clinical Department of Anaesthesiology and Intensive Therapy, University Medical Centre Ljubljana, Ljubljana, Slovenia

7. Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia

8. General Hospital Novo Mesto, Novo Mesto, Slovenia

9. University of Nicosia Medical School, Nicosia, Cyprus

10. University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom

11. Pediatric Intensive Care Unit, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel

12. Division of Biostatistics, College of Public Health, Ohio State University, Columbus

13. Clinic of Anaesthesia and Intensive Care, Medical University of Warsaw, Warsaw, Poland

14. Hospital Nursing Management, AUSL Romagna, Maurizio Bufalini Hospital, Cesena, Italy

15. Department of Neurological Surgery and Department of Biostatistics, University of Washington, Seattle

16. University Hospital of Heraklion, Crete, Greece

17. for the CREACTIVE Consortium

Abstract

ImportanceWhile the relationship between persistent elevations in intracranial pressure (ICP) and poorer outcomes is well established for patients with traumatic brain injury (TBI), there is no consensus on how ICP measurements should drive treatment choices, and the effectiveness of ICP monitoring remains unknown.ObjectiveTo evaluate the effectiveness of ICP monitoring on short- and mid-term outcomes of patients with TBI.Design, Setting, and ParticipantsCREACTIVE was a prospective cohort study that started in March 2014 and lasted 5 years. More than 8000 patients with TBI were enrolled at 83 intensive care units (ICUs) from 7 countries who joined the CREACTIVE Consortium. Patients with TBI who met the Brain Trauma Foundation guidelines for ICP monitoring were selected for the current analyses, which were performed from January to November 2022.ExposurePatients who underwent ICP monitoring within 2 days of injury (exposure group) were propensity score–matched to patients who were not monitored or who underwent monitoring 2 days after the injury (control group).Main Outcome and MeasureFunctional disability at 6 months as indicated by Glasgow Outcome Scale–Extended (GOS-E) score.ResultsA total of 1448 patients from 43 ICUs in Italy and Hungary were eligible for analysis. Of the patients satisfying the ICP-monitoring guidelines, 503 (34.7%) underwent ICP monitoring (median [IQR] age: 45 years [29-61 years]; 392 males [77.9%], 111 females [22.1%]) and 945 were not monitored (median [IQR] age: 66 years [48-78 years]; 656 males [69.4%], 289 females [30.6%]). After matching to balance the variables, worse 6-month recovery was observed for monitored patients compared with nonmonitored patients (death/vegetative state: 39.2% vs 40.6%; severe disability: 33.2% vs 25.4%; moderate disability: 15.7% vs 14.9%; good recovery: 11.9% vs 19.1%, respectively; P = .005). Monitored patients received medical therapies significantly more frequently.Conclusions and RelevanceIn this cohort study, ICP monitoring was associated with poorer recovery and more frequent medical interventions with their relevant adverse effects. Optimizing the value of ICP monitoring for TBI requires further investigation on monitoring indications, clinical interventions, and management protocols.

Publisher

American Medical Association (AMA)

Subject

General Medicine

Link

https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2809949/nattino_2023_oi_230986_1695236262.05891.pdf

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