Significance of Intracranial Pressure Monitoring after Early Decompressive Craniectomy in Patients with Severe Traumatic Brain Injury

摘要

Objective Early decompressive craniectomy (DC) has been used as the first stage treatment to prevent secondary injuries in cases of severe traumatic brain injury (TBI). Postoperative management is the major factor that influences outcome. The aim of this study is to investigate the effect of postoperative management, using intracranial pressure (ICP) monitoring and including consecutive DC on the other side, on the two-week mortality in severe TBI patients treated with early DC. Methods Seventy-eight patients with severe TBI [Glasgow Coma Scale (GCS) score Results The two-week mortality rate was significantly different between two groups [50.9% (27 patients) and 24% (6 patients), respectively, p =0.025]. After adjusting for confounding factors, including sex, low GCS score, and pupillary abnormalities, ICP monitoring was associated with a 78% lower likelihood of 2-week mortality ( p =0.021). Conclusion ICP monitoring in conjunction with postoperative treatment, after early DC, is associated with a significantly reduced risk of death.