Intracranial pressure monitoring in brain-injured patients is associated with worsening of survival.

摘要

I am writing to comment on the article "Intracranial Pressure Monitoring in Brain-Injured Patients is Associated With Worsening of Survival" by Shafi et al., published in the February issue the Journal of Trauma. This study shows that if you stratify patients using sufficiently insensitive data, you can come up with interesting and very questionable results. The National Trauma Data Bank (NTDB) is not a brain injury database and, therefore, does not index those variables (outside of GCS and age) that have been repeatedly suggested as predictive of outcome and are routinely required to be independently controlled as confounding variables in traumatic brain injury (TBI) outcome studies (i.e., early hypotension, pupillary response, and CT diagnosis).2 The absence of these specific data makes the NTDB a particularly poor platform for TBI studies.