2018•International Journal of SurgeryRequires access

Clinical study of continuous intracranial pressure monitoring after decompressive craniectomy in severe traumatic brain injury patient

Jianren Wang, Liqing Lin, Ze-xi Lin, Chunsheng Sang, Yinlong Liu, Yuhao Ding, Linxiang Lu

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Abstract

Objective To clarify the relationship between intracranial pressure monitoring and prognosis of patients with traumatic brain injury after decompressive craniectomy. Methods From December 2015 to December 2017, 48 head-injured patients in Affiliated Suzhou Hospital of Nanjing Medical University were enrolled, who were underwent decompressive craniectomy in this retrospective study. The patients were subdivided into 2 groups based on whether postoperative was monitored (n=19) or not (n=29). The prognosis was evaluated by Glasgow Outcome Scale score, with 1 point of prognosis death, 2 to 3 points of poor prognosis, and 4 to 5 points of good prognosis. Count data were expressed as a percentage (%). Count data were expressed as percentage (%). The chi-square test was used to compare the difference in the rate of good prognosis and mortality between the two groups. Results The mortality of monitoring group (10.5%) was significantly lower than that of control group (37.9%) (χ2=4.365 5, P=0.036 7) during hospitalization, The rate of good prognosis in the monitoring group (68.4%) and the control group (44.8%) was not statistically significant (χ2=2.573 8, P=0.108 6). Conclusion The study showed that continuous monitoring in patients with severe craniocerebral injury could reduce the mortality of patients during hospitalization, but had no significant effect on the improvement of prognosis. Key words: Brain injuries; Intensive care; Intracranial pressure; Decompressive craniectomy

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Objective To clarify the relationship between intracranial pressure monitoring and prognosis of patients with traumatic brain injury after decompressive craniectomy. Methods From December 2015 to December 2017, 48 head-injured patients in Affiliated Suzhou Hospital of Nanjing Medical University were enrolled, who were underwent decompressive craniectomy in this retrospective study. The patients were subdivided into 2 groups based on whether postoperative was monitored (n=19) or not (n=29). The prognosis was evaluated by Glasgow Outcome Scale score, with 1 point of prognosis death, 2 to 3 points of poor prognosis, and 4 to 5 points of good prognosis. Count data were expressed as a percentage (%). Count data were expressed as percentage (%). The chi-square test was used to compare the difference in the rate of good prognosis and mortality between the two groups. Results The mortality of monitoring group (10.5%) was significantly lower than that of control group (37.9%) (χ2=4.365 5, P=0.036 7) during hospitalization, The rate of good prognosis in the monitoring group (68.4%) and the control group (44.8%) was not statistically significant (χ2=2.573 8, P=0.108 6). Conclusion The study showed that continuous monitoring in patients with severe craniocerebral injury could reduce the mortality of patients during hospitalization, but had no significant effect on the improvement of prognosis. Key words: Brain injuries; Intensive care; Intracranial pressure; Decompressive craniectomy

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Available abstract

Objective To clarify the relationship between intracranial pressure monitoring and prognosis of patients with traumatic brain injury after decompressive craniectomy. Methods From December 2015 to December 2017, 48 head-injured patients in Affiliated Suzhou Hospital of Nanjing Medical University were enrolled, who were underwent decompressive craniectomy in this retrospective study. The patients were subdivided into 2 groups based on whether postoperative was monitored (n=19) or not (n=29). The prognosis was evaluated by Glasgow Outcome Scale score, with 1 point of prognosis death, 2 to 3 points of poor prognosis, and 4 to 5 points of good prognosis. Count data were expressed as a percentage (%). Count data were expressed as percentage (%). The chi-square test was used to compare the difference in the rate of good prognosis and mortality between the two groups. Results The mortality of monitoring group (10.5%) was significantly lower than that of control group (37.9%) (χ2=4.365 5, P=0.036 7) during hospitalization, The rate of good prognosis in the monitoring group (68.4%) and the control group (44.8%) was not statistically significant (χ2=2.573 8, P=0.108 6). Conclusion The study showed that continuous monitoring in patients with severe craniocerebral injury could reduce the mortality of patients during hospitalization, but had no significant effect on the improvement of prognosis. Key words: Brain injuries; Intensive care; Intracranial pressure; Decompressive craniectomy

Key concepts: Medicine, Decompressive craniectomy, Traumatic brain injury, Intracranial pressure, Intracranial pressure monitoring, Glasgow Outcome Scale, Glasgow Coma Scale, Mortality rate

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