Predictors of intensive care unit length of stay and intracranial pressure in severe traumatic brain injury

Journal of Critical Care
Christos LazaridisClaudia S Robertson

Abstract

The aim of this study was to explore the relationship of intracranial pressure (ICP) with intensive care unit (ICU) length of stay in a large cohort of severe traumatic brain injury patients and identify factors associating with prolonged ICU course. This was a single-center database review of de-identified research data that had been prospectively collected; setting: neurosurgical ICU, Ben Taub General Hospital, Houston, TX. In a cohort of 438 severe traumatic brain injury (TBI) patients, 149 (34%) had a motor Glasgow Coma Scale score of 1 to 3 on admission and 284 (65%) had 4 to 5. Intracranial pressure during the ICU course was 19.8±11.2 mm Hg. Favorable outcome was obtained in 148 (34%), and unfavorable, in 211 (48%) patients with a mortality of 28%. ICU length of stay (LOS) was 19.4±13.9 days. Joint modeling of ICP and ICU LOS was undertaken, adjusted for the International Mission for Prognosis and Analysis of Clinical Trials in TBI admission prognostic indicators. A higher ICP was not significantly associated with longer ICU LOS (P=.4). However, presence of a mass lesion on admission head computed tomography was strongly correlated with a prolonged ICU LOS (P=.0007). Diffuse injuries with basal cistern compression or midl...Continue Reading

References

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Citations

Dec 3, 2016·Clinical Nurse Specialist CNS·Eileen SherburneSheryl Kelber
Oct 18, 2019·Brain Circulation·Bella Gonzales-PortilloCesar V Borlongan
Jun 28, 2016·Journal of Child Neurology·Erin D BiglerKeith Owen Yeates
Jul 12, 2017·Statistics in Medicine·Maria Laura RubinClaudia Sue Robertson
Jul 16, 2021·Journal of the American College of Emergency Physicians Open·Hanjin ChoRoger J Lewis

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Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.