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Bioinformatics analysis of mortality associated with elevated intracranial pressure in children

Mark S Wainwright1, Remigiusz Lewandowski

  • 1Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. m-wainwright@northwestern.edu

Acta Neurochirurgica. Supplement
|February 14, 2012
PubMed

Insights

Hierarchical cluster analysis revealed associations between intracranial pressure (ICP), cerebral perfusion pressure (CPP), and patient outcomes in pediatric acute brain injury. Elevated ICP and lower CPP were linked to mortality, highlighting ICP

Area of Science:

  • Pediatric critical care medicine
  • Neurocritical care
  • Multivariate data analysis

Background:

  • Multivariate data analysis can enhance the interpretation of complex data in critically ill patients.
  • Acute brain injury in children requires intensive monitoring and analysis of various physiological parameters.

Purpose of the Study:

  • To apply hierarchical cluster analysis to identify factors influencing outcomes in children with acute brain injury requiring intracranial pressure (ICP) monitoring.
  • To investigate associations between physiological parameters and survival in pediatric patients with acute brain injury.

Main Methods:

  • Retrospective analysis of pediatric intensive care unit patients with ICP monitoring (2003-2008).
  • Hierarchical cluster analysis was performed comparing survivors and non-survivors.
  • Area under the curve (AUC) for ICP and cerebral perfusion pressure (CPP) were compared between groups.

Main Results:

  • Cluster analysis identified associations between CPP, PaCO(2), and end-tidal CO(2), and between ICP, central venous pressure, and lactate.
  • Survivors had significantly lower ICP (13.7 ± 7.9 mmHg) compared to non-survivors (42.7 ± 36.2 mmHg).
  • Survivors exhibited higher mean (59.4 vs 41.3) and minimum (47.3 vs 28.1) CPP; higher ICP AUC was observed in non-survivors.

Conclusions:

  • The magnitude of abnormal ICP may significantly impact outcomes in pediatric acute brain injury.
  • Hierarchical clustering demonstrates potential as a valuable tool in pediatric neurocritical care clinical practice.
Abstract

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