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Updated: May 31, 2025

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
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Is Intracranial Pressure Monitoring After Open Cranial Procedures Associated With Outcome?

Peter Aziz1, Alison Muller2, Christopher Butts2

  • 1Drexel University College of Medicine at Tower Health, Wyomissing, Pennsylvania.

The Journal of Surgical Research
|January 22, 2025
PubMed
Summary
This summary is machine-generated.

Early intracranial pressure monitoring (ICPM) after open cranial procedures (OC) for traumatic brain injury was associated with increased mortality. Further investigation into ICPM indications after OC is warranted.

Keywords:
CraniectomyCraniotomyCritical careIntracranial pressure monitoringMortalityNeurotraumaTraumatic brain injury

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Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Intracranial pressure monitoring (ICPM) is crucial in managing severe traumatic brain injury (TBI).
  • The impact of early ICPM following open cranial procedures (OC) on mortality remains unclear.
  • This study investigates the association between ICPM timing and outcomes after OC in TBI patients.

Purpose of the Study:

  • To determine if early ICPM after OC for TBI is associated with lower mortality.
  • To compare outcomes between patients receiving ICPM within 72 hours versus those with no or delayed ICPM.

Main Methods:

  • Utilized 2020-2021 data from the American College of Surgeons Trauma Quality Improvement Program.
  • Included patients aged ≥16 years undergoing OC at level 1 and 2 trauma centers.
  • Employed logistic regression to analyze in-hospital mortality based on ICPM timing (early vs. none/delayed).

Main Results:

  • A total of 19,830 patients were analyzed; 29% received early ICPM.
  • Early ICPM patients had more severe injuries and higher baseline mortality risk.
  • Early ICPM was significantly associated with increased in-hospital mortality (OR 1.35, 95% CI 1.24-1.47), even in isolated brain injury cases.

Conclusions:

  • Placing ICPM within 72 hours of OC for TBI was linked to higher mortality.
  • Current indications for ICPM after OC require further examination.
  • Multicenter prospective studies are needed to clarify ICPM's role and optimize its use in TBI management.