[Threshold levels of intracranial pressure as determinants of survival from diffuse brain injury. An observational study].

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  • Additional Information
    • Source:
      Publisher: Igaku Shoin Country of Publication: Japan NLM ID: 0377015 Publication Model: Print Cited Medium: Print ISSN: 0301-2603 (Print) Linking ISSN: 03012603 NLM ISO Abbreviation: No Shinkei Geka Subsets: MEDLINE
    • Publication Information:
      Original Publication: Tokyo, Igaku Shoin.
    • Subject Terms:
      Intracranial Pressure*; Brain Injuries/*mortality; Adolescent ; Adult ; Aged ; Female ; Glasgow Outcome Scale ; Humans ; Male ; Middle Aged ; Retrospective Studies
    • Abstract:
      Objective: Intracranial pressure (ICP) is frequently monitored in patients with severe head injuries. In this study of a series of diffuse brain injury patients, we investigated whether there are significant threshold levels that determine the outcome.
      Method: Data were obtained from 17 patients with severe head injuries (adults aged ≥ 15-years-old). The outcome was categorized using the Glasgow Outcome Scale and survival or death. Patients were also grouped according to the Traumatic Coma Data Bank (TCDB) CT classification for diffuse injury: type I (n=0); II (n=5); III (n=10); IV (n=2).
      Conclusion and Result: The mortality rate was 29% (5 of 17 patients). The average initial ICP within 24 hours (14.08 mmHg) and the peak ICP (26.75 mmHg) were lower in the survivors than that in the patients who died (57.60 mmHg and 91.00 mmHg, respectively; p=0.0006 and 0.0002, respectively). Patients with an initial ICP score>35 mmHg did not survive, and patients with a peak ICP<35 mmHg, except one who died of a traumatic brainstem hemorrhage, did survive. Using an X-bar chart, a threshold value for the initial ICP within 24 hours of 27 mmHg and for the peak ICP 46 mmHg appear to be the survival predictors in patients with diffuse brain injury.
    • Publication Date:
      Date Created: 20110702 Date Completed: 20110805 Latest Revision: 20130715
    • Publication Date:
      20231215
    • Accession Number:
      21719908