The objective of this retrospective observational study was to determine if there
is a survival benefit to intracranial pressure (ICP) monitoring in pediatric trauma
patients. Data were acquired from the National Trauma Data Bank (version 6.2, 2001–2006).
A total of 3107 patients were identified (ICP monitoring group, n = 283; and control,
n = 2817) using inclusion criteria of younger than 17 years admitted to intensive
care unit (ICU) with blunt traumatic brain injury (TBI), Injury Severity Score (ISS)
> 9, and Glascow Coma Scale (GCS) score < 9. Patients were excluded if ICU stay was
<24 h or had incomplete records. Only 7.7% of patients who met monitoring criteria
recommended by the Brain Trauma Foundation (BTF) received ICP monitoring. Stepwise
logistic regression methods were used to assess if ICP monitoring with or without
other variables (age, sex, ISS, Revised Trauma score, and GCS score) was associated
with survival. The adjustment odds ratio (OR) for admission GCS, age group, sex, Revised
Trauma Score, and ISS only showed potential reduction in mortality with ICP monitoring
and GCS score of 3 (OR = 0.64; 95% CI 0.43–1.00). Furthermore, with ICP monitoring
came longer hospital stay (21.0 days vs. 10.4 days; p < 0.001), longer ICU stay (12.6 vs. 6.3 days; p < 0.001), and more ventilator days (9.2 vs. 4.7; P 0.001).
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© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
