Intracranial pressure monitoring and case mix-adjusted mortality in intracranial hemorrhage.

Abstract:

OBJECTIVE:Intracranial pressure (ICP) monitoring is frequently used in intensive care treatment of patients with intracranial hemorrhage. Data demonstrating an improved outcome from this intervention are lacking. We analyzed standardized mortality ratios in patients with and without ICP monitoring to determine its efficacy. DESIGN:A nonrandomized study of case records of consecutively admitted intensive care unit (ICU) patients with intracranial hemorrhage. SETTING:General and medical ICU of a 900-bed tertiary-care hospital. PATIENTS:A total of 225 patients with intracranial hemorrhage (mainly nontraumatic) admitted consecutively between April 1997 and March 2000. MEASUREMENTS:Simplified Acute Physiology Score (SAPS) II, diagnosis, age, sex, use of ICP monitoring, and in-hospital mortality rates were collected from the hospital's ICU database. Expected mortality was provided by means of SAPS II. Standardized mortality ratios were calculated and compared in 119 patients with ICP monitoring and 106 patients without ICP monitoring. MAIN RESULTS:The case mix-adjusted hospital mortality in the group with ICP monitoring was in the expected range (standardized mortality ratio, 1.09 [95% confidence interval (CI), 0.87-1.31]). Patients without ICP monitoring had a significantly higher standardized mortality ratio than expected (1.26 [95% CI, 1.06-1.46]). CONCLUSIONS:A beneficial effect of ICP monitoring in patients with intracranial hemorrhage may be reflected in an improved standardized mortality ratio.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Valentin A,Lang T,Karnik R,Ammerer HP,Ploder J,Slany J

doi

10.1097/01.CCM.0000065270.53951.9E

subject

Has Abstract

pub_date

2003-05-01 00:00:00

pages

1539-42

issue

5

eissn

0090-3493

issn

1530-0293

journal_volume

31

pub_type

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