颅内压监测在创伤性脑损伤患者中的效用：基于TQIP数据的倾向评分匹配分析
Utility of intracranial pressure monitoring in patients with traumatic brain injuries: a propensity score matching analysis of TQIP data.
作者信息
Chopko Ashley, Tian Mingmei, L'Huillier Joseph C, Filipescu Radu, Yu Jinhee, Guo Weidun A
机构信息
Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, 100 High Street, Buffalo, NY, 14203, USA.
Department of Biostatistics, School of Public Health and Health Professions, University at Buffalo, 401 Kimball Tower, Buffalo, NY, 14214, USA.
出版信息
Eur J Trauma Emerg Surg. 2024 Feb;50(1):173-184. doi: 10.1007/s00068-023-02239-3. Epub 2023 Feb 16.
PURPOSE
Intracranial pressure monitoring (ICPM) is central to traumatic brain injury (TBI) management, but its utility is controversial.
METHODS
The 2016-2017 TQIP database was queried for isolated TBI. Patients with ICPM [(ICPM (+)] were propensity-score matched (PSM) to those without ICPM [ICPM (-)] and divided into three age groups by years (< 18, 18-54, ≥ 55).
RESULTS
PSM yielded 2125 patients in each group. Patients aged < 18 years had a higher survival probability (p = 0.013) and decreased mortality (p = 0.016) in the ICPM (+) group. Complications were higher and LOS was longer in ICPM (+) patients aged 18-54 years and ≥ 55 years, but not in patients aged < 18 years.
CONCLUSIONS
ICPM (+) is associated with a survival benefit without an increase in complications in patents aged < 18 years. In patients aged ≥ 18 years, ICPM (+) is associated with more complications and longer LOS without a survival benefit.
目的
颅内压监测（ICPM）是创伤性脑损伤（TBI）管理的核心，但其实用性存在争议。
方法
查询2016 - 2017年TQIP数据库中的单纯性TBI患者。将接受ICPM的患者[ICPM（+）]与未接受ICPM的患者[ICPM（-）]进行倾向评分匹配（PSM），并按年龄分为三个年龄组（<18岁、18 - 54岁、≥55岁）。
结果
PSM每组产生2125例患者。<18岁的患者在ICPM（+）组中具有更高的生存概率（p = 0.013）和更低的死亡率（p = 0.016）。18 - 54岁和≥55岁的ICPM（+）患者并发症更多，住院时间更长，但<18岁的患者并非如此。
结论
ICPM（+）与<18岁患者的生存获益相关，且并发症未增加。在≥18岁的患者中，ICPM（+）与更多并发症和更长住院时间相关，但无生存获益。
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