Lee Youngheon, Lee Jung Hwan, Choi Hyuk Jin, Kim Byung Chul, Yu Seunghan, Ha Mahnjeong
Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital, Busan, Korea.
Department of Neurosurgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Neurosurg Soc. 2023 Aug;66(5):543-551. doi: 10.3340/jkns.2023.0019. Epub 2023 Apr 4.
This study aimed to investigate the current status of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) in Korea and the association between ICP monitoring and prognosis. In addition, a survey was administered to Korean neurosurgeons to investigate the perception of ICP monitoring in patients with sTBI.
This study used data from the second Korea Neurotrauma Databank. Among the enrolled patients with sTBI, the following available clinical data were analyzed in 912 patients : Glasgow coma scale score on admission, ICP monitoring, mortality, and extended Glasgow outcome scale score at 6 months. In addition, we administered a survey, entitled "current status and perception of ICP monitoring in Korean patients with sTBI" to 399 neurosurgeons who were interested in traumatic brain injury.
Among the 912 patients, 79 patients (8.7%) underwent ICP monitoring. The mortality and favorable outcome were compared between the groups with and without ICP monitoring, and no statistically significant results were found. Regarding the survey, there were 61 respondents. Among them, 70.4% of neurosurgeons responded negatively to performing ICP monitoring after craniectomy/craniotomy, while 96.7% of neurosurgeons responded negatively to performing ICP monitoring when craniectomy/ craniotomy was not conducted. The reasons why ICP monitoring was not performed were investigated, and most respondents answered that there were no actual guidelines or experiences with post-operative ICP monitoring for craniectomy/craniotomy. However, in cases wherein craniectomy/craniotomy was not performed, most respondents answered that ICP monitoring was not helpful, as other signs were comparatively more important.
The proportion of performing ICP monitoring in patients with sTBI was low in Korea. The outcome and mortality were compared between the patient groups with and without ICP monitoring, and no statistically significant differences were noted in prognosis between these groups. Further, the survey showed that ICP monitoring in patients with sTBI was somewhat negatively recognized in Korea.
本研究旨在调查韩国重型颅脑损伤（sTBI）患者颅内压（ICP）监测的现状以及ICP监测与预后之间的关联。此外，对韩国神经外科医生进行了一项调查，以了解他们对sTBI患者ICP监测的看法。
本研究使用了来自韩国第二个神经创伤数据库的数据。在入选的sTBI患者中，对912例患者的以下可用临床数据进行了分析：入院时的格拉斯哥昏迷量表评分、ICP监测、死亡率以及6个月时的扩展格拉斯哥预后量表评分。此外，我们向399名对颅脑损伤感兴趣的神经外科医生进行了一项名为“韩国sTBI患者ICP监测的现状与看法”的调查。
在912例患者中，79例（8.7%）接受了ICP监测。对进行和未进行ICP监测的两组患者的死亡率和良好预后进行了比较，未发现统计学上的显著差异。关于调查，有61名受访者。其中，70.4%的神经外科医生对颅骨切除/开颅术后进行ICP监测持否定态度，而96.7%的神经外科医生对未进行颅骨切除/开颅时进行ICP监测持否定态度。对未进行ICP监测的原因进行了调查，大多数受访者回答说没有关于颅骨切除/开颅术后ICP监测的实际指南或经验。然而，在未进行颅骨切除/开颅的情况下，大多数受访者回答说ICP监测没有帮助，因为其他体征相对更重要。
在韩国，sTBI患者进行ICP监测的比例较低。对进行和未进行ICP监测的患者组的预后和死亡率进行了比较，两组之间在预后方面未发现统计学上的显著差异。此外，调查显示韩国对sTBI患者的ICP监测有些负面看法。
