%0 Journal Article
%T Predictors of intensive care unit length of stay and intracranial pressure in severe traumatic brain injury
%J Journal of critical care
%D 2015
%A Lazaridis, Christos
%A Yang, Ming
%A Desantis, Stacia M.
%A Luo, Sheng T.
%A Robertson, Claudia S.
%V 30
%N 6
%P 1258-1262
%X OBJECTIVE: The aim of this study was to explore the relationship of intracranial pressure (ICP) with intensive care unit (ICU) length of stay in a large cohort of severe traumatic brain injury patients and identify factors associating with prolonged ICU course. <br><br>METHODS: This was a single-center database review of de-identified research data that had been prospectively collected; setting: neurosurgical ICU, Ben Taub General Hospital, Houston, TX. <br><br>RESULTS: In a cohort of 438 severe traumatic brain injury (TBI) patients, 149 (34%) had a motor Glasgow Coma Scale score of 1 to 3 on admission and 284 (65%) had 4 to 5. Intracranial pressure during the ICU course was 19.8 ± 11.2 mm Hg. Favorable outcome was obtained in 148 (34%), and unfavorable, in 211 (48%) patients with a mortality of 28%. ICU length of stay (LOS) was 19.4 ± 13.9 days. Joint modeling of ICP and ICU LOS was undertaken, adjusted for the International Mission for Prognosis and Analysis of Clinical Trials in TBI admission prognostic indicators. A higher ICP was not significantly associated with longer ICU LOS (P =.4). However, presence of a mass lesion on admission head computed tomography was strongly correlated with a prolonged ICU LOS (P =.0007). Diffuse injuries with basal cistern compression or midline shift were marginally associated with a longer ICU LOS (P =.053). <br><br>CONCLUSIONS: ICP, as monitored and managed according to BTF guidelines, is not associated with ICU length of stay. Patients with severe TBI and a mass lesion on admission head computed tomography were found to have prolonged ICU LOS independently of other indicators of injury severity and intracranial pressure course.<p /> <p>Language: en</p>
%G en
%I Elsevier Publishing
%@ 0883-9441
%U http://dx.doi.org/10.1016/j.jcrc.2015.08.003