Compensatory-reserve-weighted intracranial pressure versus intracranial pressure for outcome association in adult traumatic brain injury : a CENTER-TBI validation study

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CTR-TBI High Resolution ICU , Zeiler , F A & Ercole , A 2019 , ' Compensatory-reserve-weighted intracranial pressure versus intracranial pressure for outcome association in adult traumatic brain injury : a CENTER-TBI validation study ' , Acta Neurochirurgica , vol. 161 , no. 7 , pp. 1275-1284 . https://doi.org/10.1007/s00701-019-03915-3

Title: Compensatory-reserve-weighted intracranial pressure versus intracranial pressure for outcome association in adult traumatic brain injury : a CENTER-TBI validation study
Author: CTR-TBI High Resolution ICU; Zeiler, Frederick A.; Ercole, Ari
Contributor organization: Neurokirurgian yksikkö
Helsinki University Hospital Area
HUS Neurocenter
Date: 2019-07
Language: eng
Number of pages: 10
Belongs to series: Acta Neurochirurgica
ISSN: 0001-6268
DOI: https://doi.org/10.1007/s00701-019-03915-3
URI: http://hdl.handle.net/10138/323911
Abstract: BackgroundCompensatory-reserve-weighted intracranial pressure (wICP) has recently been suggested as a supplementary measure of intracranial pressure (ICP) in adult traumatic brain injury (TBI), with a single-center study suggesting an association with mortality at 6months. No multi-center studies exist to validate this relationship. The goal was to compare wICP to ICP for association with outcome in a multi-center TBI cohort.MethodsUsing the Collaborative European Neuro Trauma Effectiveness Research in TBI (CENTER-TBI) high-resolution intensive care unit (ICU) cohort, we derived ICP and wICP (calculated as wICP=(1-RAP)xICP; where RAP is the compensatory reserve index derived from the moving correlation between pulse amplitude of ICP and ICP). Various univariate logistic regression models were created comparing ICP and wICP to dichotomized outcome at 6 to 12months, based on Glasgow Outcome ScoreExtended (GOSE) (alive/deadGOSE 2/GOSE=1; favorable/unfavorableGOSE 5 to 8/GOSE 1 to 4, respectively). Models were compared using area under the receiver operating curves (AUC) and p values.ResultswICP displayed higher AUC compared to ICP on univariate regression for alive/dead outcome compared to mean ICP (AUC 0.712, 95% CI 0.615-0.810, p=0.0002, and AUC 0.642, 95% CI 0.538-746, p
Subject: Compensatory reserve
Intracranial pressure
Outcome
Weighted ICP
MANAGEMENT
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion


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