J Korean Neurosurg Soc.  2023 Aug;66(5):543-551. 10.3340/jkns.2023.0019.

Current Status of Intracranial Pressure Monitoring in Patients with Severe Traumatic Brain Injury in Korea : A Post Hoc Analysis of Korea Neurotrauma Databank Project with a Nationwide Survey

• Lee Y
• Lee JH
• Choi HJ
• Kim BC
• Yu S
• Ha M
• the KNTDB Investigators

• KMID: 2545345
• DOI: http://doi.org/10.3340/jkns.2023.0019

Abstract

Objective
: 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.
Methods
: 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.
Results
: 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.
Conclusion
: 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.

Keyword

Traumatic brain injury; Intracranial pressure; Surveys and questionnaires; Social perception

Figure

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  Fig. 1. Working hospitals and information about neurosurgeons who responded to the survey. A : Number of hospital beds. B : Types of hospitals. C : Training hospitals for neurosurgery residents. D : Detailed specialties of the neurosurgeons.

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  Fig. 2. Answers for the reasons why intracranial pressure (ICP) monitoring was not performed after craniectomy/craniotomy.

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  Fig. 3. Answers for the reasons why intracranial pressure (ICP) monitoring was not performed in patients who did not undergo immediate craniectomy/ craniotomy.

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  Fig. 4. Answers for what was deemed necessary to activate intracranial pressure (ICP) monitoring.

Reference

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