Decreased intracranial pressure monitor use at level II trauma centers is associated with increased mortality

Galinos Barmparas, Matthew Singer, Eric Ley, Rex Chung, Darren Malinoski, Daniel Margulies, Ali Salim, Marko Bukur

    Research output: Contribution to journalArticle

    13 Scopus citations

    Abstract

    Previous investigations suggest outcome differences at Level I and Level II trauma centers. We examined use of intracranial pressure (ICP) monitors at Level I and Level II trauma centers after traumatic brain injury (TBI) and its effect on mortality. The 2007 to 2008 National Trauma Databank was reviewed for patients with an indication for ICP monitoring based on Brain Trauma Foundation (BTF) guidelines. Demographic and clinical outcomes at Level I and Level II centers were compared by regression modeling. Overall, 15,921 patients met inclusion criteria; 11,017 were admitted to a Level I and 4,904 to a Level II trauma center. Patients with TBI admitted to a Level II trauma center had a lower rate of Injury Severity Score greater than 16 (80 vs 82%, P < 0.01) and lower frequency of head Abbreviated Injury Score greater than 3 (80 vs 82%, P < 0.01). After regression modeling, patients with TBI admitted to a Level II trauma center were 31 per cent less likely to receive an ICP monitor (adjusted odds ratio [AOR], 0.69; P < 0.01) and had a significantly higher mortality (AOR, 1.12; P < 0.01). Admission to a Level II trauma center after severe TBI is associated with a decreased use of ICP monitoring in patients who meet BTF criteria as well as an increased mortality. These differences should be validated prospectively to narrow these discrepancies in care and outcomes between Level I and Level II centers. Copyright Southeastern Surgical Congress. All rights reserved.

    Original languageEnglish (US)
    Pages (from-to)1166-1171
    Number of pages6
    JournalAmerican Surgeon
    Volume78
    Issue number10
    StatePublished - Oct 1 2012

    ASJC Scopus subject areas

    • Surgery

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  • Cite this

    Barmparas, G., Singer, M., Ley, E., Chung, R., Malinoski, D., Margulies, D., Salim, A., & Bukur, M. (2012). Decreased intracranial pressure monitor use at level II trauma centers is associated with increased mortality. American Surgeon, 78(10), 1166-1171.