Prognostic value of intracranial pressure monitoring for the management of hypertensive intracerebral hemorrhage following minimally invasive surgery
10.5847/wjem.j.1920-8642.2020.03.007
- Author:
Xiao-ru Che
- Publication Type:Journal Article
- Keywords:
Hypertensive intracerebral hemorrhage;
Intracranial pressure;
Minimally invasive surgery
- From:
World Journal of Emergency Medicine
2020;11(3):169-173
- CountryChina
- Language:English
-
Abstract:
BACKGROUND: The incidence of hypertensive intracerebral hemorrhage (HICH) has been
increasing during the recent years in low- and middle-income countries. With high mortality and morbidity
rates, it brings huge burden to the families. It lacks evidence regarding the application of intracranial
pressure (ICP) monitoring in HICH. In the current study, the authors aimed to evaluate whether ICP
monitoring could make any difference on the prognosis of HICH patients after minimally invasive surgery.
METHODS: A retrospective review of 116 HICH patients admitted to the Second Affiliated
Hospital of Zhejiang University School of Medicine, between 2014 and 2016, was performed. The
effects of ICP monitoring on 6-month mortality and favorable outcomes were evaluated by univariate
and logistic regression analysis.
RESULTS: ICP monitors were inserted into 50 patients. Patients with ICP monitoring had a
signifi cantly better outcome (P<0.05). The average in-hospital duration in patients with ICP monitoring
was shorter than that in the patients without ICP monitoring (16.68 days vs. 20.47 days, P<0.05).
Mortality rates between ICP monitoring and no ICP monitoring did not differ significantly (16.0%
vs. 15.1%, P=0.901). On univariate analysis, age, Glasgow Coma Scale (GCS) on admission and
presence of ICP monitor were independent predictors of 6-month favorable outcomes.
CONCLUSION: ICP monitoring is associated with a better 6-month functional outcome compared
with no ICP monitoring. Future study is still needed to confi rm our results and elucidate which subgroup of
HICH patients will benefi t most from the minimally invasive surgical intervention and ICP monitoring.