Outcome of Severe Traumatic Brain Injury at KSMC: Functional Outcomes of ICP Monitor Insertion—Two Years’ Experience

• Main Authors: AL-Shudifat ARM, Kahlon B, Bin Abdulqader S, Almutairi W, Alsumali K, Aldhfyan Y, Al-Abdallat L
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-04-01
• Series: Open Access Emergency Medicine
• Subjects: traumatic brain injury; functional outcome; icp monitoring; decompressive craniectomy.
• Online Access: https://www.dovepress.com/outcome-of-severe-traumatic-brain-injury-at-ksmc-functional-outcomes-o-peer-reviewed-article-OAEM

Abdul Raman M AL-Shudifat,1,2 Babar Kahlon,2 Sarah Bin Abdulqader,2 Wajab Almutairi,2 Khairiah Alsumali,2 Yazeed Aldhfyan,2 Laith Al-Abdallat1 1Department of Neurosurgery, School of Medicine, The University of Jordan, Amman, Jordan; 2Department of Neurosurgery, King Saud Medical City (KSMC), Riyadh, Saudi ArabiaCorrespondence: Laith Al-AbdallatDepartment of Neurosurgery, School of Medicine, The University of Jordan, Queen Rania Street, Amman, 11942, JordanTel [phone]Email [e-mail]: To evaluate functional outcomes of severe traumatic brain injuries after insertion of intracranial pressure (ICP) monitor at King Saud Medical City (KSMC) and their correlation to each other.Patients and Methods: A retrospective observational study for all adult patients (age > 18 years) who were diagnosed with severe head injury and underwent ICP insertion at KSMC. Patients diagnosed between 2017 and 2019 were included. Data for measured outcomes, Glasgow outcome scale (GOS), Karnofsky Performance Score (KPS) and length of stay (LOS) and prognostic factors, data like: age, gender and primary Glasgow coma score (GCS) was obtained from patients’ files and direct communication with patients or their caregivers. We also compared patients who underwent ICP monitoring alone with those who underwent ICP with decompressive craniectomy (DC). Follow-up period ranged from 6– 24 months.Results: Seventy-four patients were included in this cohort study. Outcome measurements for patients with decompression and ICP were lower than those with ICP alone. KPS and GOS showed strong correlation (p< 0.01) in whole cohort and in both subgroups (ICP alone and ICP with DC). KPS showed significant correlation with length of stay (p=0.026).Conclusion: ICP monitoring is valid tool in management of severely head injured patients. Patients who underwent DC had a worse outcome. KPS can be used as alternative tool to measure functional outcome in severe traumatic brain injury.Keywords: traumatic brain injury, functional outcome, ICP monitoring, decompressive craniectomy