Effect of intracranial pressure changes on prognosis in patients with cerebral injury

Li Xin; Wang Fan; Liu Shaobo; Xie Zhimin; Gu Wanchun

doi:10.11850/j.issn.1009-122X.2017.06.002

Abstract：Objective To research the effect of intracranial pressure (ICP) changes on prognosis of patients with cerebral injury.Methods Clinical data of 48 patients with cerebral injury were analyzed retrospectively.The patients were planted with an ICP monitor,and the intracranial pressure value was recorded every 60 minutes and continuously recorded for 5 days.Short-term outcome was evaluated 30 days after the operation.The patients with GCS change greater than or equal to 1 score were involved in the improvement group,and the other patients were involved in the deterioration group.Long-term outcome was evaluated 3 months after the operation.The patients with GOS 4 to 5 scores were involved in the good prognosis group,and those with GOS 1 to 3 scores were involved in the poor prognosis group.Then,the statistical analysis was performed for these factors.Results There were significant differences in the preoperative GCS score,contusion or hematoma volume,the initial value of ICP and ICP changes (ICP-P1 and ICP-P2) between the improvement group and deterioration group in short-term outcome (P ＜ 0.05),and the same to the long-term outcome (P ＜ 0.05).The risk factors influcencing poor prognosis were multiplied with intracranial pressure amplitude increased 1 mmHg in a multivariable Logistic regression model,and the effect was more obviously reflected in the short-term outcome.Otherwise,the receiver operating characteristic (ROC) curve analysis showed that the critical values of poor prognosis in the short-term outcome were as follows:the initial value ofICP equal to 31.50 mmHg,ICP-P1 equal to 4.29 mmHg and ICP-P2 equal to 3.97 mmHg,while the critical values of poor prognosis in the long-term outcome were equal to 28.00 mmHg,3.21 mmHg,2.93 mmHg respectively.Conclusion Maintaining the ICP at an appropriate level is beneficial to improve the prognosis in cerebral injury patients.