Clinical value of ICP-related parameter monitoring in predicting the prognosis of patients with large-area cerebral infarction undergoing decompressive craniectomy
HE Xinghe
CAO Ke
CHEN Dayu
SHEN Yu
WEI Xiaochuan
CHEN Feng
QI Gaoyang
Abstract：Objective To explore the predictive value of intracranial pressure(ICP)-related parameter monitoring on the prognosis of patients with large-area cerebral infarction undergoing decompressive craniectomy.Methods 68 patients with large-area cerebral infarction admitted to the neurosurgery department of our hospital from July 2020 to July 2024 were selected.All patients underwent decompressive craniectomy by the same medical team and were followed up for 6 months after the operation.According to the modified Rankin scale(MRS)score,the patients were divided into the good-prognosis group(≤2 points)and the poor-prognosis group(>2 points).Univariate analysis was performed on the clinical data of the two groups.Multivariate logistic regression analysis was used to analyze the independent risk factors for poor postoperative prognosis in patients.Receiver operating characteristic(ROC)curve analysis was used to analyze the predictive value of ICP-related parameters for evaluating prognosis.Results Univariate analysis showed that the probabilities of preoperative Glasgow Coma Scale(GCS)≤8 points,ICP>15 mmHg,cerebral perfusion pressure<70 mmHg,pressure-reactivity index>0.6,correlation coefficient between ICP amplitude and arterial pressure amplitude>0.6,and the incidence of postoperative complications in the good-prognosis group were all lower than those in the poor-prognosis group,and there were differences between the two groups(P<0.05).Multivariate logistic regression analysis showed that ICP>15 mmHg,cerebral perfusion pressure<70 mmHg,pressure-reactivity index>0.6,and correlation coefficient between ICP amplitude and arterial pressure amplitude>0.6 were all independent risk factors for poor prognosis(P<0.05).There were differences in various ICP-related parameters between the two groups(P<0.05).ROC curve analysis showed that the combined detection of ICP,cerebral perfusion pressure,pressure-reactivity index,and correlation coefficient between ICP amplitude and arterial pressure amplitude had higher prediction sensitivity and specificity for poor prognosis(P<0.05).Conclusions ICP-related parameters are independent risk factors for poor prognosis in patients with large-area cerebral infarction undergoing decompressive craniectomy.Combined detection of multiple indicators can further improve the predictive value.
Keywords：intracranial pressure parameterscerebral infarctiondecompressive craniectomypoor prognosisfactor analysisreceiver operating characteristic curve
Publication Date：2026-01-28
Online Publishing Date：2026-01-17(First online date of this platform, not the publication date of the document)
Pages：6( 64-69 )