Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Current Status of Intracranial Pressure Monitoring in Patients with Severe Traumatic Brain Injury in Korea : A Post Hoc Analysis of Korea Neurotrauma Databank Project with a Nationwide Survey

  • Youngheon Lee (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • Jung Hwan Lee (Department of Neurosurgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Hyuk Jin Choi (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • Byung Chul Kim (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • Seunghan Yu (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • Mahnjeong Ha (Department of Neurosurgery, Medical Research Institute, Pusan National University Hospital) ;
  • The KNTDB Investigators (Korea Neuro-Trauma Data Bank Committee, Korea Neurotraumatology Society)
  • Received : 2023.01.27
  • Accepted : 2023.03.29
  • Published : 2023.09.01
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Abstract

Objective : This study aimed to investigate the current status of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) in Korea and the association between ICP monitoring and prognosis. In addition, a survey was administered to Korean neurosurgeons to investigate the perception of ICP monitoring in patients with sTBI. Methods : This study used data from the second Korea Neurotrauma Databank. Among the enrolled patients with sTBI, the following available clinical data were analyzed in 912 patients : Glasgow coma scale score on admission, ICP monitoring, mortality, and extended Glasgow outcome scale score at 6 months. In addition, we administered a survey, entitled "current status and perception of ICP monitoring in Korean patients with sTBI" to 399 neurosurgeons who were interested in traumatic brain injury. Results : Among the 912 patients, 79 patients (8.7%) underwent ICP monitoring. The mortality and favorable outcome were compared between the groups with and without ICP monitoring, and no statistically significant results were found. Regarding the survey, there were 61 respondents. Among them, 70.4% of neurosurgeons responded negatively to performing ICP monitoring after craniectomy/craniotomy, while 96.7% of neurosurgeons responded negatively to performing ICP monitoring when craniectomy/craniotomy was not conducted. The reasons why ICP monitoring was not performed were investigated, and most respondents answered that there were no actual guidelines or experiences with post-operative ICP monitoring for craniectomy/craniotomy. However, in cases wherein craniectomy/craniotomy was not performed, most respondents answered that ICP monitoring was not helpful, as other signs were comparatively more important. Conclusion : The proportion of performing ICP monitoring in patients with sTBI was low in Korea. The outcome and mortality were compared between the patient groups with and without ICP monitoring, and no statistically significant differences were noted in prognosis between these groups. Further, the survey showed that ICP monitoring in patients with sTBI was somewhat negatively recognized in Korea.

Keywords

Acknowledgement

Authors are thankful to members of the KNTDB investigators include Eun-Sung Park (Wonkwang University Hospital), Han-Seung Ryu (Chonnam National University Hospital), In Bok Chang (Hallym University Sacred Heart Hospital), JaeSang Oh (Soonchunhyang University Cheonan Hospital), Jeong-Ho Lee (Daegu Fatima Hospital), Jin-Gyu Choi (Yeouido St. Mary's Hospital), Jongyeon Kim (Wonju Severance Christian Hospital), Jung Hwan Lee (Pusan National University Hospital), Ki-Seong Eom (Wonkwang University Hospital), Kwang Wook Jo (Bucheon St. Mary's Hospital), Kyung Hwan Kim (Chungnam National University Hospital), MinKyun Na (Hanyang University Seoul Hospital), Min Su Kim (Ulsan University Hospital), Sae-Min Kwon (Keimyung University Dongsan Hospital), Soon O Hong (Seoul Medical Center), Tae Seok Jeong (Gacheon University Gil Medical Center), and Yu Deok Won (Hanyang University Guri Hospital).

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