Evidence map›Paper›PMID 34395918›Full record

ArticleTrauma surgery & acute care open2021

Factors associated with receipt of intracranial pressure monitoring in older adults with traumatic brain injury.

Mira Ghneim, Jennifer Albrecht, Karen Brasel, Ariel Knight, Anna Liveris, Jill Watras, Christopher P Michetti, James Haan, Kelly Lightwine, Robert D Winfield and 13 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trauma surgery & acute care open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 11 institutions in 1 country.

Mira GhneimDepartment of Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
Jennifer AlbrechtDepartment of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Karen BraselDepartment of Surgery, Oregon Health & Science University, Portland, Oregon, USA.
Ariel KnightDepartment of Surgery, University of California San Francisco, San Francisco, California, USA.
Anna LiverisDepartment of Trauma, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA.
Jill WatrasDepartment of Surgery, Inova Fairfax Medical Campus, Falls Church, Virginia, USA.
Christopher P MichettiDepartment of Surgery, Inova Fairfax Hospital, Falls Church, Virginia, USA.ORCID 0000-0002-3744-0603
James HaanDepartment of Trauma Services, Ascension Via Christi, Wichita, Kansas, USA.
Kelly LightwineDepartment of Trauma Services, Ascension Via Christi, Wichita, Kansas, USA.
Robert D WinfieldUniversity of Kansas Medical Center, Kansas City, Kansas, USA.
Sasha D AdamsDepartment of Surgery, McGovern Medical School, Houston, Texas, USA.
Jeanette PodbielskiDepartment of Surgery, McGovern Medical School, Houston, Texas, USA.
Scott ArmenDepartments of Surgery and Neurosurgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA.
J Christopher ZackoDepartments of Surgery and Neurosurgery, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA.
Fady S NasrallahTrauma Service, Scripps Memorial Hospital La Jolla, La Jolla, California, USA.
Kathryn B SchafferTrauma Service, Scripps Memorial Hospital La Jolla, La Jolla, California, USA.
Julie A DunnTrauma and Acute Care Surgery, Medical Center of the Rockies, Loveland, Colorado, USA.
Brittany SmootTrauma and Acute Care Surgery, Medical Center of the Rockies, Loveland, Colorado, USA.
Thomas J SchroeppelTrauma and Acute Care Surgery, University of Colorado Health - South, Colorado Springs, Colorado, USA.ORCID 0000-0001-9164-5004
Zachery StillmanUCHealth Memorial Hospital Central, Colorado Springs, Colorado, USA.
Zara CooperDepartment of Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Deborah M SteinDepartment of Surgery, University of California, San Francisco, CA, USA.
Geri-TBI Study
Ascension Via Christi · USInova Fairfax Hospital · USPenn State Milton S. Hershey Medical Center · USScripps Memorial Hospital · USUniversity of California, San Francisco · USUniversity of Colorado Health · USAlbert Einstein College of Medicine · USBrigham and Women's Hospital · USOregon Health & Science University · USUniversity of Kansas Medical Center · USUniversity of Maryland, Baltimore · US

Funding

Rnd Effector Molecules in Epithelial Cell TransformationR01CA092354 · NCI · BOSTON CHILDREN'S HOSPITAL · PI HANSEN, STEEN HENNING · 2003 to 2007
$2.2M
Signaling by the ATM and ATR KinasesK01CA093701 · NCI · VANDERBILT UNIVERSITY · PI CORTEZ, DAVID K · 2002 to 2006
$746k
NCI NIH HHS K01 CA093701NCI NIH HHS R01 CA092354
6 · The paper itself

Abstract

backgroundThe Brain Trauma Foundation (BTF) Guidelines for the Management of Severe Traumatic Brain Injury (TBI) include intracranial pressure monitoring (ICPM), yet very little is known about ICPM in older adults. Our objectives were to characterize the utilization of ICPM in older adults and identify factors associated with ICPM in those who met the BTF guidelines.

methodsWe analyzed data from the American Association for the Surgery of Trauma Geriatric TBI Study, a registry study conducted among individuals with isolated, CT-confirmed TBI across 45 trauma centers. The analysis was restricted to those aged ≥60. Independent factors associated with ICPM for those who did and did not meet the BTF guidelines were identified using logistic regression.

resultsOur sample was composed of 2303 patients, of whom 66 (2.9%) underwent ICPM. Relative to Glasgow Coma Scale (GCS) score of 13 to 15, GCS score of 9 to 12 (OR 10.2; 95% CI 4.3 to 24.4) and GCS score of <9 (OR 15.0; 95% CI 7.2 to 31.1), intraventricular hemorrhage (OR 2.4; 95% CI 1.2 to 4.83), skull fractures (OR 3.6; 95% CI 2.0 to 6.6), CT worsening (OR 3.3; 95% CI 1.8 to 5.9), and neurosurgical interventions (OR 3.8; 95% CI 2.1 to 7.0) were significantly associated with ICPM. Restricting to those who met the BTF guidelines, only 43 of 240 (18%) underwent ICPM. Factors independently associated with ICPM included intraparenchymal hemorrhage (OR 2.2; 95% CI 1.0 to 4.7), skull fractures (OR 3.9; 95% CI 1.9 to 8.2), and neurosurgical interventions (OR 3.5; 95% CI 1.7 to 7.2). DISCUSSION: Worsening GCS, intraparenchymal/intraventricular hemorrhage, and skull fractures were associated with ICPM among older adults with TBI, yet utilization of ICPM remains low, especially among those meeting the BTF guidelines, and potential benefits remain unclear. This study highlights the need for better understanding of factors that influence compliance with BTF guidelines and the risks versus benefits of ICPM in this population. LEVEL OF EVIDENCE: Prognostic and epidemiological, level III.

Indexed as

brain injuriesgeriatricsintracranial pressuretraumatic

Identifiers

PMID34395918
PMCPMC8311332
OpenAlexW3185545633

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.