Neuroanesthesia & neurocritical care
Intracranial pressure trends and clinical outcomes after decompressive hemicraniectomy in malignant middle cerebral artery infarction
Main finding · 3-month favorable outcome (mRS 0-4)Result — go to the resultAdjusted odds ratio 0.11 95% CI 0.01–0.59Authors' conclusion
In MMI patients, continuous ICP monitoring could be useful for detecting those with an increasing ICP trend that may be associated with unfavorable clinical outcomes.
Study context
- Population
- Patients with malignant middle cerebral artery infarction (MMI) undergoing decompressive hemicraniectomy with postoperative ICP monitoringof 112 with hemicraniectomy
- Participants
- 66 patients
- Exposure
- ICP increase vs ICP decrease trend after decompressive hemicraniectomy
- ICP increasen = 37
- ICP decreasen = 29reference
- Outcome
- Favorable outcome (modified Rankin Scale 0-4)
- Follow-up
- 3 months
Methodological detailsconsecutive patients, linear mixed model, multivariable logistic regression
- Consecutive patients
- Linear mixed model
- Multivariable logistic regression
Main finding
3-month favorable outcome (mRS 0-4)
Adjusted odds ratio
0.11
95% CI 0.01–0.59
P = 0.019
ICP increase vs ICP decrease
aOR 0.11 (95% CI 0.01–0.59); P = 0.019
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted OR (95% CI) | P value | |
|---|---|---|---|
| ICU mortalityMultivariable logistic regression | 6.98 (1.37–54.6) | P = 0.031 | |
| 0.050.21520Adjusted odds ratio (log scale) |
| Outcome | P value |
|---|---|
| ICP trendSignificantly different | P < 0.001 |
Initial monitored ICP and peak ICP
- Did not significantly differ between ICP increase and decrease groups
Duration of ICP monitoring
- Median duration of ICP monitoring (IQR 72.5-181.8), h
- 146.5
Original publication
Intracranial pressure trends and clinical outcomes after decompressive hemicraniectomy in malignant middle cerebral artery infarction. Ann Intensive Care. Published 27 November 2024. doi:10.
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