Intracranial pressure monitoring among children with severe traumatic brain injury.

OBJECT Well-designed studies linking intracranial pressure(ICP) monitoring with improved outcomes among children with severe traumatic brain injury (TBI) are lacking. The main objective of this study was to examine the relationship between ICP monitoring in children and in-hospital mortality following severe TBI. METHODS An observational study was conducted using data derived from 153 adult or mixed (adult and pediatric) trauma centersparticipating in the American College of Surgeons (ACS) Trauma Quality Improvement Program(TQIP) and 29 pediatric traumacenters participating in the pediatric pilot TQIP between 2010 and 2012. Random-intercept multilevel modelingwas used to examine the association between ICP monitoring and in-hospital mortality among children with severe TBI ≤16 years of age after adjusting for important confounders. This association was evaluated at the patient level and at the hospital level. In a sensitivity analysis, this association was reexamined in a propensity-matched cohort. R...