Response to intracranial hypertension treatment as a predictor of @entity204 in @entity1 with severe XXXX .

@entity1 @entity1545 @entity131 @entity2656 @entity428 @entity772 @entity551 @entity204 @entity130
OBJECT: The normalization of @entity428 ( @entity428 ) in @entity1 with severe @entity131 ( @entity131 ) is assumed to limit secondary @entity1545 and improve outcome. Despite evidence-based recommendations for monitoring and treatment of @entity428 , there are few studies that show an association between response to @entity428 -directed therapeutic regimens and adjusted mortality rate. This study utilizes a large prospective database to examine the effect of response to @entity428 -lowering therapy on risk of @entity204 within the first 2 weeks of injury in @entity1 who sustained @entity131 and are older than 16 years. METHODS: The current study is based on 1426 @entity1 with severe @entity131 (Glasgow @entity772 Scale [GCS] score < 9) of whom 388 were treated for @entity428 (> 25 mm Hg) between 2000 and 2008 at 22 @entity130 centers enrolled in a New York State quality improvement program. This prospectively collected database also contains information including age, admission GCS score, pupillary status, CT scanning parameters, and @entity551 , which are all known early prognostic indicators of @entity204 . Treatment of @entity428 consisted of administration of @entity2656 , hypertonic saline, barbiturates, and/or drainage of CSF or decompressive craniectomy. The factors predicting @entity428 response to treatment and predicting @entity204 at 2 weeks were evaluated using logistic regression analyses. RESULTS: Increasing age and fewer hours of @entity428 on Day 1 were found to be significant predictors (p = 0.001 and 0.0003, respectively) of a positive response to treatment. Response to @entity428 -lowering therapy (p = 0.03), younger age (p < 0.0001), fewer hours of @entity428 (p < 0.0001), and absence of arterial @entity551 on Day 1 (p = 0.001) significantly predicted reduced risk of @entity204 . CONCLUSIONS: @entity1 who responded to @entity428 -lowering treatment had a 64% lower risk of @entity204 at 2 weeks than those who did not respond after adjusting for factors that independently predict risk of @entity204 .
