Abstract：
OBJECTIVE: To describe the potential effects of Intracranial pressure monitoring on the outcome of patients with spontaneous intracerebral hemorrhage (ICH).
METHODS: This study is a systematic review with meta-analysis. Patients with spontaneous ICH treated with intracranial pressure monitoring were included. The primary outcome was mortality at 6 months and in-hospital mortality. The secondary outcome was poor neurological function outcome at 6 months.
RESULTS: This analysis compares in-hospital and 6-month mortality rates between patients with intracranial pressure monitoring (ICPm) and those without (no ICPm). Although the ICPm group had a lower in-hospital mortality rate, it was not statistically significant (24.9% vs. 34.1%; OR 0.51, 95% CI 0.20 to 1.31, P = 0.16). Excluding patients with intraventricular hemorrhage revealed a significant reduction in in-hospital mortality for the ICPm group (23.5% vs. 43%; OR 0.39, 95% CI 0.29 to 0.53, P < 0.00001). For 6-month mortality, the ICPm group showed a significant reduction (32% vs. 39.6%; OR 0.76, 95% CI 0.61 to 0.94, P = 0.01), with the effect being more pronounced after excluding intraventricular hemorrhage patients (29.1% vs. 47.2%; OR 0.45, 95% CI 0.34 to 0.60, P < 0.0001). However, there were no statistically significant differences in 6-month functional outcomes between the groups. Increased ICP was associated with higher 3-month mortality (OR 1.12, 95% CI 1.07 to 1.18, P < 0.00001) and lower likelihood of good functional outcomes (OR 1.11, 95% CI 1.04 to 1.18, P < 0.00001).
CONCLUSIONS: Elevated ICP is associated with increased mortality and poor prognosis in ICH patients. Although continuous intracranial pressure monitoring may reduce short-term mortality rates in specific subgroups of ICH patients, it does not improve neurological functional outcomes. While potential patient populations may benefit from ICP monitoring, more research is needed to screen suitable populations for ICP monitoring.
METHODS: This study is a systematic review with meta-analysis. Patients with spontaneous ICH treated with intracranial pressure monitoring were included. The primary outcome was mortality at 6 months and in-hospital mortality. The secondary outcome was poor neurological function outcome at 6 months.
RESULTS: This analysis compares in-hospital and 6-month mortality rates between patients with intracranial pressure monitoring (ICPm) and those without (no ICPm). Although the ICPm group had a lower in-hospital mortality rate, it was not statistically significant (24.9% vs. 34.1%; OR 0.51, 95% CI 0.20 to 1.31, P = 0.16). Excluding patients with intraventricular hemorrhage revealed a significant reduction in in-hospital mortality for the ICPm group (23.5% vs. 43%; OR 0.39, 95% CI 0.29 to 0.53, P < 0.00001). For 6-month mortality, the ICPm group showed a significant reduction (32% vs. 39.6%; OR 0.76, 95% CI 0.61 to 0.94, P = 0.01), with the effect being more pronounced after excluding intraventricular hemorrhage patients (29.1% vs. 47.2%; OR 0.45, 95% CI 0.34 to 0.60, P < 0.0001). However, there were no statistically significant differences in 6-month functional outcomes between the groups. Increased ICP was associated with higher 3-month mortality (OR 1.12, 95% CI 1.07 to 1.18, P < 0.00001) and lower likelihood of good functional outcomes (OR 1.11, 95% CI 1.04 to 1.18, P < 0.00001).
CONCLUSIONS: Elevated ICP is associated with increased mortality and poor prognosis in ICH patients. Although continuous intracranial pressure monitoring may reduce short-term mortality rates in specific subgroups of ICH patients, it does not improve neurological functional outcomes. While potential patient populations may benefit from ICP monitoring, more research is needed to screen suitable populations for ICP monitoring.
摘要：
目的：描述颅内压监测对自发性脑出血患者预后的潜在影响。
方法：系统评价与荟萃分析。
方法：截至5月30日发表的观察性和介入性研究，2024年，被考虑纳入。我们研究了颅内压升高和颅内压监测对相关临床结局的影响。
方法：颅内压监测治疗自发性脑出血患者。
方法：主要结局是6个月时的死亡率和院内死亡率。次要结果是6个月时神经功能不良。
结果：该分析比较了有颅内压监测（ICPm）和没有颅内压监测（ICPm）的患者的住院和6个月死亡率。尽管ICPm组的住院死亡率较低，无统计学意义(24.9%vs.34.1%；OR0.51，95%CI0.20至1.31，p=0.16）。排除脑室内出血（IVH）患者后，ICPm组的住院死亡率显着降低（23.5％vs.43%；OR0.39，95%CI0.29至0.53，p<0.00001)。对于6个月的死亡率，ICPm组显着降低(32%vs.39.6%；OR0.76，95%CI0.61至0.94，p=0.01），排除IVH患者后效果更明显(29.1%vs.47.2%；OR0.45，95%CI0.34至0.60，p<0.0001)。然而,两组间6个月功能结局无统计学差异.ICP升高与较高的3个月死亡率（OR1.12，95％CI1.07至1.18，p<0.00001）和较低的良好功能结局可能性（OR1.11，95％CI1.04至1.18，p<0.00001）相关。
结论：颅内压升高与ICH患者死亡率增加和预后不良相关。虽然连续颅内压监测可以降低ICH患者特定亚组的短期死亡率，它不能改善神经功能预后.虽然潜在的患者群体可能受益于ICP监测，需要更多的研究来筛选适合ICP监测的人群.
方法：系统评价与荟萃分析。
方法：截至5月30日发表的观察性和介入性研究，2024年，被考虑纳入。我们研究了颅内压升高和颅内压监测对相关临床结局的影响。
方法：颅内压监测治疗自发性脑出血患者。
方法：主要结局是6个月时的死亡率和院内死亡率。次要结果是6个月时神经功能不良。
结果：该分析比较了有颅内压监测（ICPm）和没有颅内压监测（ICPm）的患者的住院和6个月死亡率。尽管ICPm组的住院死亡率较低，无统计学意义(24.9%vs.34.1%；OR0.51，95%CI0.20至1.31，p=0.16）。排除脑室内出血（IVH）患者后，ICPm组的住院死亡率显着降低（23.5％vs.43%；OR0.39，95%CI0.29至0.53，p<0.00001)。对于6个月的死亡率，ICPm组显着降低(32%vs.39.6%；OR0.76，95%CI0.61至0.94，p=0.01），排除IVH患者后效果更明显(29.1%vs.47.2%；OR0.45，95%CI0.34至0.60，p<0.0001)。然而,两组间6个月功能结局无统计学差异.ICP升高与较高的3个月死亡率（OR1.12，95％CI1.07至1.18，p<0.00001）和较低的良好功能结局可能性（OR1.11，95％CI1.04至1.18，p<0.00001）相关。
结论：颅内压升高与ICH患者死亡率增加和预后不良相关。虽然连续颅内压监测可以降低ICH患者特定亚组的短期死亡率，它不能改善神经功能预后.虽然潜在的患者群体可能受益于ICP监测，需要更多的研究来筛选适合ICP监测的人群.
