UNASSIGNED: OBJECT Well-designed studies linking @entity428 ( @entity428 ) monitoring with improved outcomes among @entity1 with severe @entity131 ( @entity131 ) are lacking. The main objective of this study was to examine the relationship between @entity428 monitoring in @entity1 and in-hospital mortality following severe @entity131 . METHODS An observational study was conducted using data derived from 153 adult or mixed (adult and pediatric) @entity130 centers participating in the American College of Surgeons (ACS) @entity130 Quality Improvement Program (TQIP) and 29 pediatric @entity130 centers participating in the pediatric pilot TQIP between 2010 and 2012. Random-intercept multilevel modeling was used to examine the association between @entity428 monitoring and in-hospital mortality among @entity1 with severe @entity131  <=16 years of age after adjusting for important confounders. This association was evaluated at the @entity1 level and at the hospital level. In a sensitivity analysis, this association was reexamined in a propensity-matched cohort. RESULTS A total of 1705 @entity1 with severe @entity131 were included in the study cohort. The overall in-hospital mortality was 14.3% of @entity1 (n = 243), whereas the mortality of the 273 @entity1 (16%) who underwent invasive @entity428 monitoring was 11% (n = 30). After adjusting for @entity1 - and hospital-level characteristics, @entity428 monitoring was associated with lower in-hospital mortality (adjusted OR 0.50; 95% CI 0.30-0.85; p = 0.01). It is possible that @entity1 who were managed with @entity428 monitoring were selected because of an anticipated favorable or unfavorable outcome. To further address this potential selection bias, the analysis was repeated with the hospital-specific rate of @entity428 monitoring use as the exposure. The adjusted OR for death of @entity1 treated at high @entity428 -use hospitals was 0.49 compared with those treated at low @entity428 -use hospitals (95% CI 0.31-0.78; p = 0.003). Variations in @entity428 monitoring use accounted for 15.9% of the interhospital variation in mortality among @entity1 with severe @entity131 . Similar results were obtained after analyzing the data using propensity score-matching methods. CONCLUSIONS In this observational study, @entity428 monitoring use was associated with lower hospital mortality at both the @entity1 and hospital levels. However, the contribution of variable @entity428 monitoring rates to interhospital variation in pediatric @entity131 mortality was modest.

Intracranial pressure monitoring among XXXX with severe @entity131 .

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'patient'] @entity131 :: ('MESH:D001930', 'Disease') :: ['TBI', 'traumatic brain injury'] @entity130 :: ('MESH:D014947', 'Disease') :: ['Trauma', 'trauma'] @entity428 :: ('MESH:D019586', 'Disease') :: ['ICP', 'intracranial pressure']
@entity1 :: (9606,Species) :: ['children']
