1314 Prediction of Raised Intracranial Pressure in Traumatic Brain Injury Patient by Non-Invasive Methods in Lower-Middle Income Countries: Systematic Review and Meta-Analysis
Y C H Dokponou, O B A Badirou, K N Agada, M W Dossou, L D Lawson, M A D Ossaga, A D Nyalundja, D K F P Adjiou, K U Lassissi, S M C Houndodjade, F B B Gbenou, R P Lantonkpode, N D L Togbenon, N D A Bankole- Surgery
Abstract
Background
The prediction of raised Intracranial Pressure (ICP) with accuracy in Traumatic Brain Injury (TBI) patients is a clinical important decision and therapeutic tool. This study aimed to evaluate the existing methods used for non-invasive ICP monitoring in TBI patients in LMICs.
Method
Systematic searches of PubMed, Google Scholar, and ScienceDirect were performed from database inception to November 2021. Studies reporting the prediction of raised ICP in TBI patients by non-invasive means in LMICs were included. Pooled estimates of sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios with 95%CI were calculated for each index test in JAMOVI 2.2.5. We carried out a “Medical Decision”, “Plots”, “Fagan Normogram” and the ROC curve to find the perfect discrimination point of all the five tests used for the non-invasive measurement of ICP in the TBI patients in LMICs.
Results
A total of 1032 studies were identified, of which, 15 included 3316 patients with male predominance (n = 2458, 74.13%). Patients' ages range from 15-96 years with 40-80 (n = 1205, 36.34%), being the most represented population. The ICP measured by Transcranial Doppler (TCD) had a sensitivity of 92.3%, and a specificity of 70%. The positive predictive value was 66.67%, with a negative predictive value of 93.33%. Furthermore, the positive Likelihood Ratio (+LR) was 3.69; 2<+LR<5, and the negative Likelihood Ratio (-LR) was 0.103; 0.1<-LR<0.2.
Conclusions
The TCD had shown high performance in its sensitivity and specificity, placing it on top of the other four different tests used in LMICs for the management of patients with TBI.