6/29/23, 1:12 AM RESCUEicp Pathway Feedback Search Clinical Topics Home Studies RESCUEicp RESCUEicp Disease Disease Cerebral edema Traumatic brain injury Trial question What is the effect of decompressive craniectomy on clinical outcomes in patients with refractory traumatic intracranial hypertension? Study design Multi-center Open label RCT Population Characteristics of study participants 19.4% female N = 408 80.6% male 408 patients (76 female, 321 male) Inclusion criteria: patients with TBI and refractory elevated ICP (> 25 mmHg) Key exclusion criteria: bilateral fixed and dilated pupils, bleeding diathesis, or an injury that was deemed to be unsurvivable Interventions N=202 surgical (decompressive craniectomy with medical therapy) N=196 medical (continued medical therapy with the option of adding barbiturates to reduce ICP) Primary outcome Death at 6 months https://web.pathway.md/studies/reccZYePxtkCyfvUk 1/2 6/29/23, 1:12 AM RESCUEicp Pathway 48.9 % 48.9 36.7 % 26.9 24.4 % Significant decrease 12.2 % NNT = 5 0.0 % Surgical Medical Significant decrease in death at 6 months (26.9% vs. 48.9%; AD -22.1%, 95% CI -31.5 to -12.7) Safety outcomes Significant differences in adverse events (16.3% vs. 9.2%, p = 0.03) and hours with ICP > 25 mmHg (median, 5.0 vs. 17.0 hours, p < 0.001). Conclusion In patients with TBI and refractory elevated ICP (> 25 mmHg), surgical was superior to medical with respect to death at 6 months. Reference Hutchinson PJ, Kolias AG, Timofeev IS et al. Trial of Decompressive Craniectomy for Traumatic Intracranial Hypertension. N Engl J Med. 2016 Sep 22;375(12):1119-30. Open reference URL https://web.pathway.md/studies/reccZYePxtkCyfvUk 2/2