Digital Commons Network^™

Systemic Α₂-Agonist Use And Lower Hazard Of Glaucoma Compared With Β-Blockers: A Cohort Study, Ibrahim Abboud, Amin Z. Khudari, Abdelaziz Abdelaal, Amr Almobayed, Subhi J. Al'aref, Jonathan S. Myers, Richard K. Lee, Abdelrahman M. Elhusseiny

Wills Eye Hospital Papers

OBJECTIVE: Systemic antihypertensive medications may influence glaucoma-related outcomes through intraocular pressure-dependent and vascular mechanisms. While topical α₂-agonists are established glaucoma therapies, the association between systemic α₂-agonists and glaucoma hazard remains unexamined; we compared their hazard with systemic β-blockers in adults with hypertension.

METHODS AND ANALYSIS: We conducted a multicentre retrospective cohort study using deidentified electronic health records. Adults aged ≥40 years with hypertension and chronic exposure to systemic α₂-agonists or β-blockers were included. Patients with pre-existing ocular hypertension (OHT), primary open-angle glaucoma (POAG), concomitant comparator use, or inadequate ophthalmic follow-up were excluded. We balanced cohorts using propensity score matching (PSM) …

Agenda (Pdf), Department Of Surgery

Surgery Research Symposium

Agenda for the 4th Annual Surgery Research Symposium held May 7, 2026.

Short-Term Bayesian Influenza Forecasting In A Hospital Environment Using A Linear Kalman Filter., Shankar Kaleeswaran Mani, Grzegorz A Rempala, Eben Kenah, Fernanda L Schumacher

Ambulatory and Primary Care Articles

Accurately forecasting the weekly number of influenza (flu) lab tests and positive cases is important for hospitals as they work to plan staffing, manage supplies, and provide timely patient care. In this paper, we describe a practical use of a Bayesian Kalman filter to forecast weekly flu tests and positives in a hospital setting. Using data from a large hospital system in Ohio, we show that this approach, which blends real-time hospital information with historical patterns, offers a dependable way to anticipate flu-related patient volume as far as four weeks ahead.

A Case Of Successful Survival In A High-Risk Elderly Patient With Copd After Endotracheal Intubation, Julia Cueto Oms-Ii

Rowan-Virtua Research Day

Exacerbations of chronic obstructive pulmonary disease (COPD) leading to acute respiratory failure (ARF) is one of the major causes of mortality worldwide, thus typically having poor outcomes. Risk factors such as the need for invasive mechanical ventilation (IMV), severity of disease, comorbidities, and increased age are predictors of increased mortality rates in COPD patients. Noninvasive ventilation (NIV), like bilevel positive airway pressure (BiPAP) or high flow nasal cannula (HFNC), is the initial standard of care for acute exacerbations of COPD. However, longer periods of NIV and failure of NIV therapy can lead to delayed endotracheal intubation and higher mortality rates. …

A Neck Too Tight: Emergent Cricothyrotomy For Airway Collapse From Expanding Post Anterior Cervical Discectomy And Fusion (Acdf) Hematoma, Nicole R. Eregha, Kishan Patel, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Anterior cervical discectomy and fusion (ACDF) is a commonly performed surgical procedure used to treat cervical spine pathology including radiculopathy and spinal cord compression. Although generally safe, postoperative complications can occur. One of the most feared complications is expanding neck hematoma, which may lead to rapid airway obstruction due to tracheal compression and soft tissue swelling. The reported incidence of postoperative hematoma after ACDF ranges from 0.2–1.9%, with a subset of patients requiring emergent airway intervention or surgical evacuation [1]. Patients with postoperative hematoma typically present with neck swelling, dysphagia, hoarseness, dyspnea, and inability to tolerate secretions, symptoms that may …

Learning From Our Dental Colleagues: A Brief Review Of Counter-Stimulation To Reduce Procedural Pain In Emergency Medicine Mechanisms, Existing Evidence, And A Pragmatic Research Agenda, James Espinosa, Neal Appelstein, Alan Lucerna

Rowan-Virtua Research Day

Counter-stimulation techniques such as tapping, pressure, vibration, and tissue shaking are commonly observed in dental practice during administration of local anesthetic nerve blocks. Although not systematically described in the Emergency Medicine literature, individual clinicians may employ tactile counter-stimulation techniques during needle-based procedures. The practice remains under-theorized and under-studied within the Emergency Medicine literature. This brief review synthesizes mechanistic neurobiology—including segmental gate control theory (Melzack & Wall, 1965), descending inhibitory modulation, and attentional salience models—with evidence from dental and needle-procedure research. We propose a practical taxonomy of counter-stimulation techniques applicable to Emergency Medicine and identify gaps in the current literature. Finally, …

From Confirmation To Guidance: Making The Case For Intraprocedural Pocus As The Next Developmental Step In Ultrasound-Supported Shoulder Reduction A Conceptual Practice Proposal And Research Agenda, James Espinosa

Rowan-Virtua Research Day

Point-of-care ultrasound (POCUS) is well established for the diagnosis of shoulder dislocation and for the confirmation of successful reduction. However, its role during the reduction maneuver itself remains under-described. This conceptual practice proposal argues that intraprocedural POCUS represents the logical next developmental step in ultrasound-supported shoulder reduction. By introducing real-time visualization of humeral head translation during reduction attempts, clinicians may identify ineffective vectors earlier, adjust technique midstream, and potentially reduce repeated attempts or escalation of procedural sedation. This work does not present outcome data but instead proposes a practical framework, workflow model, and research agenda for intraprocedural implementation. Future study …

Improving Emergency Department Throughput: Implementation Of A Nurse-Driven Protocol In Pediatric Fast-Track Patients Presenting With Fever, Kerrigan A. Teeple

Evidence-Based Practice Project Reports

Overcrowding in the emergency department presents significant operational challenges and is associated with adverse patient outcomes (Gottlieb et al., 2020). Despite throughput initiatives, increasing patient acuity and rising census levels continue to strain emergency department efficiency. This quality improvement project evaluated whether implementing a fever-reduction standing order protocol could reduce door-to-provider and door-to-disposition times for pediatric fast-track patients presenting to the emergency department. A review of evidence across 6 databases identified nurse-initiated standing orders as a best-practice strategy to expedite care, improve throughput, and reduce delays in disposition. Guided by this evidence, a standing order protocol for acetaminophen administration was …

Barriers To Palliative Care Access In Rural South Dakota: A Policy And System-Level Analysis, Harshavardhan Kadarkaraisamy

Honors Thesis

Palliative care improves the quality of life for people living with serious illness. It helps by addressing symptoms, improving communication, and providing mental, physical, and spiritual support. However, in South Dakota access to palliative care is limited in rural areas. These challenges include geographic isolation, workforce shortages, healthcare infrastructure, reimbursement, and misunderstandings about palliative care. This thesis examines the key policy barriers that limit access to palliative care in rural South Dakota. This work involves engaging with South Dakota-specific literature, rural health research, policy sources, community education, telehealth expansion, and policy reform. By focusing on the rural context of South …

Comparison Of Ecg Features, Cardiac Biomarkers, And Clinical Outcomes In Three Waves Of Hospitalized Covid-19 Pneumonia Patients With Cardiovascular Events, Yuchen Han, Jahnavi Sunkara, Tshura S Ali, Harideep Samanapally, Vidyulata Salunkhe, Fnu Deepti, Emma C. Huang, Justin J. Huang, Maiying Kong, Jiapeng Huang

The University of Louisville Journal of Respiratory Infections

Background

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a rapidly evolving virus that can severely impact the cardiovascular system. With new variants, it is important to characterize wave-specific (defined by dominant circulating variants) clinical changes.

Methods

A multi-center retrospective cohort study of patients hospitalized with SARS-CoV-2 community acquired pneumonia at eight adult acute-care hospitals in the city of Louisville, KY was conducted. Patients hospitalized with Coronavirus Disease 2019 (COVID-19) community acquired pneumonia who experienced a cardiovascular event between March 2020 and July 2022 were included in this analysis. Variant assignment was based on temporal prevalence rather than genomic confirmation, and …

Falling Star Program: A Visual Cue Intervention To Reduce Falls In Long-Term Care, Maggie Shanahan

Evidence-Based Practice Project Reports

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using …

Impact Of Intravenous Thrombolysis On Aspiration Thrombectomy Outcomes: An Imperative Trial Subgroup Analysis, Maxim Mokin, Reade Andrew De Leacy, William Mack, Raul G. Nogueira, Shahram Majidi, Dana Tomalty, Jan Vargas, Brett L. Cucchiara, Kenneth V. Snyder, Victoria Parada

School of Medicine Publications

Background The impact of intravenous (IV) thrombolysis on the outcomes of aspiration thrombectomy as the primary endovascular approach to stroke in patients with large vessel occlusion is unknown.

Methods The Imperative Trial was a prospective, investigational device exemption, multicenter trial of first-line aspiration thrombectomy that assessed the safety and efficacy of the Zoom System, including a novel 0.088 inch aspiration catheter in patients with stroke within 8 hours of onset. We compared procedural, technical, and clinical outcomes of aspiration thrombectomy based on whether patients had received IV thrombolytics prior to the intervention.

Results Among the 260 patients treated with front-line …

Increasing Medication Adherence In Those With Hypertension, Holly Kimiecik

Evidence-Based Practice Project Reports

Hypertension is a chronic condition characterized by persistently elevated blood pressure and remains a significant contributor to morbidity and mortality in the United States. According to the Centers for Disease Control and Prevention (2024), approximately 47.7% of U.S. adults have hypertension, yet only about one in five achieve blood pressure control below 130/80 mm Hg. Medication adherence plays a critical role in managing hypertension and preventing complications. Adults aged 18 years and older prescribed antihypertensive medications from a primary care clinic in Valparaiso, Indiana, participated in this six-week quality improvement intervention. Evidence from a comprehensive literature review supports combining patient …

Cystic Fibrosis Mental Health And Wellness Questionnaire - Factors And Properties Of A Comprehensive Cf-Specific Self-Report Measure, C. Virginia O'Hayer, Patrick J. Smith, Max J. Genecov, Christopher F. Drescher, Heather Bruschwein, Chelsi N. Nurse, Katherine Lawliss, Darcy C. Esiason, Gunnar H. Esiason

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Existing mental health self-report measures have been criticized for over-simplification, lack of CF-specific focus, susceptibility to measurement reactivity bias, and conflation of symptoms of anxiety and/or depression with CF-related symptoms and/or treatment side effects. The CF Mental Health and Wellness Questionnaire (CFMHWQ) is a 25-item measure assessing CF-specific mental health burden symptoms.

METHODS: To examine common underlying factors contributing to scores on the CFMHWQ, principal component analysis (PCA) was conducted of all 25 items. We conducted cross-validation of CFMHWQ principal components, examining unadjusted correlations between each principal component, demographic characteristics (age and biological sex), negative affect (mean rank global …

The Meaning Of Physical Activity In The Context Of Health Sciences: A Concept Analysis, Martín G. Farinola

International Journal of Physical Activity and Health

Physical activity has been defined in numerous ways. Thus, this study aimed to conduct a concept analysis of the existing physical activity definitions in the health sciences literature to evaluate its conceptual precision and assess the need for a revised or novel concept better suited for this domain. The concept analysis was accomplished using tools derived from philosophical semantics. The analysis identified six definitions that explicitly state what physical activity is with sufficient clarity to allow for conceptual examination. The findings indicated that these definitions frequently merge the concept of physical activity with its contextual attributes. To address these semantic …

Anthropometric Measurements Inform Complete Concentric Collapse Status In Patients With Obstructive Sleep Apnea, Jordan Weiner, Eugene Chio, Raj Dedhia, Colin Huntley, Michael Hutz, Phillip Huyett, Daniel Lee, Philip Losavio, Ilya Perepelitsyn, Ryan Soose, David Kent

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: Hypoglossal nerve stimulation in the US requires drug-induced sleep endoscopy to exclude patients with complete concentric collapse. This is an expensive and time-consuming requirement. We hypothesized that supine pharyngeal width, and other demographic and polysomnographic variables would associate with complete concentric collapse.

STUDY DESIGN: Prospective, multicenter cohort study.

SETTING: 10 centers in the United States with experience selecting patients for and performing airway surgeries for sleep apnea including hypoglossal nerve stimulation implantation.

METHODS: 600 patients meeting criteria for hypoglossal nerve stimulation underwent measurement of supine pharyngeal width and collection of demographic and polysomnographic data followed by drug-induced sleep endoscopy. …

Diabetic Nephropathy Masquerading As Systemic Disease: The Critical Role Of Renal Biopsy In A Young Uninsured Woman With Nephrotic Syndrome, Yolanda V. Gutierrez, Alexis Vargas Del Toro, Cristina Kochi Yamamoto, Jose Loayza Pintado, Andres Suarez-Parraga

School of Medicine Publications

Nephrotic syndrome can have overlapping features across multiple diseases, making diagnosis difficult without tissue confirmation. We describe a 30-year-old uninsured Hispanic woman with type 1 diabetes, hypertension, and CKD3B who presented with nephrotic syndrome, sepsis, and progressive muscle weakness. Her pleural effusions, periorbital changes, elevated free light chains, and dysphagia raised concern for systemic conditions such as amyloidosis or polymyositis, especially given inconsistent outpatient follow-up. Because her management would differ significantly depending on the underlying cause and due to the high risk of loss to follow-up, a renal biopsy was pursued. Serologic studies were unremarkable, and biopsy ultimately confirmed diabetic …

Automated Analysis Of Radiation Oncology Incident Reports Using Large Language Models, Nathan A. Dobranski

LSU Master's Theses

Patient safety incident reporting in radiation oncology requires expert analysis that is time-intensive and subject to variability. This thesis presents the development and technical validation of a locally deployed large language model (LLM) system for automated incident report analysis across multiple cancer centers. The system was designed for automated summarization and taxonomy assignment of Radiation Oncology Incident Learning System (RO-ILS) reports, operating entirely on local infrastructure to preserve patient privacy. A two-round, multi-rater evaluation methodology was employed, incorporating 600 total expert evaluations from two academic cancer centers. Round 1 established baseline performance using Mistral 7B and Mixtral 8x7B models with …

Isass Brave New Continuing Medical Education World: The Stifling Of Innovation In Spine Surgery Through Overrestriction Of Collaboration, Morgan P. Lorio, Kai-Uwe Lewandrowski, Óscar L. Alves, Avelino Parajón, Matthew Scott-Young, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: in 2020, the accreditation Council for Continuing Medical education (aCCMe) released the Standards for Integrity and Independence in Accredited Continuing Medical Education, effective january 1, 2022, to ensure that accredited activities are accurate, balanced, evidence-based, and clearly separated from marketing and sales. although these aims are broadly supported, implementation may have unintended consequences in procedure-intensive specialties such as spine surgery, where surgeon–industry collaboration often drives device innovation, clinical trials, and dissemination of new techniques.

OBJECTIVE: To examine how current interpretations of ACCME eligibility and financial-relationship standards may affect continuing medical education in spine surgery and to propose practical adaptations …

Mogad Is The Most Common Cause Of Isolated Optic Neuritis In Children, Chaitanya Aduru, Akansha Chandrasekar, Kyla Blasingame, Jonathan Rosen, Jesse M Levine, Karla Salazar, Madhuri Chilakapati, Rod Foroozan, Victoria Hardwick, Jonathan M Yarimi, Nikita Shukla, Timothy E Lotze, Kristen S Fisher, Alexander J Sandweiss

Faculty, Staff and Students Publications

Objectives: The study aimed to characterize the clinical features, etiologies, and outcomes of isolated, first-time pediatric ON in the post-MOG-IgG era.

Methods: This was a single-center retrospective cohort study at Texas Children's Hospital of patients diagnosed with first-time ON between 2018-2024, with follow-up data collected through 2025. Inclusion criteria required monocular or binocular subacute vision loss with supportive paraclinical signs. Subjects were excluded if they had a prior history of demyelinating disease or extra-orbital demyelinating lesions on initial brain/spine MRI. Primary outcomes were the proportion of MOG-IgG seropositivity, retinal nerve fiber layer thickness, and visual acuity at onset and most …

Ebp Project In A Primary, Foster Care Medical Home: Implementation Of The Ages & Stages: Social Emotional Screener, Sara Moore

2026

Background: Children in the foster care system have increased diagnoses, mental health concerns, and developmental delays.
Purpose: The pilot used the ASQ-SE to determine if the protocol was feasible and if the screener identified social-emotional difficulties in a primary care clinic that serves children in foster care. 
Method: A pilot was created, and the ASQ-SE was administered to 33 patients during well-child visits (ages 2 months-70 months) over six weeks.
Results: Implementing a social-emotional screener was feasible in the foster care primary care clinic. The infants and toddlers screened (N=33) were grouped by referral status: 57.6 % (19) …

Implementation Of Evidenced Based Practice Guidelines For Reducing Emergence Delirium In Elderly Patients Undergoing A Total Hip Replacement, Luke D. Kleinfelder

Doctor of Nursing Practice Scholarly Projects

A total hip replacement is a common surgery for the elderly population, as it is a successful treatment option for hip fractures and end-stage osteoarthritis, a common condition associated with aging. Recovery from surgery is critical, and any postoperative complication can delay recovery, increase cost, lengthen hospital stay, and lead to a poorer long-term surgical outcome. One of the most common and severe postoperative complications for elderly patients following general anesthesia is emergence delirium. Traditional practice focuses on treating the symptoms of emergence delirium reactively instead of proactively and lacks standardized guidelines. Recent literature found a promising decrease in the …

Proposed Evidence-Based Practice Guidelines For Using Esmolol To Blunt The Sympathetic Stress Response To Laryngoscopy And Intubation, Maya Kurdi

Doctor of Nursing Practice Scholarly Projects

Direct laryngoscopy (DL) and endotracheal intubation (ETI) are standard procedures performed during general anesthetic induction, which provoke a sympathetic stress response that can result in intraoperative hemodynamic instability. Traditional agents like lidocaine and fentanyl, commonly used to mitigate the stress response, have limitations and can lead to adverse effects. Recent literature suggests that esmolol, an ultra-short-acting, cardio-selective beta-1 adrenergic receptor antagonist, may be an effective alternative due to its rapid onset, short duration, and minimal side effects. This final scholarly project (FSP) aims to develop evidence-based practice guidelines for using esmolol as an adjunctive induction agent. A systematic literature review …

Enhancing The Diversity And Number Of Certified Registered Nurse Anesthetists: A Proposed Pipeline Program For Underrepresented Students, Alexis Lamoreaux

Doctor of Nursing Practice Scholarly Projects

The underrepresentation of minority groups in the Certified Registered Nurse Anesthetist (CRNA) profession impacts healthcare providers’ diversity and cultural competence. This Final Scholarly Project (FSP) proposes a pipeline program to increase diversity within the CRNA field by providing academic support, mentorship, and clinical exposure to students from underrepresented backgrounds. Given the shortage of anesthesia providers, especially in underserved areas, improving access to the CRNA profession for minority students is critical for enhancing patient outcomes. This FSP suggests establishing mentorship and skill development concepts through a 12-month structured program that targets minorities, first-generation college students, or those from rural backgrounds. The …

Assessing The Risk Of Low Energy Availability In Ncaa Division Iii Female Soccer Players, Emma C. Sturts

Masters Theses/Capstone Projects

Low Energy Availability (LEA) can occur when an athlete’s energy intake is insufficient to meet the physiological demands of training as well as normal physiological functions. Female soccer players may be at an increased risk of developing LEA due to the high exercise energy expenditure paired with decreased energy intake. The purpose of this study is to assess the prevalence of LEA among Division III female soccer players. Division III female soccer players (n = 11) completed the Low Energy Availability in Females Questionnaire (LEAF-Q). 45.5% (n = 5) of the participants were classified as “At Risk” for LEA. Of …

Metabolic Dysfunction And Metabolic Management In Episodic Migraine, Delora E. Denney, Michael J. Marmura

Department of Jefferson Headache Center Papers and Presentations

PURPOSE OF REVIEW: Evidence suggests a significant link between migraine and metabolic syndrome,, especially in those with chronic or refractory migraine. Weight loss and exercise may effectively prevent migraine. Here, we review the evidence behind exercise and weight loss as migraine treatments.

RECENT FINDINGS: While metabolic syndrome and pain have long had a known association, only recently have strong studies demonstrated a higher risk of developing metabolic syndrome in people with migraine. Additionally, other sequelae of metabolic syndrome, obesity, hypertension, hypercoagulability, and diabetes also interplay with migraine. New medications like GLP-1 agonists may be a potential treatment for migraine as …

Experiences Of Discrimination, Paternal Support, And Hypertensive Disorders Of Pregnancy (Hdp) In The Miehr Study, Houston, Texas, Tahereh Alinia, Elaine Symanski, Juan Manuel Alvarez, Kristina Walker Whitworth

Faculty, Staff and Students Publications

Background: Discrimination is a psychosocial stressor that, through activation of stress-response pathways, may influence risk of adverse perinatal health outcomes. However, few studies have evaluated the association between discrimination and hypertensive disorders of pregnancy (HDP), and none have explored effect modification by race or paternal support, which may buffer the adverse effects of discrimination.

Methods: We included 1,847 non-Hispanic Black and White participants from the Maternal and Infant Environmental Health Riskscape (MIEHR) study. Krieger's validated Experiences of Discrimination (EOD) scale was used to assess occurrence (yes/no) and frequency (once, 2-3, ≥ 4 times) of discrimination in nine situations. We created …

Personalized Treatment Of Chronic Tendinopathy Using Ultrasound And Neuroimmune Markers: A Narrative Review, Rohan Phadke, Samer Salman, Kirtan Patel, Jad Wardeh, Akhil Marupudi, Rahul Kumar, Arbaz A. Momin, Alireza Tavakkoli

Department of Neurosurgery Faculty Papers

Introduction: : Chronic tendinopathy affects approximately 30% of musculoskeletal consultations, yet treatment outcomes remain inconsistent despite numerous available interventions. This variability stems from the absence of validated frameworks to match individual patients to optimal treatments based on underlying pathophysiology. To synthesize current evidence on ultrasound imaging biomarkers, neuroimmune mechanisms, and interventional therapies in chronic tendinopathy, and propose a clinically applicable framework integrating ultrasound phenotyping with neuroimmune assessment to guide personalized treatment selection. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science through December 2025. Studies examining ultrasound/elastography imaging, neuroimmune mechanisms, or treatment interventions in chronic …

Transcranial Doppler Ultrasound Velocity Measurements In Children With Sickle Cell Disease In Kenya, Catherine Mwalimu, Oscar Odhiambo, Elaine Mashisia, Teresa Mwanja, Allan Ade, Maria De Vita, Katherine Oyieke, Pauline Samia, Fenella Kirkham, Samson Gwer

Paediatrics and Child Health, East Africa

Background Sickle cell disease (SCD) is the most common inherited haemoglobinopathy and poses a high public health burden in Sub-Saharan Africa. Children with sickle cell anaemia are at a highrisk of ischemic stroke, and transcranial Doppler (TCD) ultrasonography helps identify those at highest risk for primary stroke prevention.

Objective To determine the prevalence of abnormal cerebral blood flow velocity (CBFV) in children with SCD and describe CBFV in children without SCD.

Methods We conducted a two-component study comprising a retrospective review and a cross-sectional assessment. TCD measurements from 143 children with confirmed SCD aged 2–16 years were reviewed. In a …

Impact Of Intracranial Pressure Monitoring On 30-Day Mortality In Severe Traumatic Brain Injury: A Retrospective Cohort Study In Kenya, George Ongas, Idris Chikophe, Jacqueline Mavuti, David Olunya, Mubashir Qureshi, Beverly Cheserem, Edwin Mogere

General Surgery, East Africa

OBJECTIVE The objective of this study was to evaluate 15-year trends in epidemiology, baseline severity, management, and outcomes of severe traumatic brain injury (sTBI) at a Kenyan tertiary center, and to determine the impact of invasive intracranial pressure (ICP) monitoring on 30-day mortality in a low- and middle-income country (LMIC) context.

METHODS A retrospective quasi-experimental cohort analysis of consecutive sTBI admissions (postresuscitation Glasgow Coma Scale [GCS] score ≤ 8, age ≥ 13 years) from January 1, 2010, to December 31, 2024, was conducted. This time period was divided into two eras: era 1 (2010–2014), premonitoring, and era 2 (2015–2024), routine …