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1. Quality indicators in intensive care medicine for Germany – fourth edition 2022

Author

Kumpf, Oliver, Assenheimer, Markus, Bloos, Frank, Brauchle, Maria, Braun, Jan-Peter, Brinkmann, Alexander, Czorlich, Patrick, Dame, Christof, Dubb, Rolf, Gahn, Georg, Greim, Clemens-A., Gruber, Bernd, Habermehl, Hilmar, Herting, Egbert, Kaltwasser, Arnold, Krotsetis, Sabine, Kruger, Bastian, Markewitz, Andreas, Marx, Gernot, Muhl, Elke, Nydahl, Peter, Pelz, Sabrina, Sasse, Michael, Schaller, Stefan J., Schäfer, Andreas, Schürholz, Tobias, Ufelmann, Marina, Waydhas, Christian, Weimann, Jörg, Wildenauer, René, Wöbker, Gabriele, Wrigge, Hermann, and Riessen, Reimer

Subjects
quality management, intensive care medicine, quality indicators, peer review, Medicine
Abstract

The measurement of quality indicators supports quality improvement initiatives. The German Interdisciplinary Society of Intensive Care Medicine (DIVI) has published quality indicators for intensive care medicine for the fourth time now. After a scheduled evaluation after three years, changes in several indicators were made. Other indicators were not changed or only minimally. The focus remained strongly on relevant treatment processes like management of analgesia and sedation, mechanical ventilation and weaning, and infections in the ICU. Another focus was communication inside the ICU. The number of 1ndicators remained the same. The development method was more structured and transparency was increased by adding new features like evidence levels or author contribution and potential conflicts of interest. These quality indicators should be used in the peer review in intensive care, a method endorsed by the DIVI. Other forms of measurement and evaluation are also reasonable, for example in quality management. This fourth edition of the quality indicators will be updated in the future to reflect the recently published recommendations on the structure of intensive care units by the DIVI.

Published
2023
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2. Natural volume time course of the middle cerebral artery in patients with aneurysmal subarachnoid haemorrhage

Author

Pantel, TF, Czorlich, P, Fröhlich, A, Westphal, M, Neulen, A, and Dührsen, L

Subjects
ddc: 610, cardiovascular system, cardiovascular diseases, 610 Medical sciences, Medicine, circulatory and respiratory physiology, nervous system diseases
Abstract

Objective: Posthemorrhagic erebral vasospasm is one of the major contributors to delayed cerebral ischemia (DCI) which frequently causes neurological deterioration in SAH patients. A major target during intensive care treatment is monitoring of vasospasm with transcranial Doppler sonography (TCD), CT-angiography[for full text, please go to the a.m. URL], 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Published
2021
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3. Ocular ultrasound as an easy applicable tool for detection of Terson's syndrome after aneurysmal subarachnoid hemorrhage.

Author

Patrick Czorlich, Till Burkhardt, Volker Knospe, Gisbert Richard, Eik Vettorazzi, Lars Wagenfeld, Manfred Westphal, Jan Regelsberger, and Christos Skevas

Subjects
Medicine, Science
Abstract

IntroductionIntraocular hemorrhage in patients suffering from aneurysmal subarachnoid hemorrhage is known as Terson's syndrome and is an underestimated but common pathology. We therefore designed a prospective single-blinded study to evaluate the validity of ocular ultrasound compared to the gold standard indirect funduscopy in the diagnosis of Terson's syndrome.Material and methodsFifty-two patients (104 eyes in total) suffering from aneurysmal subarachnoid hemorrhage were enrolled in this study. Two investigators independently performed a single-blinded ocular ultrasound using a standard intensive care ultrasound system to detect an intraocular hemorrhage. Indirect funduscopy following iatrogenic mydriasis served as the gold standard for confirmation or exclusion of an intraocular hemorrhage. Statistical analyses were performed to evaluate the sensitivity and specificity, positive and negative predictive values of the method as well as the learning curve of ocular ultrasound.ResultsIndirect funduscopy detected Terson's syndrome in 11 of 52 (21.2%) respectively in 21 of 104 (20.2%) eyes in patients suffering from subarachnoid hemorrhage. Sensitivity and specificity increased with the number of ocular ultrasound examinations for both investigators, reaching 81.8% and 100% respectively. Positive and negative predictive values were different for both investigators (63.6% vs. 100% positive and 100% vs. 95.7% negative) but were both correlated to the amount of intraocular hemorrhage. A low Glasgow Coma scale (p = 0.015) and high Hunt & Hess grade (p = 0.003) was associated with a higher rate of Terson's syndrome.ConclusionsOcular ultrasound using standard ultrasound equipment has been confirmed as a reliable, easy-to-handle bedside screening tool for detecting Terson's syndrome. Nevertheless funduscopy remains the gold standard to detect Terson's syndrome.

Published
2014
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4. The German national TBI-registry – preliminary data from the pilot period

Author

Younsi, A, Unterberg, AW, Czorlich, P, Hussam, AH, Lindner, D, Luchtmann, M, Lustenberger, T, Maegele, M, Marzi, I, Mauer, UM, Schmieder, K, Strowitzki, M, Uhl, E, Westermaier, T, Wolf, S, and Steudel, WI

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Since nationwide data on the epidemiology, treatment characteristics and long-term outcome of severe traumatic brain injury (TBI) in Germany are lacking, neurosurgeons from the German Neurosurgery Society (DGNC) and traumatologists from the German Trauma Society (DGU) joined forces in 2016[for full text, please go to the a.m. URL], 71. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 9. Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Published
2020
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5. Comparison of the clinical course and functional outcome in patients treated with Woven EndoBrigde, microsurgical clipping or endovascular coiling after aneurysmal subarachnoid haemorrhage

Author

Sauvigny, T, Nawka, MT, Buhk, JH, Bester, M, Regelsberger, J, Schmidt, NO, Westphal, M, and Czorlich, P

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Woven EndoBridge (WEB) devices have been highlighted in securing aneurysm after subarachnoid hemorrhage (SAH) while recent major clinical trials have actually excluded these devices. In an analysis of an unselected “real world” patient group we seek to examine the rational for[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Published
2019
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6. Operative neurosurgical treatment of isolated traumatic brain injury in patients ≥80 years of age – Who might benefit?

Author

Czorlich, P, Mader, M, Emami, P, Westphal, M, Lefering, R, and Hoffmann, M

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Traumatic Brain Injuries (TBI) in older adults is an increasing issue in modern medicine. Nevertheless, it remains unclear which patients presenting with TBI and 80 years of age or older benefit from an aggressive surgical treatment. Aim of this study was to explore the effect of an aggressive[for full text, please go to the a.m. URL], 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Published
2019
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7. Epidemiology and impact of multidrug-resistant organisms in patients with aneurysmal subarachnoid hemorrhage

Author

Mader, M, Grensemann, J, Kluge, S, Westphal, M, and Czorlich, P

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Multidrug-resistant organisms (MDRO) are an increasing problem in critical care medicine. Despite this fact, no data on the rate of MDRO in patients with an aneurysmal subarachnoid hemorrhage (SAH) are published so far. This study describes for the first time the epidemiology and impact of[for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Published
2018
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8. Intraocular pressure during neurosurgical procedures in respect to head positioning and loss of cerebrospinal fluid

Author

Czorlich, P, Krätzig, T, Kluge, N, Skevas, C, Knospe, V, Mende, KC, Westphal, M, and Eicker, SO

Subjects
ddc: 610, genetic structures, 610 Medical sciences, Medicine, eye diseases
Abstract

Objective: Perioperative visual loss (POVL) is a rare but serious complication in surgical disciplines, especially in spine surgery. The exact pathophysiology of POVL still remains unclear but an elevated intraocular pressure (IOP) is known to be part of it. As POVL is rarely described in patients undergoing[for full text, please go to the a.m. URL], 69. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Mexikanischen und Kolumbianischen Gesellschaft für Neurochirurgie

Published
2018
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9. Prognostic value of S100B protein and neuron-specific enolase in patients with poor grade aneurysmal subarachnoid haemorrhage

Author

Abboud, T, Mende, C, Jung, R, Czorlich, P, Vettorazzi, E, Priefler, M, Kluge, S, Westphal, M, and Regelsberger, J

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: To investigate the value of S100b protein (S100) and neuron-specific enolase (NSE) in prognosticating outcome in patients with high grade aneurysmal subarachnoid haemorrhage (SAH). Methods: Between 2012- 2014, patients SAH (Hunt & Hess grade 3-5) who were admitted within 24 hours [for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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10. Vasospasm as a life threatening complication after pituitary surgery

Author

Osterhage, K, Burkhardt, T, Czorlich, P, Rotermund, R, Grzyska, U, Westphal, M, and Flitsch, J

Subjects
body regions, ddc: 610, 610 Medical sciences, Medicine, humanities
Abstract

Objective: To identify clinically relevant vasospasms as a rare complication after pituitary surgery with emphasis on management and outcome. Methods: In a retrospective design, 1900 patient charts undergoing transsphenoidal pituitary surgery from January 2008 through Octobre 2016 were retrospectively[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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11. Perioperative corticosteroids in neurosurgery – risk factor for preoperative complications

Author

Burkhardt, T, Mende, C, Treitz, A, Czorlich, P, Westphal, M, and Schmidt, NO

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Objective: Administration of corticosteroids is common practice in cranial neurosurgery to reduce edema during surgery and in the immediate postoperative period or to prevent post-operative nausea and vomiting (PONV). Corticosteroids are well known for their adverse effects. While currently no guidelines[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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12. Incidence and Risk factors for Delirium in patients with aneurysmal Subarachnoid Hemorrhage

Author

Czorlich, P, Sauvigny, T, Mohme, M, Regelsberger, J, Westphal, M, and Schmidt, NO

Subjects
ddc: 610, mental disorders, cardiovascular diseases, 610 Medical sciences, Medicine, behavioral disciplines and activities, nervous system diseases
Abstract

Objective: Delirium is a known comorbidity in intensive care patients and especially in patients with neurological diseases such as aneurysmal subarachnoid hemorrhage (SAH). Nevertheless, data on delirium after SAH are rare. The aim of this study was to evaluate the rate of delirium in a cohort of SAH[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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13. Somatosensory evoked potentials in patients with high grade subarachnoid hemorrhage

Author

Mende, C, Gelderblom, M, Czorlich, P, Regelsberger, J, Westphal, M, and Abboud, T

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: The aim of this prospective study was to investigate the value of somatosensory evoked potentials (SEP) in prognosticating outcome in patients with high grade aneurysmal subarachnoid haemorrhage (SAH). Methods: Between 2013 and 2015, 48 patients with high grade SAH (Hunt & Hess grade[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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14. Size of aneurysm matters in subarachnoid hemorrhage

Author

Sauvigny, T, Schmidt, NO, Regelsberger, J, Westphal, M, and Czorlich, P

Subjects
ddc: 610, macromolecular substances, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: The Hunt&Hess (H&H) grade is still one of the best scores to assess disease severity and neurological outcome in subarachnoid hemorrhage (SAH). However, the question remains, which biological factors determine the severity of SAH. Previous studies analyzing the amount of blood and[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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15. Brain Death and Organ Donation in Patients Suffering from Aneurysmal Subarachnoid Hemorrhage

Author

Czorlich, P, Sauvigny, T, Söffker, G, Kluge, S, Grensemann, J, Westphal, M, and Schmidt, NO

Subjects
ddc: 610, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Aneurysmal subarachnoid hemorrhage (SAH) is a life threatening disease with a mortality rate of ~ 20%. In part of the deceased patients cause of death is an irreversible loss of brain functions also known as brain death which is a precondition for a possible organ donation in Germany.[for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

Published
2017
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16. Terson Syndrome (TS) in patients suffering from subarachnoid haemorrhage (SAH): Incidence, visual rehabilitation after surgery and the effect of ocular ultrasound (OUS) as an easy applicable tool for detection of TS

Author

Skevas, C, Knospe, V, Richard, G, Wagenfeld, L, Westphal, M, Regelsberger, J, and Czorlich, P

Subjects
ddc: 610, genetic structures, cardiovascular diseases, 610 Medical sciences, Medicine, nervous system diseases
Abstract

Objective: Terson syndrome (TS) is commonly defined as the occurrence of an intraocular hemorrhage (IOH) associated with a subarachnoid hemorrhage (SAH). IOH may be subretinal, intraretinal, preretinal, subhyaloid, or intravitreal, and, at present, any type of intracranial hemorrhage accompanied by [for full text, please go to the a.m. URL], 29. Jahrestagung der Retinologischen Gesellschaft

Published
2016
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17. Intraocular pressure during intradural spine surgery in prone position – preliminary results of a prospective single center trial

Author

Czorlich, P, Kluge, N, Skevas, C, Knospe, V, Westphal, M, and Eicker, SO

Subjects
ddc: 610, genetic structures, 610 Medical sciences, Medicine, eye diseases
Abstract

Objective: Postoperative loss of vision (PLV) is a rare but serious complication in approximately 0.05% of all spinal surgeries performed in prone position. The intraocular pressure (IOP) increases in the prone position and it is supposed that this leads to a decrease of the perfusion pressure [for full text, please go to the a.m. URL], 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Published
2016
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18. Die Ultraschalluntersuchung des Auges zum Nachweis eines Terson Syndroms-eine prospektive Studie von 52 Patienten

Author

Skevas, Christos, Richard, G., Wagenfeld., L., Knospe, V., Vettorazzi, E., Westphal, M., Regelsberger, J., and Czorlich, P.

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Ziel der Studie war die Überprüfung der Aussagekraft einer bettseitigen Ultraschalluntersuchung des Auges zum Nachweis eines Terson Syndroms bei Patienten mit aneurysmatischer Subarachnoidalblutung. Methoden: 52 Patienten wurden in dieser prospektiven, interdisziplinären[for full text, please go to the a.m. URL], 65. Tagung der Vereinigung Norddeutscher Augenärzte

Published
2015
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19. Die Ultraschalluntersuchung des Auges zum Nachweis eines Terson-Syndroms – eine prospektive Studie von 52 Patienten

Author

Skevas, C, Richard, G, Wagenfeld, L, Knospe, V, Vettorazzi, E, Westphal, M, Regelsberger, J, and Czorlich, P

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Ziel der Studie war die Überprüfung der Aussagekraft einer bettseitigen Ultraschalluntersuchung des Auges zum Nachweis eines Terson Syndroms bei Patienten mit aneurysmatischer Subarachnoidalblutung. Methoden: 52 Patienten wurden in dieser prospektiven, interdisziplinären[for full text, please go to the a.m. URL], 28. Jahrestagung der Retinologischen Gesellschaft

Published
2015
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20. Simplified acute physiology score (SAPS) II and SAPS – Diagnosis related groups improve the prediction of outcome in subarachnoid hemorrhage

Author

Czorlich, P, Sauvigny, T, Ricklefs, F, Regelsberger, J, Westphal, M, and Schmidt, NO

Subjects
ddc: 610, cardiovascular diseases, Subarachnoid Hemorrhage, 610 Medical sciences, Medicine, Simplified Acute Physiology Sc, Outcome
Abstract

Objective: Prediction of outcome in patients suffering from subarachnoid hemorrhage (SAH) is still uncertain and most prediction models ignore extra cerebral organ functions and pre-existing diseases. Aim of our study was to analyze the predictive value of the simplified acute physiology score II (SAPS[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2015
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21. Reconsidering commonly tolerated postsurgical ICP-values in patients undergoing decompressive craniectomy

Author

Sauvigny, T, Göttsche, J, Fritzsche, F, Czorlich, P, Westphal, M, and Regelsberger, J

Subjects
ddc: 610, ICP-values, 610 Medical sciences, Medicine, decompressive hemicraniectomy
Abstract

Objective: Decompressive craniectomy (DC) is a well-established ultima ratio therapy in the management of patients with increased intracranial pressure (ICP). Yet, recordings of intracranial pressure in this subgroup of patients are not sufficiently correlated with clinical outcome. Therefore we analyzed[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2015
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22. Predictive value of Fisher, Graeb and Le Roux score for case fatality risk and chronic hydrocephalus in subarachnoid hemorrhage

Author

Czorlich, P, Ricklefs, F, Reitz, M, Regelsberger, J, Westphal, M, and Schmidt, NO

Subjects
ddc: 610, Chronic Hydrocephalus, cardiovascular diseases, Subarachnoid Hemorrhage, 610 Medical sciences, Medicine, nervous system diseases, Case Fatality Rate
Abstract

Objective: Reliable prognostic tools to estimate the case fatality rate (CFR) and the development of chronic hydrocephalus (CHC) in aneurysmal subarachnoid hemorrhage (SAH) are not well-defined. This study aimed to investigate the practicability and reliability of Fisher, Graeb and Le Roux scores for[for full text, please go to the a.m. URL], 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2015
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23. Treating pediatric AVM patients – angioarchitectural risk factors, treatment regimen and long-term outcome in a cohort of 46 patients

Author

Reitz, M, von Spreckelsen, N, Treszl, A, Czorlich, P, Grzyska, U, Schmidt, NO, Westphal, M, and Regelsberger, J

Subjects
pediatric, ddc: 610, brain, AVM, 610 Medical sciences, Medicine
Abstract

Objective: Dealing with pediatric AVM patients is challenging due to the rare number of patients presenting with brain AVMs and consequently little knowledge about adequate treatment approaches. We here identify angioarchitectural risk factors for hemorrhage, demonstrate treatment options and display[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2014
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24. Morphological aspects of small aneurysms increasing the risk of SAH

Author

Czorlich, P, Bukh, JH, Reitz, M, Schmidt, NO, Westphal, M, and Regelsberger, J

Subjects
ddc: 610, subarachnoid hemorrhage, morpholgy, aneurysm, cardiovascular diseases, 610 Medical sciences, Medicine
Abstract

Objective: According to ISUIA cerebral aneurysms smaller than 7mm are believed to be associated with a low bleeding risk. Previous bleedings, size and location of aneurysms have been well addressed in previous studies to increase the likelihood of SAH. However, little is known about the morphological[for full text, please go to the a.m. URL], 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)

Published
2014
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25. Terson syndrome in patients suffering from subarachnoid haemorrhage: A prospective interdisciplinary study

Author

Czorlich, P., Knospe, V., Skevas, C., Richard, G., Westphal, M., and Regelsberger, J.

Subjects
Terson-Syndrom, ddc: 610, Subarachnoidalblutung, predisposing factors, Subarachnoid Haemorrahge, cardiovascular diseases, 610 Medical sciences, Medicine, Terson Syndrome, Prädisponierende Faktoren, nervous system diseases
Abstract

Objective: Terson-Syndrome (TS) in patients suffering from subarachnoid haemorrhage (SAH) has been known since 1900. Nevertheless only little data has been published on the subject to date. The aim of this prospective interdisciplinary study, which was approved by the local ethic committee (PV3611),[for full text, please go to the a.m. URL], 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Published
2012
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