Author: "Lecky, F.E." - Searchworks@Jio Institute Digital Library Search Results

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48 results on '"Lecky, F.E."'

1. Lack of Consistency in Threat to Life from Single Injury Abbreviated Injury Scale (AIS) 4 Codes in Different Body Areas

Author: Woodford, M., Bouamra, O., Wrotchford, A., Yates, D.W., Lecky, F.E., Gladwell, G.M.L., editor, and Gilchrist, M. D., editor
Published: 2005
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2. Vital signs and estimated blood loss in patients with major trauma: Testing the validity of the ATLS classification of hypovolaemic shock

Author: Guly, H.R., Bouamra, O., Spiers, M., Dark, P., Coats, T., and Lecky, F.E.
Published: 2011
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3. Testing the validity of the ATLS classification of hypovolaemic shock

Author: Guly, H.R., Bouamra, O., Little, R., Dark, P., Coats, T., Driscoll, P., and Lecky, F.E.
Published: 2010
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4. Health-related quality of life (HRQoL) outcomes following injury in childhood and adolescence using EuroQol (EQ-5D) responses with pooled longitudinal data

Author: Dipnall, J.F., Rivara, F.P., Lyons, R.A., Ameratunga, S., Brussoni, M., Lecky, F.E., Bradley, C., Beck, B., Lyons, J., Schneeberg, A., Harrison, J.E., and Gabbe, B.J.
Abstract: Background: Injury is a leading contributor to the global disease burden in children, affecting their health-related quality of life (HRQoL)—yet valid estimates of burden are absent. Methods: This study pooled longitudinal data from five cohort studies of pediatric injury survivors (5–17 years) at baseline, 1-, 4-, 6-, 12-, and 24- months (n = 2334). HRQoL post-injury was measured using the 3-level EQ-5D utility score (EQ-5D) and five health states (mobility, self-care, activity, pain, anxiety and depression (anxiety)). Results: Mean EQ-5D post-injury did not return to baseline level (0.95) by 24 months (0.88) and was lower for females over time (−0.04, 95%CI −0.05, −0.02). A decreased adjusted risk ratio over time (ARR) was observed for intentional injuries (pain: 0.85, 95%CI 0.73,0.98; anxiety: 0.62, 95%CI 0.49,0.78); spinal cord injuries (mobility: 0.61, 95%CI 0.45,0.83), self-care: 0.76, 95%CI 0.63,0.91, activity: 0.64, 95%CI 0.47,0.88); moderate/severe traumatic brain injury (activity: 0.83, 95%CI 0.71,0.96). ARRs were also low for certain fractures, with various health states affected. Conclusions: HRQoL outcomes over time for children and adolescents post-injury differed across key demographic and injury related attributes. HRQoL did not reach levels consistent with full health by 24 months with recovery plateauing from 6 to 24 months. Tailored interventions are required to respond to the varying post-injury recovery trajectories in this population.
Published: 2021

5. The burden of traumatic brain injury from low-energy falls among patients from 18 countries in the CENTER-TBI Registry : a comparative cohort study

Author: Lecky, F.E., Otesile, O., Marincowitz, C., Majdan, M., Nieboer, D., Lingsma, H.F., Maegele, M., Citerio, G., Stocchetti, N., Steyerberg, E.W., Menon, D.K., and Maas, A.I.R.
Abstract: Background\ud \ud Traumatic brain injury (TBI) is an important global public health burden, where those injured by high-energy transfer (e.g., road traffic collisions) are assumed to have more severe injury and are prioritised by emergency medical service trauma triage tools. However recent studies suggest an increasing TBI disease burden in older people injured through low-energy falls. We aimed to assess the prevalence of low-energy falls among patients presenting to hospital with TBI, and to compare their characteristics, care pathways, and outcomes to TBI caused by high-energy trauma.\ud \ud \ud \ud Methods and findings\ud \ud We conducted a comparative cohort study utilising the CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) Registry, which recorded patient demographics, injury, care pathway, and acute care outcome data in 56 acute trauma receiving hospitals across 18 countries (17 countries in Europe and Israel). Patients presenting with TBI and indications for computed tomography (CT) brain scan between 2014 to 2018 were purposively sampled. The main study outcomes were (i) the prevalence of low-energy falls causing TBI within the overall cohort and (ii) comparisons of TBI patients injured by low-energy falls to TBI patients injured by high-energy transfer—in terms of demographic and injury characteristics, care pathways, and hospital mortality. In total, 22,782 eligible patients were enrolled, and study outcomes were analysed for 21,681 TBI patients with known injury mechanism; 40% (95% CI 39% to 41%) (8,622/21,681) of patients with TBI were injured by low-energy falls. Compared to 13,059 patients injured by high-energy transfer (HE cohort), the those injured through low-energy falls (LE cohort) were older (LE cohort, median 74 [IQR 56 to 84] years, versus HE cohort, median 42 [IQR 25 to 60] years; p < 0.001), more often female (LE cohort, 50% [95% CI 48% to 51%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001), more frequently taking pre-injury anticoagulants or/and platelet aggregation inhibitors (LE cohort, 44% [95% CI 42% to 45%], versus HE cohort, 13% [95% CI 11% to 14%]; p < 0.001), and less often presenting with moderately or severely impaired conscious level (LE cohort, 7.8% [95% CI 5.6% to 9.8%], versus HE cohort, 10% [95% CI 8.7% to 12%]; p < 0.001), but had similar in-hospital mortality (LE cohort, 6.3% [95% CI 4.2% to 8.3%], versus HE cohort, 7.0% [95% CI 5.3% to 8.6%]; p = 0.83). The CT brain scan traumatic abnormality rate was 3% lower in the LE cohort (LE cohort, 29% [95% CI 27% to 31%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001); individuals in the LE cohort were 50% less likely to receive critical care (LE cohort, 12% [95% CI 9.5% to 13%], versus HE cohort, 24% [95% CI 23% to 26%]; p < 0.001) or emergency interventions (LE cohort, 7.5% [95% CI 5.4% to 9.5%], versus HE cohort, 13% [95% CI 12% to 15%]; p < 0.001) than patients injured by high-energy transfer. The purposive sampling strategy and censorship of patient outcomes beyond hospital discharge are the main study limitations.\ud \ud \ud \ud Conclusions\ud \ud We observed that patients sustaining TBI from low-energy falls are an important component of the TBI disease burden and a distinct demographic cohort; further, our findings suggest that energy transfer may not predict intracranial injury or acute care mortality in patients with TBI presenting to hospital. This suggests that factors beyond energy transfer level may be more relevant to prehospital and emergency department TBI triage in older people. A specific focus to improve prevention and care for patients sustaining TBI from low-energy falls is required.
Published: 2021

6. Prehospital management of traumatic brain injury across Europe: a CENTER-TBI Study

Author: Gravesteijn, B.Y., Sewalt, C.A., Stocchetti, N., Citerio, G., Ercole, A., Lingsma, H.F., von Steinbüchel, N., Steyerberg, E.W., Wilson, L., Maas, A.I.R., Menon, D.K., and Lecky, F.E.
Abstract: Background\ud \ud Prehospital care for traumatic brain injury (TBI) is important to prevent secondary brain injury. We aim to compare prehospital care systems within Europe and investigate the association of system characteristics with the stability of patients at hospital arrival.\ud \ud \ud \ud Methods\ud \ud We studied TBI patients who were transported to CENTER-TBI centers, a pan-European, prospective TBI cohort study, by emergency medical services between 2014 and 2017. The association of demographic factors, injury severity, situational factors, and interventions associated with on-scene time was assessed using linear regression. We used mixed effects models to investigate the case mix adjusted variation between countries in prehospital times and interventions. The case mix adjusted impact of on-scene time and interventions on hypoxia (oxygen saturation
Published: 2021

7. The incidence of neurogenic shock in patients with isolated spinal cord injury in the emergency department

Author: Guly, H.R., Bouamra, O., and Lecky, F.E.
Published: 2008
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8. The volume-outcome relationship among severely injured patients admitted to English major trauma centres : a registry study

Author: Sewalt, C.A., Wiegers, E.J.A., Lecky, F.E., den Hartog, D., Schuit, S.C.E., Venema, E., and Lingsma, H.F.
Abstract: Background\ud \ud Many countries have centralized and dedicated trauma centres with high volumes of trauma patients. However, the volume-outcome relationship in severely injured patients (Injury Severity Score (ISS) > 15) remains unclear. The aim of this study was to determine the association between hospital volume and outcomes in Major Trauma Centres (MTCs).\ud \ud \ud \ud Methods\ud \ud A retrospective observational cohort study was conducted using the Trauma Audit and Research Network (TARN) consisting of all English Major Trauma Centres (MTCs). Severely injured patients (ISS > 15) admitted to a MTC between 2013 and 2016 were included. The effect of hospital volume on outcome was analysed with random effects logistic regression models with a random intercept for centre and was tested for nonlinearity. Primary outcome was in-hospital mortality.\ud \ud \ud \ud Results\ud \ud A total of 47,157 severely injured patients from 28 MTCs were included in this study. Hospital volume varied from 69 to 781 severely injured patients per year. There were small between-centre differences in mortality after adjusting for important demographic and injury severity characteristics (adjusted 95% odds ratio range: 0.99–1.01). Hospital volume was found to be linear and not associated with in-hospital mortality (adjusted odds ratio (aOR) 1.02 per 10 patients, 95% confidence interval (CI) 0.68–1.54, p = 0.92).\ud \ud \ud \ud Conclusions\ud \ud Despite the large variation in volume of the included MTCs, no relationship between hospital volume and outcome of severely injured patients was found. These results suggest that centres with similar structure and processes of care can achieve comparable outcomes in severely injured patients despite the number of severely injured patients they treat.
Published: 2020

9. The CRASH3 study: prehospital TXA for every injured patient?

Author: Coats, T.J. and Lecky, F.E.
Published: 2020

10. Trends in head injury outcome from 1989 to 2003 and the effect of neurosurgical care: an observational study

Author: Patel, H.C., Bouamra, O., Woodford, M., King, A.T., Yates, D.W., and Lecky, F.E.
Subjects: Head injuries -- Care and treatment, Head injuries -- Patient outcomes, Trauma centers -- Forecasts and trends, Market trend/market analysis
Published: 2005

11. Patterns and risks in spinal trauma

Author: Martin, B.W., Dykes, E., and Lecky, F.E.
Subjects: Spinal cord injuries -- Research, Prevalence studies (Epidemiology), Children
Published: 2004

12. Frequency of fatigue and its changes in the first 6 months after traumatic brain injury: results from the CENTER-TBI study

Author: Andelic, N. (Nada), Røe, C. (Cecilie), Brunborg, C. (Cathrine), Zeldovich, M. (Marina), Løvstad, M. (Marianne), Løke, D. (Daniel), Borgen, I.M. (Ida M.), Voormolen, D.C. (Daphne), Howe, E.I. (Emilie I.), Forslund, M.V. (Marit V.), Dahl, H.M. (Hilde M.), Von Steinbuechel, N. (Nicole), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Ceyisakar, I.E. (Iris), Clusmann, H. (Hans), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), Dawes, H. (Helen), Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Boogert, H. (Hugo), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy -Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Johnson, F. (Faye), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Ledoux, D. (Didier), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Castaño-León, A.M. (Ana M), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mikolic, A. (Ana), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Maria Tudora, C. (Cristina), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Jagt, M. (Mathieu), Steen, G. (Gregory), Naalt, J. (Joukje), Jeroen, T.J.M.D. (T.J.M. van Dijck), Essen, T.A. (Thomas A.), Hecke, W. (Wim), Heugten, C. (Caroline), Praag, D. (Dominique), Vyvere, T. (Thijs), RoelWijk, P.J. (P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Steinbüchel, N. (Nicole), Voormolen, D. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), Zoerle, T. (Tommaso), Andelic, N. (Nada), Røe, C. (Cecilie), Brunborg, C. (Cathrine), Zeldovich, M. (Marina), Løvstad, M. (Marianne), Løke, D. (Daniel), Borgen, I.M. (Ida M.), Voormolen, D.C. (Daphne), Howe, E.I. (Emilie I.), Forslund, M.V. (Marit V.), Dahl, H.M. (Hilde M.), Von Steinbuechel, N. (Nicole), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Ceyisakar, I.E. (Iris), Clusmann, H. (Hans), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), Dawes, H. (Helen), Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Boogert, H. (Hugo), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy -Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Johnson, F. (Faye), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Ledoux, D. (Didier), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Castaño-León, A.M. (Ana M), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mikolic, A. (Ana), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Maria Tudora, C. (Cristina), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Jagt, M. (Mathieu), Steen, G. (Gregory), Naalt, J. (Joukje), Jeroen, T.J.M.D. (T.J.M. van Dijck), Essen, T.A. (Thomas A.), Hecke, W. (Wim), Heugten, C. (Caroline), Praag, D. (Dominique), Vyvere, T. (Thijs), RoelWijk, P.J. (P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Steinbüchel, N. (Nicole), Voormolen, D. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), and Zoerle, T. (Tommaso)
Abstract: Background: Fatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities. Methods: Patients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subje
Published: 2020
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13. Informed consent procedures in patients with an acute inability to provide informed consent

Author: van Wijk, R.P.J. (Roel P.J.), van Dijck, J.T.J.M. (Jeroen T.J.M.), Timmers, M. (Marjolein), Veen, E. (Ernest) van, Citerio, G. (Giuseppe), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Menon, D.K. (David K.), Peul, W.C. (Wilco C.), Stocchetti, N. (Nino), Kompanje, E.J.O. (Erwin), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Ceyisakar, I.E. (Iris), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), den Boogert, H. (Hugo), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K.A. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B.Y. (Benjamin), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, A.L.C.J.R.M. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Johnson, F. (Faye), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Ledoux, D. (Didier), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Castaño-León, A.M. (Ana M.), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Misset, B. (Benoit), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C.A. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Essen, T.A. (Thomas A.), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K.B. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers-Groeneweg, E.J.A. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), Zoerle, T. (Tommaso), van Wijk, R.P.J. (Roel P.J.), van Dijck, J.T.J.M. (Jeroen T.J.M.), Timmers, M. (Marjolein), Veen, E. (Ernest) van, Citerio, G. (Giuseppe), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Menon, D.K. (David K.), Peul, W.C. (Wilco C.), Stocchetti, N. (Nino), Kompanje, E.J.O. (Erwin), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Ceyisakar, I.E. (Iris), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), den Boogert, H. (Hugo), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K.A. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B.Y. (Benjamin), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, A.L.C.J.R.M. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Johnson, F. (Faye), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Ledoux, D. (Didier), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Castaño-León, A.M. (Ana M.), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Misset, B. (Benoit), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C.A. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Essen, T.A. (Thomas A.), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K.B. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers-Groeneweg, E.J.A. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), and Zoerle, T. (Tommaso)
Abstract: Purpose: Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed consent policy and practice. Methods: Variation was explored in the CENTER-TBI study. Policies were reported by using a questionnaire and national legislation. Data on used informed consent procedures were available for 4498 patients from 57 centres across 17 European countries. Results: Variation in the use of informed consent procedures was found between and within EU member states. Proxy informed consent (N = 1377;64%) was the most frequently used type of consent in the ICU, followed by patient informed consent (N = 426;20%) and deferred consent (N = 334;16%). Deferred consent was only actively used in 15 centres (26%), although it was considered valid in 47 centres (82%). Conclusions: Alternatives to patient consent are essential for TBI research. While there seems to be concordance amongst national legislations, there is regional variability in institutional practices with respect to the use of different informed consent procedures. Variation could be caused by several reasons, including inconsistencies in clear legislation or knowledge of such legislation amongst researchers.
Published: 2020
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14. Tracheal intubation in traumatic brain injury

Author: Gravesteijn, B.Y. (Benjamin), Sewalt, C.A. (Charlie), Nieboer, D. (Daan), Menon, D.K. (David Krishna), Maas, A.I.R. (Andrew), Lecky, F.E. (Fiona), Klimek, M. (Markus), Lingsma, H.F. (Hester), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Ceyisakar, I.E. (Iris), Clusmann, H. (Hans), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Della Corte, F. (Francesco), Boogert, H.D. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K.A. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, A.L.C.J.R.M. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Johnson, F. (Faye), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Ledoux, D. (Didier), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Maas, A.I.R. (Andrew I.R.), Castaño-León, A.M. (Ana M.), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mikolic, A. (Ana), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Jagt, M. (Mathieu) van der, Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T.J.M.), van Essen, T.A. (Thomas A.), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), van Wijk, R.P.J. (Roel P.J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K.B. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers-Groeneweg, E.J.A. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), Zoerle, T. (Tommaso), Gravesteijn, B.Y. (Benjamin), Sewalt, C.A. (Charlie), Nieboer, D. (Daan), Menon, D.K. (David Krishna), Maas, A.I.R. (Andrew), Lecky, F.E. (Fiona), Klimek, M. (Markus), Lingsma, H.F. (Hester), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Ceyisakar, I.E. (Iris), Clusmann, H. (Hans), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Della Corte, F. (Francesco), Boogert, H.D. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K.A. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, A.L.C.J.R.M. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Johnson, F. (Faye), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Ledoux, D. (Didier), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Maas, A.I.R. (Andrew I.R.), Castaño-León, A.M. (Ana M.), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mikolic, A. (Ana), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Jagt, M. (Mathieu) van der, Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T.J.M.), van Essen, T.A. (Thomas A.), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), van Wijk, R.P.J. (Roel P.J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K.B. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers-Groeneweg, E.J.A. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), and Zoerle, T. (Tommaso)
Abstract: Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. Results: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio=1.01; 95% confidence interval, 0.79–1.28; P=0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio=0.86; 95% confidence interval, 0.65–1.13; P=0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P=0.009 and P=0.02, respectively), whereas in-hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P=0.01): in-hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. Conclusion: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that e
Published: 2020
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15. Health-related quality of life after traumatic brain injury: deriving value sets for the QOLIBRI-OS for Italy, The Netherlands and The United Kingdom

Author: Voormolen, D.C. (Daphne), Polinder, S. (Suzanne), Von Steinbuechel, N. (Nicole), Feng, Y. (Yan), Wilson, L. (Lindsay), Oppe, M. (Mark), Haagsma, J.A. (Juanita), Åkerlund, C. (Cecilia), Adams, H. (Hadie), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzó, P. (Pál), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Castaño-León, A.M. (Ana M.), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Cnossen, M.C. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Boogert, H. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), L.Gruen, R. (Russell), Gupta, D. (Deepak), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Jones, K.M. (Kelly M.), Karan–, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McFadyen, C. (Charles), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Nair, N. (Nandesh), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Real, R. (Ruben), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevanovic, A. (Ana), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T. J. M.), van Essen, T. (Thomas), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vanhaudenhuyse, A. (Audrey), van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederik A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), Zoerle, T. (Tommaso), Voormolen, D.C. (Daphne), Polinder, S. (Suzanne), Von Steinbuechel, N. (Nicole), Feng, Y. (Yan), Wilson, L. (Lindsay), Oppe, M. (Mark), Haagsma, J.A. (Juanita), Åkerlund, C. (Cecilia), Adams, H. (Hadie), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzó, P. (Pál), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Castaño-León, A.M. (Ana M.), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Cnossen, M.C. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Boogert, H. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), L.Gruen, R. (Russell), Gupta, D. (Deepak), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Jones, K.M. (Kelly M.), Karan–, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McFadyen, C. (Charles), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Nair, N. (Nandesh), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Real, R. (Ruben), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevanovic, A. (Ana), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T. J. M.), van Essen, T. (Thomas), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vanhaudenhuyse, A. (Audrey), van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederik A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), and Zoerle, T. (Tommaso)
Abstract: Purpose: The Quality of Life after Brain Injury overall scale (QOLIBRI-OS) measures health-related quality of life (HRQoL) after traumatic brain injury (TBI). The aim of this study was to derive value sets for the QOLIBRI-OS in three European countries, which will allow calculation of utility scores for TBI health states. Methods: A QOLIBRI-OS value set was derived by using discrete choice experiments (DCEs) and visual analogue scales (VAS) in general population samples from the Netherlands, United Kingdom and Italy. A three-stage procedure was used: (1) A selection of health states, covering the entire spectrum of severity, was defined; (2) General population samples performed the health state valuation task using a web-based survey with three VAS questions and an at random selection of sixteen DCEs; (3) DCEs were analysed using a conditional logistic regression and were then anchored on the VAS data. Utility scores for QOLIBRI-OS health states were generated resulting in estimates for all potential health states. Results: The questionnaire was completed by 13,623 respondents. The biggest weight increase for all attributes is seen from “slightly” to “not at all satisfied”, resulting in the largest impact on HRQoL. “Not at all satisfied with how brain is working” should receive the greatest weight in utility calculations in all three countries. Conclusion: By transforming the QOLIBRI-OS into utility scores, we enabled the application in economic evaluations and in summary measures of population health, which may be used to inform decision-makers on the best interventions and strategies for TBI patients.
Published: 2020
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16. Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe

Author: Huijben, A.L.C.J.R.M. (Jilske), Wiegers-Groeneweg, E.J.A. (Eveline), Lingsma, H.F. (Hester), Citerio, G. (Giuseppe), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Ercole, A. (Ari), Nelson, D. (David), Jagt, M. (Mathieu) van der, Steyerberg, E.W. (Ewout), Helbok, R. (Raimund), Lecky, F.E. (Fiona), Peul, W.C. (Wilco), Birg, T. (Tatiana), Zoerle, T. (Tommaso), Carbonara, M. (Marco), Stocchetti, N. (Nino), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beqiri, E. (Erta), Blaabjerg, M. (Morten), Lund, S.B. (Stine Borgen), Brorsson, C. (Camilla), Buki, A. (Andras), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Castaño-León, A.M. (Ana M.), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), DeKeyser, V. (Véronique), Degos, V. (Vincent), Della Corte, F. (Francesco), den Boogert, H. (Hugo), Depreitere, B. (Bart), Dilvesi, D. (Dula), Dixit, A. (Abhishek), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Galanaud, D. (Damien), Gantner, D. (Dashiell), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Golubovic, J. (Jagos), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gupta, D. (Deepak), Haitsma, I. (Iain), Helseth, E. (Eirik), Hutchinson, P.J. (Peter J.), Jankowski, S. (Stefan), Johnson, F. (Faye), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Laureys, S. (Steven), Ledoux, D. (Didier), Lejeune, A. (Aurelie), Lightfoot, R. (Roger), Manara, A. (Alex), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Menovsky, T. (Tomas), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Newcombe, V.F. (Virginia F.), Nyirádi, J. (József), Ortolano, F. (Fabrizio), Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Persona, P. (Paolo), Piippo-Karjalainen, A. (Anna), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rhodes, J.K.J. (Jonathan K.J.), Richter, S. (Sophie), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Sahuquillo, J. (Juan), Sandrød, O. (Oddrun), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Schirmer-Mikalsen, K. (Kari), Schou, R. (Rico), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Sundström, N. (Nina), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Tenovuo, O. (Olli), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (CristinaMaria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Vulekovic, P. (Peter), Williams, G. (Guy), Winzeck, S. (Stefan), Wolf, S. (Stefan), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Clusmann, A.Z.H. (Agate Ziverte Hans), Voormolen, D.C. (Daphne), van Dijck, J.T.J.M. (Jeroen T. J. M.), van Essen, T.A. (Thomas A.), Huijben, A.L.C.J.R.M. (Jilske), Wiegers-Groeneweg, E.J.A. (Eveline), Lingsma, H.F. (Hester), Citerio, G. (Giuseppe), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Ercole, A. (Ari), Nelson, D. (David), Jagt, M. (Mathieu) van der, Steyerberg, E.W. (Ewout), Helbok, R. (Raimund), Lecky, F.E. (Fiona), Peul, W.C. (Wilco), Birg, T. (Tatiana), Zoerle, T. (Tommaso), Carbonara, M. (Marco), Stocchetti, N. (Nino), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beqiri, E. (Erta), Blaabjerg, M. (Morten), Lund, S.B. (Stine Borgen), Brorsson, C. (Camilla), Buki, A. (Andras), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Castaño-León, A.M. (Ana M.), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), DeKeyser, V. (Véronique), Degos, V. (Vincent), Della Corte, F. (Francesco), den Boogert, H. (Hugo), Depreitere, B. (Bart), Dilvesi, D. (Dula), Dixit, A. (Abhishek), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Galanaud, D. (Damien), Gantner, D. (Dashiell), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Golubovic, J. (Jagos), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gupta, D. (Deepak), Haitsma, I. (Iain), Helseth, E. (Eirik), Hutchinson, P.J. (Peter J.), Jankowski, S. (Stefan), Johnson, F. (Faye), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Laureys, S. (Steven), Ledoux, D. (Didier), Lejeune, A. (Aurelie), Lightfoot, R. (Roger), Manara, A. (Alex), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Menovsky, T. (Tomas), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Newcombe, V.F. (Virginia F.), Nyirádi, J. (József), Ortolano, F. (Fabrizio), Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Persona, P. (Paolo), Piippo-Karjalainen, A. (Anna), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rhodes, J.K.J. (Jonathan K.J.), Richter, S. (Sophie), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Sahuquillo, J. (Juan), Sandrød, O. (Oddrun), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Schirmer-Mikalsen, K. (Kari), Schou, R. (Rico), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Sundström, N. (Nina), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Tenovuo, O. (Olli), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (CristinaMaria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Vulekovic, P. (Peter), Williams, G. (Guy), Winzeck, S. (Stefan), Wolf, S. (Stefan), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Clusmann, A.Z.H. (Agate Ziverte Hans), Voormolen, D.C. (Daphne), van Dijck, J.T.J.M. (Jeroen T. J. M.), and van Essen, T.A. (Thomas A.)
Abstract: Purpose: To describe ICU stay, selected management aspects, and outcome of Intensive Care Unit (ICU) patients with traumatic brain injury (TBI) in Europe, and to quantify variation across centers. Methods: This is a prospective observational multicenter study conducted across 18 countries in Europe and Israel. Admission characteristics, clinical data, and outcome were described at patient- and center levels. Between-center variation in the total ICU population was quantified with the median odds ratio (MOR), with correction for case-mix and random variation between centers. Results: A total of 2138 patients were admitted to the ICU, with median age of 49 years; 36% of which were mild TBI (Glasgow Coma Scale; GCS 13–15). Within, 72 h 636 (30%) were discharged and 128 (6%) died. Early deaths and long-stay patients (> 72 h) had more severe injuries based on the GCS and neuroimaging characteristics, compared with short-stay patients. Long-stay patients received more monitoring and were treated at higher intensity, and experienced worse 6-month outcome compared to short-stay patients. Between-center variations were prominent in the proportion of short-stay patients (MOR = 2.3, p < 0.001), use of intracranial pressure (ICP) monitoring (MOR = 2.5, p < 0.001) and aggressive treatmen
Published: 2020
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17. Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury

Author: Gravesteijn, B.Y. (Benjamin), Nieboer, D. (Daan), Ercole, A. (Ari), Lingsma, H.F. (Hester), Nelson, D. (David), Calster, B. (Ben) Van, Steyerberg, E.W. (Ewout), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Cnossen, M.C. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, D.J. (D. Jamie), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Della Corte, F. (Francesco), Boogert, H.D. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Guy-Loup Dulière, J.D. (Jens Dreier), Esser, P. (Patrick), Martin Fabricius, E.E. (Erzsébet Ezer), Feigin, Kelly Foks, V.L. (Valery L.), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Ji-yao Jiang, M.J. (Mike Jarrett), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H. (Hester), Maas, A.I.R. (Andrew), Castaño-León, A.M. (Ana M.), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Nair, N. (Nandesh), Negru, A. (Ancuta), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Real, R. (Ruben), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Kowark, A. (Ana), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T.J.M.), van Essen, T.A. (Thomas A.), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vanhaudenhuyse, A. (Audrey), van Wijk, R.P.J. (Roel P.J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederik A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), Zoerle, T. (Tommaso), Gravesteijn, B.Y. (Benjamin), Nieboer, D. (Daan), Ercole, A. (Ari), Lingsma, H.F. (Hester), Nelson, D. (David), Calster, B. (Ben) Van, Steyerberg, E.W. (Ewout), Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Cnossen, M.C. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, D.J. (D. Jamie), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Della Corte, F. (Francesco), Boogert, H.D. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Guy-Loup Dulière, J.D. (Jens Dreier), Esser, P. (Patrick), Martin Fabricius, E.E. (Erzsébet Ezer), Feigin, Kelly Foks, V.L. (Valery L.), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Ji-yao Jiang, M.J. (Mike Jarrett), Jones, K.M. (Kelly M.), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H. (Hester), Maas, A.I.R. (Andrew), Castaño-León, A.M. (Ana M.), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Nair, N. (Nandesh), Negru, A. (Ancuta), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Polinder, S. (Suzanne), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Real, R. (Ruben), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Kowark, A. (Ana), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T.J.M.), van Essen, T.A. (Thomas A.), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vanhaudenhuyse, A. (Audrey), van Wijk, R.P.J. (Roel P.J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wilson, L. (Lindsay), Winzeck, S. (Stefan), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederik A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), and Zoerle, T. (Tommaso)
Abstract: Objective: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. Study Design and Setting: We performed logistic regression (LR), lasso regression, and ridge regression with key baseline predictors in the IMPACT-II database (15 studies, n = 11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks and were trained using the same predictors. To assess generalizability of predictions, we performed internal, internal-external, and external validation on the recent CENTER-TBI study (patients with Glasgow Coma Scale <13, n = 1,554). Both calibration (calibration slope/intercept) and discrimination (area under the curve) was quantified. Results: In the IMPACT-II database, 3,332/11,022 (30%) died and 5,233(48%) had unfavorable outcome (Glasgow Outcome Scale less than 4). In the CENTER-TBI study, 348/1,554(29%) died and 651(54%) had unfavorable outcome. Discrimination and calibration varied widely between the studies and less so between the studied algorithms. The mean area under the curve was 0.82 for mortality and 0.77 for unfavorable outcomes in the CENTER-TBI study. Conclusion: ML algorithms may not outperform traditional regression approaches in a low-dimensional setting for outcome prediction after moderate or severe traumatic brain injury. Similar to regression-based prediction models, ML algorithms should be rigorously validated to ensure applicability to new populations.
Published: 2020
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18. Blood biomarkers on admission in acute traumatic brain injury: Relations to severity, CT findings and care path in the CENTER-TBI study

Author: Czeiter, E. (Endre), Amrein, K. (Krisztina), Gravesteijn, B.Y. (Benjamin Y.), Lecky, F.E. (Fiona), Menon, D.K. (David ), Mondello, S. (Stefania), Newcombe, V.F. (Virginia F.), Richter, S. (Sophie), Steyerberg, E.W. (Ewout), Vyvere, T.V. (Thijs Vande), Verheyden, J. (Jan), Xu, H. (Haiyan), Yang, Z. (Zhihui), Maas, A.I.R. (Andrew), Wang, K.K.W. (Kevin), Büki, A. (András), Czeiter, E. (Endre), Amrein, K. (Krisztina), Gravesteijn, B.Y. (Benjamin Y.), Lecky, F.E. (Fiona), Menon, D.K. (David ), Mondello, S. (Stefania), Newcombe, V.F. (Virginia F.), Richter, S. (Sophie), Steyerberg, E.W. (Ewout), Vyvere, T.V. (Thijs Vande), Verheyden, J. (Jan), Xu, H. (Haiyan), Yang, Z. (Zhihui), Maas, A.I.R. (Andrew), Wang, K.K.W. (Kevin), and Büki, A. (András)
Abstract: Background: Serum biomarkers may inform and improve care in traumatic brain injury (TBI). We aimed to correlate serum biomarkers with clinical severity, care path and imaging abnormalities in TBI, and explore their incremental value over clinical characteristics in predicting computed tomographic (CT) abnormalities. Methods: We analyzed six serum biomarkers (S100B, NSE, GFAP, UCH-L1, NFL and t-tau) obtained <24 h post-injury from 2867 patients with any severity of TBI in the Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) Core Study, a prospective, multicenter, cohort study. Univariable and multivariable logistic regression analyses were performed. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals. Findings: All biomarkers scaled with clinical severity and care path (ER only, ward admission, or ICU), and with presence of CT abnormalities. GFAP achieved the highest discrimination for predicting CT abnormalities (AUC 0•89 [95%CI: 0•87–0•90]), with a 99% likelihood of better discriminating CT-positive patients than clinical characteristics used in contemporary decision rules. In patients with mild TBI, GFAP also showed incremental diagnostic value: discrimination increased from 0•84 [95%CI: 0•83–0•86] to 0•89 [95%CI: 0•87–0•90] when GFAP was included. Results were consistent across strata, and injury severity. Combinations of biomarkers did not improve discrimination compared to GFAP alone. Interpretation: Currently available biomarkers reflect injury severity, and serum GFAP, measured within 24 h after injury, outperforms clinical characteristics in predicting CT abnormalities. Our results support the further development of serum GFAP assays towards implementation in clinical practice, for which robust clinical assay platforms are required. Funding: CENTER-TBI study was supported by the European Union 7th Framework program (EC grant 602150).
Published: 2020
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19. Quality indicators for patients with traumatic brain injury in European intensive care units

Author: Huijben, A.L.C.J.R.M. (Jilske), Wiegers-Groeneweg, E.J.A. (Eveline), Ercole, A. (Ari), Keizer, N.F. (Nicolette) de, Maas, A.I.R. (Andrew), Steyerberg, E.W. (Ewout), Citerio, G. (Giuseppe), Wilson, L. (Lindsay), Polinder, S. (Suzanne), Nieboer, D. (Daan), Menon, D.K. (David ), Lingsma, H.F. (Hester), Jagt, M. (Mathieu) van der, Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beqiri, E. (Erta), Blaabjerg, M. (Morten), Lund, S.B. (Stine Borgen), Brorsson, C. (Camilla), Buki, A. (Andras), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Castaño-León, A.M. (Ana M.), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Den Boogert, H. (Hugo), Depreitere, B. (Bart), Dilvesi, D. (Dula), Dixit, A. (Abhishek), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Galanaud, D. (Damien), Gantner, D. (Dashiell), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Golubovic, J. (Jagos), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gupta, D. (Deepak), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Hutchinson, P.J. (Peter J.), Jankowski, S. (Stefan), Johnson, F. (Faye), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Laureys, S. (Steven), Lecky, F.E. (Fiona), Ledoux, D. (Didier), Lejeune, A. (Aurelie), Lightfoot, R. (Roger), Manara, A. (Alex), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Menovsky, T. (Tomas), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nyirádi, J. (József), Ortolano, F. (Fabrizio), Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rhodes, J.K.J. (Jonathan K.J.), Richter, S. (Sophie), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Sahuquillo, J. (Juan), Sandrød, O. (Oddrun), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Schirmer-Mikalsen, K. (Kari), Schou, R. (Rico), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stocchetti, N. (Nino), Sundström, N. (Nina), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Tenovuo, O. (Olli), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van Der Steen, G. (Gregory), Van Dijck, J.T.J.M. (Jeroen T. J. M.), Van Essen, T.A. (Thomas A.), Van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Williams, G. (Guy), Winzeck, S. (Stefan), Wolf, S. (Stefan), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Ziverte, A. (Agate), Zoerle, T. (Tommaso), Clusmann, H. (Hans), Huijben, A.L.C.J.R.M. (Jilske), Wiegers-Groeneweg, E.J.A. (Eveline), Ercole, A. (Ari), Keizer, N.F. (Nicolette) de, Maas, A.I.R. (Andrew), Steyerberg, E.W. (Ewout), Citerio, G. (Giuseppe), Wilson, L. (Lindsay), Polinder, S. (Suzanne), Nieboer, D. (Daan), Menon, D.K. (David ), Lingsma, H.F. (Hester), Jagt, M. (Mathieu) van der, Åkerlund, C. (Cecilia), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beqiri, E. (Erta), Blaabjerg, M. (Morten), Lund, S.B. (Stine Borgen), Brorsson, C. (Camilla), Buki, A. (Andras), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Castaño-León, A.M. (Ana M.), Cavallo, S. (Simona), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dark, P. (Paul), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Den Boogert, H. (Hugo), Depreitere, B. (Bart), Dilvesi, D. (Dula), Dixit, A. (Abhishek), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Galanaud, D. (Damien), Gantner, D. (Dashiell), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Golubovic, J. (Jagos), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gupta, D. (Deepak), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Hutchinson, P.J. (Peter J.), Jankowski, S. (Stefan), Johnson, F. (Faye), Karan, M. (Mladen), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koraropoulos, E. (Evgenios), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kowark, A. (Ana), Lagares, A. (Alfonso), Laureys, S. (Steven), Lecky, F.E. (Fiona), Ledoux, D. (Didier), Lejeune, A. (Aurelie), Lightfoot, R. (Roger), Manara, A. (Alex), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McMahon, C. (Catherine), Menovsky, T. (Tomas), Misset, B. (Benoit), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nyirádi, J. (József), Ortolano, F. (Fabrizio), Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rhodes, J.K.J. (Jonathan K.J.), Richter, S. (Sophie), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Sahuquillo, J. (Juan), Sandrød, O. (Oddrun), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Schirmer-Mikalsen, K. (Kari), Schou, R. (Rico), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stocchetti, N. (Nino), Sundström, N. (Nina), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Tenovuo, O. (Olli), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van Der Steen, G. (Gregory), Van Dijck, J.T.J.M. (Jeroen T. J. M.), Van Essen, T.A. (Thomas A.), Van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Voormolen, D.C. (Daphne), Vulekovic, P. (Peter), Williams, G. (Guy), Winzeck, S. (Stefan), Wolf, S. (Stefan), Younsi, A. (Alexander), Zeiler, F.A. (Frederick A.), Ziverte, A. (Agate), Zoerle, T. (Tommaso), and Clusmann, H. (Hans)
Abstract: Background: The aim of this study is to validate a previously published consensus-based quality indicator set for the management of patients with traumatic brain injury (TBI) at intensive care units (ICUs) in Europe and to study its potential for quality measurement and improvement. Methods: Our analysis was based on 2006 adult patients admitted to 54 ICUs between 2014 and 2018, enrolled in the CENTER-TBI study. Indicator scores were calculated as percentage adherence for structure and process indicators and as event rates or median scores for outcome indicators. Feasibility was quantified by the completeness of the variables. Discriminability was determined by the between-centre variation, estimated with a random effect regression model adjusted for case-mix severity and quantified by the median odds ratio (MOR). Statistical uncertainty of outcome indicators was determined by the median number of events per centre, using a cut-off of 10. Results: A total of 26/42 indicators could be calculated from the CENTER-TBI database. Most quality indicators proved feasible to obtain with more than 70% completeness. Sub-optimal adherence was found for most quality indicators, ranging from 26 to 93% and 20 to 99% for structure and process indicators. Significant (p < 0.001) between-centre variation was found in seven process and five outcome indicators with MORs ranging from 1.51 to 4.14. Statistical uncertainty of outcome indicators was generally high; five out of seven had less than 10 events per centre. Conclusions: Overall, nine structures, five processes, but none of the outcome indicators showed potential for quality improvement purposes for TBI patients in the ICU. Future research should focus on implementation efforts and continuous reevaluation of quality indicators. Trial registration: The core study was registered with ClinicalTrials.gov, number NCT02210221, registered on August 06, 2014, with Resource Identification Portal (RRID: SCR_015582).
Published: 2020
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20. The volume-outcome relationship among severely injured patients admitted to English major trauma centres: A registry study

Author: Sewalt, C.A. (Charlie), Wiegers-Groeneweg, E.J.A. (Eveline), Lecky, F.E. (Fiona), Hartog, D. (Dennis) den, Klein Nagelvoort-Schuit, S.C.E. (Stephanie), Venema, E. (Esmee), Lingsma, H.F. (Hester), Sewalt, C.A. (Charlie), Wiegers-Groeneweg, E.J.A. (Eveline), Lecky, F.E. (Fiona), Hartog, D. (Dennis) den, Klein Nagelvoort-Schuit, S.C.E. (Stephanie), Venema, E. (Esmee), and Lingsma, H.F. (Hester)
Abstract: Background: Many countries have centralized and dedicated trauma centres with high volumes of trauma patients. However, the volume-outcome relationship in severely injured patients (Injury Severity Score (ISS) > 15) remains unclear. The aim of this study was to determine the association between hospital volume and outcomes in Major Trauma Centres (MTCs). Methods: A retrospective observational cohort study was conducted using the Trauma Audit and Research Network (TARN) consisting of all English Major Trauma Centres (MTCs). Severely injured patients (ISS > 15) admitted to a MTC between 2013 and 2016 were included. The effect of hospital volume on outcome was analysed with random effects logistic regression models with a random intercept for centre and was tested for nonlinearity. Primary outcome was in-hospital mortality. Results: A total of 47,157 severely injured patients from 28 MTCs were included in this study. Hospital volume varied from 69 to 781 severely injured patients per year. There were small between-centre differences in mortality after adjusting for important demographic and injury severity characteristics (adjusted 95% odds ratio range: 0.99-1.01). Hospital volume was found to be linear and not associated with in-hospital mortality (adjusted odds ratio (aOR) 1.02 per 10 patients, 95% confidence interval (CI) 0.68-1.54, p = 0.92). Conclusions: Despite the large variation in volume of the included MTCs, no relationship between hospital volume and outcome of severely injured patients was found. These results suggest that centres with similar structure and processes of care can achieve comparable outcomes in severely injured patients despite the number of severely injured patients they treat.
Published: 2020
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21. Predictors of persistent neck pain after whiplash injury

Author: Atherton, K., Wiles, N.J., Lecky, F.E., Hawes, S.J., Silman, A.J., Macfarlane, G.J., and Jones, G.T.
Subjects: Whiplash injuries -- Complications and side effects, Neck pain -- Risk factors, Neck pain -- Research, Traffic accidents -- Physiological aspects, Traffic accidents -- Research, Health
Published: 2006

22. Lack of change in trauma care in England and Wales since 1994

Author: Lecky, F.E., Woodford, M., Bouamra, O., and Yates, D.W.
Subjects: History, Hospitalization -- History, Trauma centers -- History, Hospital care -- History
Abstract: To demonstrate trends in trauma care in England and Wales from 1989 to 2000. Study population: Database of the Trauma Audit and Research Network that includes hospital patients admitted for [...]
Published: 2002

23. The volume-outcome relationship in severely injured patients: A systematic review and meta-analysis

Author: Sewalt, C.A., Wiegers, E.J.A., Venema, E., Lecky, F.E., Schuit, S.C.E., Hartog, D.D., and Lingsma, H.F.
Abstract: © 2018 Wolters Kluwer Health, Inc. All rights reserved. BACKGROUND The volume-outcome relationship in severely injured patients remains under debate and this has consequences for the designation of trauma centers. OBJECTIVES The aim of this study was to evaluate the relationship between hospital or surgeon volume and health outcomes in severely injured patients. METHODS Six electronic databases were searched from 1980 up to January 30, 2018, to identify studies that describe the relationship between hospital or surgeon volume and health outcomes in severely injured patients (preferably Injury Severity Score above 15). Selection of relevant studies, data extraction, and critical appraisal of the methodological quality were performed by two independent reviewers. Pooled adjusted and unadjusted estimates of the effect of volume on in-hospital mortality, only in study populations with Injury Severity Score greater than 15, were calculated with a random-effects meta-analysis. A mixed effects linear regression model was used to assess hospital volume as continuous parameter. RESULTS Eighteen observational cohort studies were included. The majority (13 [72%] of 18) reported an association between higher hospital or surgeon volume and lower mortality rate. Overall, the quality of the included studies was reasonable, with insufficient adjustment as one of the most common limitations. Eight studies were included in the meta-analysis with a total of 222,418 patients. High hospital volume (>240 admitted severely injured patients per year) was associated with a lower risk of mortality (adjusted odds ratio, 0.85; 95% confidence interval, 0.76-0.94). Four studies were included in the regression model, providing a beta of-0.17 per 10 patients (95% CI,-0.27 to-0.07). There was no clear association between surgeon volume and mortality rates based on three available studies. CONCLUSION Our systematic overview of the literature reveals a modest association between high-volume centers and lower mortality in severely injured patients, suggesting that designation of high-volume centers might improve outcomes among severely injured patients.
Published: 2018

24. Validating injury burden estimates using population birth cohorts and longitudinal cohort studies of injury outcomes: The VIBES-Junior study protocol

Author: Gabbe, B.J., Dipnall, J.F., Lynch, J.W., Rivara, F.P., Lyons, R.A., Ameratunga, S., Brussoni, M., Lecky, F.E., Bradley, C., Simpson, P.M., Beck, B., Demmler, J.C., Lyons, J., Schneeberg, A., and Harrison, J.E.
Abstract: © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Introduction Traumatic injury is a leading contributor to the global disease burden in children and adolescents, but methods used to estimate burden do not account for differences in patterns of injury and recovery between children and adults. A lack of empirical data on postinjury disability in children has limited capacity to derive valid disability weights and describe the long-term individual and societal impacts of injury in the early part of life. The aim of this study is to establish valid estimates of the burden of non-fatal injury in children and adolescents. Methods and analysis Five longitudinal studies of paediatric injury survivors 18 years at the time of injury (Australia, Canada, UK and USA) and two whole-of-population linked administrative data paediatric studies (Australia and Wales) will be analysed over a 3-year period commencing 2018. Meta-analysis of deidentified patient-level data (2,600) from five injury-specific longitudinal studies (Victorian State Trauma Registry; Victorian Orthopaedic Trauma Outcomes Registry; UK Burden of Injury; British Columbia Children's Hospital Longitudinal Injury Outcomes; Children's Health After Injury) and >1 million children from two whole-of-population cohorts (South Australian Early Childhood Data Project and Wales Electronic Cohort for Children). Systematic analysis of pooled injury-specific cohort data using a variety of statistical techniques, and parallel analysis of whole-of-population cohorts, will be used to develop estimated disability weights for years lost due to disability, establish appropriate injury classifications and explore factors influencing recovery. Ethics and dissemination The project was approved by the Monash University Human Research Ethics Committee project number 12 311. Results of this study will be submitted for publication in internationally peer-reviewed journals. The findings from this project have the capacity to improve the validity of paediatric injury burden measurements in future local and global burden of disease studies.
Published: 2018

25. Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI: a European prospective, multicentre, longitudinal, cohort study

Author: Steyerberg, E.W. (Ewout), Wiegers-Groeneweg, E.J.A. (Eveline), Sewalt, C.A. (Charlie), Buki, A. (Andras), Citerio, G. (Giuseppe), De Keyser, V. (Véronique), Ercole, A. (Ari), Kunzmann, K. (Kevin), Lanyon, L. (Linda), Lecky, F.E. (Fiona), Lingsma, H.F. (Hester), Manley, G. (Geoffrey), Nelson, D., Peul, W.C. (Wilco), Stocchetti, N. (Nino), Von Steinbüchel, N. (Nicole), Vande Vyvere, T. (Thijs), Verheyden, J. (Jan), Wilson, L. (Lindsay), Maas, A. (Arne), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Wiegers-Groeneweg, E.J.A. (Eveline), Sewalt, C.A. (Charlie), Buki, A. (Andras), Citerio, G. (Giuseppe), De Keyser, V. (Véronique), Ercole, A. (Ari), Kunzmann, K. (Kevin), Lanyon, L. (Linda), Lecky, F.E. (Fiona), Lingsma, H.F. (Hester), Manley, G. (Geoffrey), Nelson, D., Peul, W.C. (Wilco), Stocchetti, N. (Nino), Von Steinbüchel, N. (Nicole), Vande Vyvere, T. (Thijs), Verheyden, J. (Jan), Wilson, L. (Lindsay), Maas, A. (Arne), and Menon, D.K. (David )
Abstract: Background The burden of traumatic brain injury (TBI) poses a large public health and societal problem, but the characteristics of patients and their care pathways in Europe are poorly understood. We aimed to characterise patient case-mix, care pathways, and outcomes of TBI. Methods CENTER-TBI is a Europe-based, observational cohort study, consisting of a core study and a registry. Inclusion criteria for the core study were a clinical diagnosis of TBI, presentation fewer than 24 h after injury, and an indication for CT. Patients were differentiated by care pathway and assigned to the emergency room (ER) stratum (patients who were discharged from an emergency room), admission stratum (patients who were admitted to a hospital ward), or intensive care unit (ICU) stratum (patients who were admitted to the ICU). Neuroimage
Published: 2019
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26. Variation in the practice of tracheal intubation in Europe after traumatic brain injury: a prospective cohort study

Author: Gravesteijn, B.Y. (B. Y.), Sewalt, C.A. (C. A.), Ercole, A. (Ari), Lecky, F.E. (Fiona), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Maas, A.I.R. (Andrew), Lingsma, H.F. (Hester), Klimek, M. (Markus), Åkerlund, C. (C.), Adams, H. (H.), Amrein, K. (K.), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (A.), Audibert, G. (Gérard), Azouvi, P. (P.), Azzolini, M. (M.), Bartels, R.H.M.A. (Ronald), Beer, R. (R.), Bellander, B.-M. (Bo-Michael), Benali, H. (H.), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (M.), Borgen, L. (L.), Brorsson, C. (C.), Buki, A. (A.), Cabeleira, M. (M.), Caccioppola, A. (A.), Calappi, E. (E.), Calvi, M. (M.), Cameron, P. (Peter), Carbayo, L. (L.), Carbonara, M. (M.), León, A. (A.), Chevallard, G. (G.), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J. (J.), Correia, M. (M.), Cnossen, M.C. (Maryse), Czeiter, E. (Endre), Czosnyka, M. (Marek), Fizelier, C. (C.), De Keyser, V. (V.), Degos, V. (V.), Della Corte, F. (F.), den Boogert, H. (H.), Depreitere, B. (Bart), Dilvesi, D. (D.), Dixit, A. (A.), Donoghue, E. (E.), Dreier, J.P. (Jens), Dulière, G. (G.), Ercole Ari, A. (A.), Ezer, E. (E.), Fabricius, M. (Martin), Foks, K. (K.), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (A.), Galanaud, D. (Damien), Gantner, D. (D.), Ghuysen, A. (Alexandre), Giga, L. (L.), Golubovic, J. (J.), Gomez, P. (P.), Grossi, F. (F.), Gupta, D. (D.), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Hutchinson, P.J. (Peter J.), Jankowski, S. (S.), Karan, M. (M.), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (N.), Lagares, A. (Alfonso), Laureys, S. (Steven), Lightfoot, R. (Roger), Lingsma, H. (H.), Maas, A. (A.), Manara, A. (Alex), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (J.), McFadyen, C. (C.), McMahon, C. (C.), Menovsky, T. (Tomas), Mulazzi, D. (D.), Muraleedharan, V. (V.), Murray, L. (L.), Nair, N. (N.), Negru, A. (A.), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Q.), Nyirádi, J. (J.), Ortolano, F. (F.), Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Persona, P. (P.), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (A.), Ples, H. (Horia), Pomposo, I. (I.), Posti, J. (J.), Puybasset, L. (Louis), Radoi, A. (A.), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rhodes, J.K.J. (Jonathan K.J.), Richter, S. (S.), Rocka, S. (Saulius), Roe, C. (C.), Roise, O. (O.), Rosenfeld, J. (J.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Sahuquillo, J. (Juan), Sandro, O. (O.), Sakowitz, O. (Oliver), Porras, R. (R.), Schirmer-Mikalsen, K. (K.), Schou Rico, F. (F.), Smielewski, P. (P.), Sorinola, A. (A.), Stamatakis, E. (Emmanuel), Kowalk, A. (A.), Steyerberg, E. (E.), Stocchetti, N. (Nino), Sundström, N. (N.), Takala, R. (R.), Tamás, V. (V.), Tamosuitis, T. (T.), Tenovuo, O. (Olli), Thomas, M. (M.), Tibboel, D. (D.), Tolias, C.M. (Christos M.), Trapani, T. (T.), Tudora, C. (C.), Vajkoczy, P. (Peter), Vallance, S. (S.), Valeinis, E. (E.), Vámos, Z. (Z.), Van der Steen, G. (G.), van Dijck, J. (J.), van Essen, T. (T.), Vanhaudenhuyse, A. (A.), van Wijk, R. (R.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Voormolen, D. (D.), Vulekovic, P. (Peter), Williams, G. (Guy), Wolf, S. (Stefan), Younsi, A. (A.), Zeiler, F. (F.), Ziverte, A. (A.), Zoerle, T. (T.), Gravesteijn, B.Y. (B. Y.), Sewalt, C.A. (C. A.), Ercole, A. (Ari), Lecky, F.E. (Fiona), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Maas, A.I.R. (Andrew), Lingsma, H.F. (Hester), Klimek, M. (Markus), Åkerlund, C. (C.), Adams, H. (H.), Amrein, K. (K.), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (A.), Audibert, G. (Gérard), Azouvi, P. (P.), Azzolini, M. (M.), Bartels, R.H.M.A. (Ronald), Beer, R. (R.), Bellander, B.-M. (Bo-Michael), Benali, H. (H.), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (M.), Borgen, L. (L.), Brorsson, C. (C.), Buki, A. (A.), Cabeleira, M. (M.), Caccioppola, A. (A.), Calappi, E. (E.), Calvi, M. (M.), Cameron, P. (Peter), Carbayo, L. (L.), Carbonara, M. (M.), León, A. (A.), Chevallard, G. (G.), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J. (J.), Correia, M. (M.), Cnossen, M.C. (Maryse), Czeiter, E. (Endre), Czosnyka, M. (Marek), Fizelier, C. (C.), De Keyser, V. (V.), Degos, V. (V.), Della Corte, F. (F.), den Boogert, H. (H.), Depreitere, B. (Bart), Dilvesi, D. (D.), Dixit, A. (A.), Donoghue, E. (E.), Dreier, J.P. (Jens), Dulière, G. (G.), Ercole Ari, A. (A.), Ezer, E. (E.), Fabricius, M. (Martin), Foks, K. (K.), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (A.), Galanaud, D. (Damien), Gantner, D. (D.), Ghuysen, A. (Alexandre), Giga, L. (L.), Golubovic, J. (J.), Gomez, P. (P.), Grossi, F. (F.), Gupta, D. (D.), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Hutchinson, P.J. (Peter J.), Jankowski, S. (S.), Karan, M. (M.), Kolias, A.G. (Angelos G.), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (N.), Lagares, A. (Alfonso), Laureys, S. (Steven), Lightfoot, R. (Roger), Lingsma, H. (H.), Maas, A. (A.), Manara, A. (Alex), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (J.), McFadyen, C. (C.), McMahon, C. (C.), Menovsky, T. (Tomas), Mulazzi, D. (D.), Muraleedharan, V. (V.), Murray, L. (L.), Nair, N. (N.), Negru, A. (A.), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Q.), Nyirádi, J. (J.), Ortolano, F. (F.), Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Persona, P. (P.), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (A.), Ples, H. (Horia), Pomposo, I. (I.), Posti, J. (J.), Puybasset, L. (Louis), Radoi, A. (A.), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rhodes, J.K.J. (Jonathan K.J.), Richter, S. (S.), Rocka, S. (Saulius), Roe, C. (C.), Roise, O. (O.), Rosenfeld, J. (J.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Sahuquillo, J. (Juan), Sandro, O. (O.), Sakowitz, O. (Oliver), Porras, R. (R.), Schirmer-Mikalsen, K. (K.), Schou Rico, F. (F.), Smielewski, P. (P.), Sorinola, A. (A.), Stamatakis, E. (Emmanuel), Kowalk, A. (A.), Steyerberg, E. (E.), Stocchetti, N. (Nino), Sundström, N. (N.), Takala, R. (R.), Tamás, V. (V.), Tamosuitis, T. (T.), Tenovuo, O. (Olli), Thomas, M. (M.), Tibboel, D. (D.), Tolias, C.M. (Christos M.), Trapani, T. (T.), Tudora, C. (C.), Vajkoczy, P. (Peter), Vallance, S. (S.), Valeinis, E. (E.), Vámos, Z. (Z.), Van der Steen, G. (G.), van Dijck, J. (J.), van Essen, T. (T.), Vanhaudenhuyse, A. (A.), van Wijk, R. (R.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Voormolen, D. (D.), Vulekovic, P. (Peter), Williams, G. (Guy), Wolf, S. (Stefan), Younsi, A. (A.), Zeiler, F. (F.), Ziverte, A. (A.), and Zoerle, T. (T.)
Abstract: Traumatic brain injury patients frequently undergo tracheal intubation. We aimed to assess current intubation practice in Europe and identify variation in practice. We analysed data from patients with traumatic brain injury included in the prospective cohort study collaborative European neurotrauma effectiveness research in traumatic brain injury (CENTER-TBI) in 45 centres in 16 European countries. We included patients who were transported to hospital by emergency medical services. We used mixed-effects multinomial regression to quantify the effects on pre-hospital or in-hospital tracheal intubation of the following: patient characteristics; injury characteristics; centre; and trauma system characteristics. A total of 3843 patients were included. Of these, 1322 (34%) had their tracheas intubated; 839 (22%) pre-hospital and 483 (13%) in-hospital. The fit of the model with only patient characteristics predicting intubation was good (Nagelkerke R2 64%). The probability of tracheal intubation increased with the following: younger age; lower pre-hospital or emergency department GCS; higher abbreviated injury scale scores (head and neck, thorax and chest, face or abdomen abbreviated injury score); and one or more unreactive pupils. The adjusted median odds ratio for intubation between two randomly chosen centres was 3.1 (95%CI 2.1–4.3) for pre-hospital intubation, and 2.7 (95%CI 1.9–3.5) for in-hospital intubation. Furthermore, the presence of an anaesthetist was independently associated with more pre-hospital intubation (OR 2.9, 95%CI 1.3–6.6), in contrast to the presence of ambulance personnel who are allowed to intubate (OR 0.5, 95%CI 0.3–0.8). In conclusion, patient and injury characteristics are key drivers of tracheal intubation. Between-centre differences were also substantial. Further studies are needed to improve the evidence base supporting
Published: 2019
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27. Trauma models to identify major trauma and mortality in the prehospital setting

Author: Sewalt, C.A. (Charlie), Venema, E. (Esmee), Wiegers-Groeneweg, E.J.A. (Eveline), Lecky, F.E. (Fiona), Klein Nagelvoort-Schuit, S.C.E. (Stephanie), Hartog, D. (Dennis) den, Steyerberg, E.W. (Ewout), Lingsma, H.F. (Hester), Sewalt, C.A. (Charlie), Venema, E. (Esmee), Wiegers-Groeneweg, E.J.A. (Eveline), Lecky, F.E. (Fiona), Klein Nagelvoort-Schuit, S.C.E. (Stephanie), Hartog, D. (Dennis) den, Steyerberg, E.W. (Ewout), and Lingsma, H.F. (Hester)
Abstract: Background: Patients with major trauma might benefit from treatment in a trauma centre, but early identification of major trauma (Injury Severity Score (ISS) over 15) remains difficult. The aim of this study was to undertake an external validation of existing prognostic models for injured patients to assess their ability to predict mortality and major trauma in the prehospital setting. Methods: Prognostic models were identified through a systematic literature search up to October 2017. Injured patients transported by Emergency Medical Services to an English hospital from the Trauma Audit and Research Network between 2013 and 2016 were included. Outcome measures were major trauma (ISS over 15) and in-hospital mortality. The performance of the models was assessed in terms of discrimination (concordance index, C-statistic) and net benefit to assess the clinical usefulness. Results: A total of 154 476 patients were included to validate six previously proposed prediction models. Discriminative ability ranged from a C-statistic value of 0·602 (95 per cent c.i. 0·596 to 0·608) for the Mechanism, Glasgow Coma Scale, Age and Arterial
Published: 2019
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28. Prehospital Trauma Care among 68 European Neurotrauma Centers: Results of the CENTER-TBI Provider Pr

Author: Cnossen, M.C. (Maryse), Van Der Brande, R. (Ruben), Lingsma, H.F. (Hester), Polinder, S. (Suzanne), Lecky, F.E. (Fiona), Maas, A.I.R. (Andrew), Cnossen, M.C. (Maryse), Van Der Brande, R. (Ruben), Lingsma, H.F. (Hester), Polinder, S. (Suzanne), Lecky, F.E. (Fiona), and Maas, A.I.R. (Andrew)
Abstract: The first hour following traumatic brain injury (TBI) is considered crucial to prevent death and disability. It is, however, not established yet how the prehospital care should be organized to optimize recovery during the first hour. The objective of the current study was to examine variation in prehospital trauma care across Europe aiming to inform comparative effectiveness analyses on care for neurotrauma patients. A survey on prehospital trauma care was sent to 68 neurotrauma centers from 20 European countries participating in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study. The survey was developed using literature review and expert opinion and was pilot tested in 16 centers. All participants completed the questionnaire. Advanced life support was used in half of the centers (n = 35; 52%), whereas the other centers used mainly basic life support (n = 26; 38%). A mobile medical team (MMT) could be dispatched 24/7 in most centers (n = 66; 97%). Helicopters were used in approximately half of the centers to transport the MMT to the scene (n = 39; 57%) and the patient to the hospital (n = 31, 46%). Half of the centers used a stay-and-play approach at the scene (n = 37; 55%), while the others used a scoop-and-run approach or another policy. We found wide variation in prehospital trauma care across Europe. This may reflect differences in socio-economic situations, geographic differences, and a general lack of strong evidence for some aspects of prehospital care. The current variation provides the opportunity to study the effectiveness of prehospital interventions and systems of care in comparative effectiveness research.
Published: 2019
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29. Major trauma from suspected child abuse: A profile of the patient pathway

Author: Davies, F.C., Lecky, F.E., Fisher, R., Fragoso-Iiguez, M., and Coats, T.J.
Abstract: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. Background Networked organised systems of care for patients with major trauma now exist in many countries, designed around the needs of the majority of patients (90% adults). Non-accidental injury is a significant cause of paediatric major trauma and has a different injury and age profile from accidental injury (AI). This paper compares the prehospital and inhospital phases of the patient pathway for children with suspected abuse, with those accidentally injured. Methods The paediatric database of the national trauma registry of England and Wales, Trauma Audit and Research Network, was interrogated from April 2012 (the launch of the major trauma networks) to June 2015, comparing the patient pathway for cases of suspected child abuse (SCA) with AI. Results In the study population of 7825 children, 7344 (94%) were classified as AI and 481 (6%) as SCA. SCA cases were younger (median 0.4 years vs 7 years for AI), had a higher Injury Severity Score (median 16vs9 for AI), and had nearly three times higher mortality (5.7%vs2.2% for AI). Other differences included presentation to hospital evenly throughout the day and year, arrival by non-ambulance means to hospital (74%) and delayed presentation to hospital from the time of injury (median 8 hours vs 1.8 hours for AI). Despite more severe injuries, these infants were less likely to receive key interventions in a timely manner. Only 20% arrived to a designated paediatric-capable major trauma centre. Secondary transfer to specialist care, if needed, took a median of 21.6 hours from injury(vs 13.8 hours for AI). Conclusion These data show that children with major trauma that is inflicted rather than accidental follow a different pathway through the trauma system. The current model of major trauma care is not a good fit for the way in which child victims of suspected abuse present to healthcare. To achieve better care, awareness of this patient profile needs to increase, and trauma networks should adjust their conventional responses.
Published: 2017

30. Consensus-derived clinical decision rules to guide advanced imaging decisions for pulmonary embolism in pregnancy and the postpartum period

Author: Fuller, G.W., Nelson-Piercy, C., Hunt, B.J., Lecky, F.E., Thomas, S., Horspool, K., and Goodacre, S.
Published: 2017

31. Protocol for a multicentre randomised feasibility STUdy evaluating the impact of a prognostic model for Management of BLunt chest wall trauma patients: STUMBL trial

Author: Battle, C., Abbott, Z., Hutchings, H.A., Oâ Neill, C., Groves, S., Watkins, A., Lecky, F.E., Jones, S., Gagg, J., Body, R., and Evans, P.A.
Abstract: INTRODUCTION: A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). A definitive randomised controlled trial (impact trial) is required to assess the clinical and cost effectiveness of the new model before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design. \ud \ud METHODS/ANALYSIS: This feasibility trial is designed to test the methods of a multicentre, cluster-randomised (stepped- wedge) trial, with a substantial qualitative component. Four EDs in England and Wales will collect data for all blunt chest wall trauma patients over a 5-month period; in the initial period acting as the controls (normal care), and in the second period acting as the interventions (in which the new model will be used). Baseline measurements including completion of the SF-12v2 will be obtained on initial assessment in the ED. Patient outcome data will then be collected for any subsequent hospitalisations. Data collection will conclude with a 6-week follow-up completion of two surveys (SF-12v2 and Client Services Receipt Inventory). Analysis of outcomes will focus on feasibility, acceptability and trial processes and will include recruitment and retention rates, attendance at clinician training rates and use of model in the ED. Qualitative feedback will be obtained through clinician interviews and a research nurse focus group. An evaluation of the feasibility of health economics outcomes data will be completed. \ud \ud ETHICS AND DISSEMINATION: Wales Research Ethics Committee 6 granted approval for the trial in September 2016. Patient recruitment will commence in February 2017. Planned dissemination is through publication in a peer-reviewed Emergency Medicine Journal, presentation at appropriate conferences and to stakeholders at professional meetings. \ud \ud TRIAL REGISTRATION NUMBER: ISRCTN95571506; Pre-results.
Published: 2017

32. Differential effects of the Glasgow Coma Scale Score and its Components: An analysis of 54,069 patients with traumatic brain injury

Author: Reith, F.C.M., Lingsma, H.F., Gabbe, B.J., Lecky, F.E., Roberts, I., and Maas, A.I.R.
Abstract: INTRODUCTION: The Glasgow Coma Scale (GCS) is widely used in the assessment of clinical severity and prediction of outcome after traumatic brain injury (TBI). The sum score is frequently applied, but the differential influence of the components infrequently addressed. We aimed to investigate the contribution of the GCS components to the sum score, floor and ceiling effects of the components, and their prognostic effects. \ud \ud METHODS: Data on adult TBI patients were gathered from three data repositories: TARN (n=50,064), VSTR (n=14,062), and CRASH (n=9,941). Data on initial hospital GCS-assessment and discharge mortality were extracted. A descriptive analysis was performed to identify floor and ceiling effects. The relation between GCS and outcome was studied by comparing case fatality rates (CFR) between different component-profiles adding up to identical sum scores using Chi(2)-tests, and by quantifying the prognostic value of each component and sum score with Nagelkerke's R(2) derived from logistic regression analyses across TBI severities. \ud \ud RESULTS: In the range 3-7, the sum score is primarily determined by the motor component, as the verbal and eye components show floor-effects at sum scores 7 and 8, respectively. In the range 8-12, the effect of the motor component attenuates and the verbal and eye components become more relevant. The motor, eye and verbal scores reach their ceiling-effects at sum 13, 14 and 15, respectively. Significant variations were exposed in CFR between different component-profiles despite identical sum scores, except in sum scores 6 and 7. Regression analysis showed that the motor score had highest R(2) values in severe TBI patients, whereas the other components were more relevant at higher sum scores. The prognostic value of the three components combined was consistently higher than that of the sum score alone. \ud \ud CONCLUSION: The GCS-components contribute differentially across the spectrum of consciousness to the sum score, each having floor and ceiling effects. The specific component-profile is related to outcome and the three components combined contain higher prognostic value than the sum score across different TBI severities. We, therefore, recommend a multidimensional use of the three-component GCS both in clinical practice, and in prognostic studies.
Published: 2017

33. [Accepted Manuscript] Differential effects of the Glasgow Coma Scale Score and its Components: An analysis of 54,069 patients with traumatic brain injury

Author: Reith, F.C.M., Lingsma, H.F., Gabbe, B.J., Lecky, F.E., Roberts, I., and Maas, A.I.R.
Abstract: The Glasgow Coma Scale (GCS) is widely used in the assessment of clinical severity and prediction of outcome after traumatic brain injury (TBI). The sum score is frequently applied, but the differential influence of the components infrequently addressed. We aimed to investigate the contribution of the GCS components to the sum score, floor and ceiling effects of the components, and their prognostic effects. Data on adult TBI patients were gathered from three data repositories: TARN (n=50,064), VSTR (n=14,062), and CRASH (n=9,941). Data on initial hospital GCS-assessment and discharge mortality were extracted. A descriptive analysis was performed to identify floor and ceiling effects. The relation between GCS and outcome was studied by comparing case fatality rates (CFR) between different component-profiles adding up to identical sum scores using Chi(2)-tests, and by quantifying the prognostic value of each component and sum score with Nagelkerke's R(2) derived from logistic regression analyses across TBI severities. In the range 3-7, the sum score is primarily determined by the motor component, as the verbal and eye components show floor-effects at sum scores 7 and 8, respectively. In the range 8-12, the effect of the motor component attenuates and the verbal and eye components become more relevant. The motor, eye and verbal scores reach their ceiling-effects at sum 13, 14 and 15, respectively. Significant variations were exposed in CFR between different component-profiles despite identical sum scores, except in sum scores 6 and 7. Regression analysis showed that the motor score had highest R(2) values in severe TBI patients, whereas the other components were more relevant at higher sum scores. The prognostic value of the three components combined was consistently higher than that of the sum score alone. The GCS-components contribute differentially across the spectrum of consciousness to the sum score, each having floor and ceiling effects. The specific component-profile is related to outcome and the three components combined contain higher prognostic value than the sum score across different TBI severities. We, therefore, recommend a multidimensional use of the three-component GCS both in clinical practice, and in prognostic studies.
Published: 2017

34. Survival trends after surgery for acute subdural hematoma in adults over a 20-year period

Author: Fountain, D.M., Kolias, A.G., Lecky, F.E., Bouamra, O., Lawrence, T., Adams, H., Bond, S.J., and Hutchinson, P.J.
Abstract: Published by Wolters Kluwer Health, Inc.Objective: We sought to determine 30-day survival trends and prognostic factors following surgery for acute subdural hematomas (ASDHs) in England and Wales over a 20-year period. Summary of Background Data: ASDHs are still considered the most lethal type of traumatic brain injury. It remains unclear whether the adjusted odds of survival have improved significantly over time. Methods: Using the Trauma Audit and Research Network (TARN) database, we analyzed ASDH cases in the adult population (>16 yrs) treated surgically between 1994 and 2013. Two thousand four hundred ninety-eight eligible cases were identified. Univariable and multiple logistic regression analyses were performed, using multiple imputation for missing data. Results: The cohort was 74% male with a median age of 48.9 years. Over half of patients were comatose at presentation (53%). Mechanism of injury was due to a fall (2 m 24%), road traffic collision (25%), and other (17%). Thirty-six per cent of patients presented with polytrauma. Gross survival increased from 59% in 1994 to 1998 to 73% in 2009 to 2013. Under multivariable analysis, variables independently associated with survival were year of injury, Glasgow Coma Scale, Injury Severity Score, age, and pupil reactivity. The time interval from injury to craniotomy and direct admission to a neurosurgical unit were not found to be significant prognostic factors. Conclusions: A significant improvement in survival over the last 20 years was observed after controlling for multiple prognostic factors. Prospective trials and cohort studies are expected to elucidate the distribution of functional outcome in survivors.
Published: 2017

35. Ocular injuries in patients with major trauma

Author: Guly, C.M., Guly, H.R., Bouamra, O., Gray, R.H., and Lecky, F.E.
Subjects: Emergency medical services -- Management, Eye -- Injuries, Eye -- Research, Eye -- Causes of, Eye -- Diagnosis, Company business management, Health
Published: 2006

36. The volume-outcome relationship in severely injured patients: A systematic review and meta-analysis

Author: Sewalt, C.A. (Charlie A.), Wiegers, E.J.A. (Eveline J. A.), Venema, E. (Esmee), Lecky, F.E. (Fiona), Klein Nagelvoort-Schuit, S.C.E. (Stephanie), Hartog, D. (Dennis) den, Lingsma, H.F. (Hester), Sewalt, C.A. (Charlie A.), Wiegers, E.J.A. (Eveline J. A.), Venema, E. (Esmee), Lecky, F.E. (Fiona), Klein Nagelvoort-Schuit, S.C.E. (Stephanie), Hartog, D. (Dennis) den, and Lingsma, H.F. (Hester)
Abstract: BACKGROUND The volume-outcome relationship in severely injured patients remains under debate and this has consequences for the designation of trauma centers. OBJECTIVES The aim of this study was to evaluate the relationship between hospital or surgeon volume and health outcomes in severely injured patients. METHODS Six electronic databases were searched from 1980 up to January 30, 2018, to identify studies that describe the relationship between hospital or surgeon volume and health outcomes in severely injured patients (preferably Injury Severity Score above 15). Selection of relevant studies, data extraction, and critical appraisal of the methodological quality were performed by two independent reviewers. Pooled adjusted and unadjusted estimates of the effect of volume on in-hospital mortality, only in study populations with Injury Severity Score greater than 15, were calculated with a random-effects meta-analysis. A mixed effects linear regression model was used to assess hospital volume as continuous parameter. RESULTS Eighteen observational cohort studies were included. The majority (13 [72%] of 18) reported an association between higher hospital or surgeon volume and lower mortality rate. Overall, the quality of the included studies was reasonable, with insufficient adjustment as one of the most common limitations. Eight studies were included in the meta-analysis with a total of 222,418 patients. High hospital volume (>240 admitted severely injured patients per year) was associated with a lower risk of mortality (adjusted odds ratio, 0.85; 95% confidence interval, 0.76-0.94). Four studies were included in the regression model, providing a beta of-0.17 per 10 patients (95% CI,-0.27 to-0.07). There was no clear association between surgeon volume and mortality rates based on three available studies. CONCLUSION Our systematic overview of the literature reveals a modest association between high-volume centers and lower mortality in severely injured patients, suggest
Published: 2018
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37. Factors Affecting Mortality in Older Trauma Patients - A Systematic Review and Meta-analysis

Author: Sammy, I.A., Lecky, F.E., Sutton, A., Leaviss, J., and O'Cathain, A.
Published: 2016

38. Management of the anticoagulated trauma patient in the emergency department: A survey of current practice in England and Wales

Author: Battle, C.E., Lecky, F.E., Stacey, T., Edwards, A., and Evans, P.A.
Abstract: Objective The aim of this study was to investigate current management of the anticoagulated trauma patient in the emergency departments (EDs) in England and Wales. Methods A survey exploring management strategies for anticoagulated trauma patients presenting to the ED was developed with two patient scenarios concerning assessment of coagulation status, reversal of international normalised ratio (INR), management of hypotension and management strategies for each patient. Numerical data are presented as percentages of total respondents to that particular question. Results 106 respondents from 166 hospitals replied to the survey, with 24% of respondents working in a major trauma unit with a specialist neurosurgical unit. Variation was reported in the assessment and management strategies of the elderly anticoagulated poly-trauma patient described in scenario one. Variation was also evident in the responses between the neurosurgical and non-neurosurgical units for the headinjured, anticoagulated trauma patient in scenario two. Conclusion The results of this study highlight the similarities and variation in the management strategies used in the EDs in England and Wales for the elderly, anticoagulated trauma patient. The variations in practice reported may be due to the differences evident in the available guidelines for these patients.
Published: 2016

39. Quantifying the healthcare costs of treating severely bleeding major trauma patients: a national study for England

Author: Campbell, H.E., Stokes, E.A., Bargo, D.N., Curry, N., Lecky, F.E., Edwards, A., Woodford, M., Seeney, F., Eaglestone, S., Brohi, K., Gray, A.M., and Stanworth, S.J.
Abstract: INTRODUCTION: Severely bleeding trauma patients are a small proportion of the major trauma population but account for 40% of all trauma deaths. Healthcare resource use and costs are likely to be substantial but have not been fully quantified. Knowledge of costs is essential for developing targeted cost reduction strategies, informing health policy, and ensuring the cost-effectiveness of interventions. METHODS: In collaboration with the Trauma Audit Research Network (TARN) detailed patient-level data on in-hospital resource use, extended care at hospital discharge, and readmissions up to 12 months post-injury were collected on 441 consecutive adult major trauma patients with severe bleeding presenting at 22 hospitals (21 in England and one in Wales). Resource use data were costed using national unit costs and mean costs estimated for the cohort and for clinically relevant subgroups. Using nationally available data on trauma presentations in England, patient-level cost estimates were up-scaled to a national level. RESULTS: The mean (95% confidence interval) total cost of initial hospital inpatient care was £19,770 (£18,177 to £21,364) per patient, of which 62% was attributable to ventilation, intensive care, and ward stays, 16% to surgery, and 12% to blood component transfusion. Nursing home and rehabilitation unit care and re-admissions to hospital increased the cost to £20,591 (£18,924 to £22,257). Costs were significantly higher for more severely injured trauma patients (Injury Severity Score ≥15) and those with blunt injuries. Cost estimates for England were £148,300,000, with over a third of this cost attributable to patients aged 65 years and over. CONCLUSIONS: Severely bleeding major trauma patients are a high cost subgroup of all major trauma patients, and the cost burden is projected to rise further as a consequence of an aging population and as evidence continues to emerge on the benefits of early and simultaneous administration of blood products in pre-specified ratios. The findings from this study provide a previously unreported baseline from which the potential impact of changes to service provision and/or treatment practice can begin to be evaluated. Further studies are still required to determine the full costs of post-discharge care requirements, which are also likely to be substantial.
Published: 2015

40. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: A survey in 66 neurotrauma centers participating in the CENTER-TBI study

Author: Cnossen, M.C. (Maryse), Huijben, J.A. (Jilske A.), van der Jagt, M. (Mathieu), Volovici, V. (Victor), van Essen, T. (Thomas), Polinder, S. (Suzanne), Nelson, D. (David), Ercole, A. (Ari), Stocchetti, N. (Nino), Citerio, G. (Giuseppe), Peul, W.C. (Wilco), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Lingsma, H.F. (Hester F.), Adams, H. (Hadie), Alessandro, M. (Masala), Allanson, J.E. (Judith), Amrein, K. (Krisztina), Andaluz, N. (Norberto), Andelic, N. (Nada), Andrea, N. (Nanni), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Ardon, H. (Hilko), Audibert, G. (Gérard), Auslands, K. (Kaspars), Azouvi, P. (Philippe), Baciu, C. (Camelia), Bacon, A. (Andrew), Badenes, R. (Rafael), Baglin, T. (Trevor), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Bauerfeind, U. (Ursula), Beer, R. (Ronny), Belda, F.J. (Francisco Javier), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Bellier, R. (Rémy), Benali, H. (Habib), Benard, T. (Thierry), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beynon, C. (Christopher), Bilotta, F. (Federico), Binder, H. (Harald), Biqiri, E. (Erta), Blaabjerg, M. (Morten), Lund, S.B. (Stine Borgen), Bouzat, P. (Pierre), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brehar, F. (Felix), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Bucková, V. (Veronika), Calappi, E. (Emiliana), Cameron, P. (Peter), Carbayo, L.G. (Lozano Guillermo), Carise, E. (Elsa), Carpenter, K.L.H. (Keri L.H.), Castaño-León, A.M. (Ana M.), Causin, F. (Francesco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Cnossen, M. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Damas, F. (François), Damas, P. (Pierre), Dawes, H. (Helen), De Keyser, V. (Véronique), Corte, F.D. (Francesco), Depreitere, B. (Bart), Ding, S. (Shenghao), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dulière, G.-L. (Guy-Loup), Dzeko, A. (Adelaida), Eapen, G. (George), Engemann, H. (Heiko), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (V.), Feng, J. (Junfeng), Foks, K. (Kelly), Fossi, F. (Francesca), Francony, G. (Gilles), Frantzén, J. (Janek), Freo, U. (Ulderico), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Geleijns, K. (Karin), Ghuysen, A. (Alexandre), Giraud, B. (Benoit), Glocker, B. (Ben), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hertle, D. (Daniel), Hill, S. (Sean), Hoedemaekers, A. (Astrid), Hoefer, S. (Stefan), Hutchinson, P.J. (Peter J.), Håberg, K.A. (Kristine Asta), Jacobs, B.C. (Bart), Janciak, I. (Ivan), Janssens, K. (Koen), Jiang, J.-Y. (Ji-Yao), Jones, K. (Kelly), Kalala, J.-P. (Jean-Pierre), Kamnitsas, K. (Konstantinos), Karan, M. (Mladen), Karau, J. (Jana), Katila, A. (Ari), Kaukonen, M. (Maija), Keeling, D. (David), Kerforne, T. (Thomas), Ketharanathan, N. (Naomi), Kettunen, J. (Johannes), Kivisaari, R. (Riku), Kolias, A.G. (Angelos G.), Kolumbán, B. (Bálint), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kalovits, F. (Ferenc), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lauritzen, M. (Martin), Lecky, F.E. (Fiona), Ledig, C. (Christian), Lefering, R., Legrand, V. (Valerie), Lei, J. (Jin), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lozano, A. (Angels), Luddington, R. (Roger), Luijten-Arts, C. (Chantal), Maas, A.I.R. (Andrew I.R.), MacDonald, S. (Stephen), MacFayden, C. (Charles), Maegele, M. (Marc), Majdan, M. (Marek), Major, S. (Sebastian), Manara, A. (Alex), Manhes, P. (Pauline), Manley, G. (Geoffrey), Martin, D. (Didier), Martino, C. (Costanza), Maruenda, A. (Armando), Maréchal, H. (Hugues), Mastelova, D. (Dagmara), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D. (David), Menovsky, T. (Tomas), Morganti-Kossmann, C. (Cristina), Mulazzi, D. (Davide), Mutschler, M. (Manuel), Mühlan, H. (Holger), Negru, A. (Ancuta), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Oddo, M. (Mauro), Oldenbeuving, A.W., Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Patruno, A. (Adriana), Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W. (Wilco), Pichon, N. (Nicolas), Piilgaard, H. (Henning), Piippo, A. (Anna), Floury, S.P. (Sébastien Pili), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rehorcíková, V. (Veronika), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Rodier, N. (Nicolas), Roe, C. (Cecilie), Roise, O. (Olav), Roks, C.M.A.A. (Gerwin), Romegoux, P. (Pauline), Rosand, J. (Jonathan), Rosenfeld, J. (Jeffrey), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rostalski, T. (Tim), Rueckert, D. (Daniel), de Ruiz, A.F. (Arcaute Felix), Rusnák, M. (Martin), Sacchi, M. (Marco), Sahakian, B. (Barbara), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sala, F. (Francesca), Sanchez-Pena, P. (Paola), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Santos, E. (Edgar), Sasse, N. (Nadine), Sasu, L. (Luminita), Savo, D. (Davide), Schipper, I.B. (Inger), Schlößer, B. (Barbara), Schmidt, S. (Silke), Schneider, A. (Annette), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Rico, F.S. (Frederik Schou), Schwendenwein, E. (Elisabeth), Schöll, M. (Michael), Sir, O. (özcan), Skandsen, T. (Toril), Smakman, L. (Lidwien), Smeets, D. (Dominique), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stegemann, K. (Katrin), Steinbüchel, N. (Nicole), Stevens, R. (Robert), Stewart, W. (William), Sundström, N. (Nina), Synnot, A. (Anneliese), Szabó, J. (József), Söderberg, J. (Jeannette), Taccone, F.S. (Fabio), Tamás, V. (Viktória), Tanskanen, P. (Päivi), Tascu, A. (Alexandru), Taylor, M.S. (Mark Steven), Te, A.B. (Ao Braden), Tenovuo, O. (Olli), Teodorani, G. (Guido), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Tshibanda, J.-F.L. (Jean-Flory Luaba), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Valeinis, E. (Egils), Hecke, W.V. (Wim Van), Praag, D.V. (Dominique Van), Dirk, V.R. (Van Roost), Vlierberghe, E.V. (Eline Van), Vyvere, T.V. (Thijs vande), Vanhaudenhuyse, A. (Audrey), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Vizzino, G. (Giacinta), Vleggeert-Lankamp, C.L.A.M. (Carmen), Vulekovic, P. (Peter), Vámos, Z. (Zoltán), Wade, D. (Derick), Wang, K.K.W. (Kevin K.W.), Wang, L. (Lei), Wildschut, E.D. (Enno), Williams, G. (Guy), Willumsen, L. (Lisette), Wilson, A. (Adam), Wilson, L. (Lindsay), Winkler, M.K.L. (Maren K.L.), Ylén, P. (Peter), Younsi, A. (Alexander), Zaaroor, M. (Menashe), Zhang, Z. (Zhiqun), Zheng, Z. (Zelong), Zumbo, F. (Fabrizio), de Lange, S. (Stefanie), De Ruiter, G.C.W. (Godard C.W.), den Boogert, H. (Hugo), van Dijck, J. (Jeroen), Essen, T.A. (T.) van, van Heugten, C.M. (Caroline M.), Jagt, M. (Mathieu) van der, Naalt, J. (Joukje) van der, Cnossen, M.C. (Maryse), Huijben, J.A. (Jilske A.), van der Jagt, M. (Mathieu), Volovici, V. (Victor), van Essen, T. (Thomas), Polinder, S. (Suzanne), Nelson, D. (David), Ercole, A. (Ari), Stocchetti, N. (Nino), Citerio, G. (Giuseppe), Peul, W.C. (Wilco), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Lingsma, H.F. (Hester F.), Adams, H. (Hadie), Alessandro, M. (Masala), Allanson, J.E. (Judith), Amrein, K. (Krisztina), Andaluz, N. (Norberto), Andelic, N. (Nada), Andrea, N. (Nanni), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Ardon, H. (Hilko), Audibert, G. (Gérard), Auslands, K. (Kaspars), Azouvi, P. (Philippe), Baciu, C. (Camelia), Bacon, A. (Andrew), Badenes, R. (Rafael), Baglin, T. (Trevor), Bartels, R.H.M.A. (Ronald), Barzo, P. (P.), Bauerfeind, U. (Ursula), Beer, R. (Ronny), Belda, F.J. (Francisco Javier), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Bellier, R. (Rémy), Benali, H. (Habib), Benard, T. (Thierry), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beynon, C. (Christopher), Bilotta, F. (Federico), Binder, H. (Harald), Biqiri, E. (Erta), Blaabjerg, M. (Morten), Lund, S.B. (Stine Borgen), Bouzat, P. (Pierre), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brehar, F. (Felix), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Bucková, V. (Veronika), Calappi, E. (Emiliana), Cameron, P. (Peter), Carbayo, L.G. (Lozano Guillermo), Carise, E. (Elsa), Carpenter, K.L.H. (Keri L.H.), Castaño-León, A.M. (Ana M.), Causin, F. (Francesco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Cnossen, M. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Damas, F. (François), Damas, P. (Pierre), Dawes, H. (Helen), De Keyser, V. (Véronique), Corte, F.D. (Francesco), Depreitere, B. (Bart), Ding, S. (Shenghao), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dulière, G.-L. (Guy-Loup), Dzeko, A. (Adelaida), Eapen, G. (George), Engemann, H. (Heiko), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (V.), Feng, J. (Junfeng), Foks, K. (Kelly), Fossi, F. (Francesca), Francony, G. (Gilles), Frantzén, J. (Janek), Freo, U. (Ulderico), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Geleijns, K. (Karin), Ghuysen, A. (Alexandre), Giraud, B. (Benoit), Glocker, B. (Ben), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hertle, D. (Daniel), Hill, S. (Sean), Hoedemaekers, A. (Astrid), Hoefer, S. (Stefan), Hutchinson, P.J. (Peter J.), Håberg, K.A. (Kristine Asta), Jacobs, B.C. (Bart), Janciak, I. (Ivan), Janssens, K. (Koen), Jiang, J.-Y. (Ji-Yao), Jones, K. (Kelly), Kalala, J.-P. (Jean-Pierre), Kamnitsas, K. (Konstantinos), Karan, M. (Mladen), Karau, J. (Jana), Katila, A. (Ari), Kaukonen, M. (Maija), Keeling, D. (David), Kerforne, T. (Thomas), Ketharanathan, N. (Naomi), Kettunen, J. (Johannes), Kivisaari, R. (Riku), Kolias, A.G. (Angelos G.), Kolumbán, B. (Bálint), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kalovits, F. (Ferenc), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lauritzen, M. (Martin), Lecky, F.E. (Fiona), Ledig, C. (Christian), Lefering, R., Legrand, V. (Valerie), Lei, J. (Jin), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lozano, A. (Angels), Luddington, R. (Roger), Luijten-Arts, C. (Chantal), Maas, A.I.R. (Andrew I.R.), MacDonald, S. (Stephen), MacFayden, C. (Charles), Maegele, M. (Marc), Majdan, M. (Marek), Major, S. (Sebastian), Manara, A. (Alex), Manhes, P. (Pauline), Manley, G. (Geoffrey), Martin, D. (Didier), Martino, C. (Costanza), Maruenda, A. (Armando), Maréchal, H. (Hugues), Mastelova, D. (Dagmara), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D. (David), Menovsky, T. (Tomas), Morganti-Kossmann, C. (Cristina), Mulazzi, D. (Davide), Mutschler, M. (Manuel), Mühlan, H. (Holger), Negru, A. (Ancuta), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Oddo, M. (Mauro), Oldenbeuving, A.W., Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Patruno, A. (Adriana), Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W. (Wilco), Pichon, N. (Nicolas), Piilgaard, H. (Henning), Piippo, A. (Anna), Floury, S.P. (Sébastien Pili), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rehorcíková, V. (Veronika), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Rodier, N. (Nicolas), Roe, C. (Cecilie), Roise, O. (Olav), Roks, C.M.A.A. (Gerwin), Romegoux, P. (Pauline), Rosand, J. (Jonathan), Rosenfeld, J. (Jeffrey), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rostalski, T. (Tim), Rueckert, D. (Daniel), de Ruiz, A.F. (Arcaute Felix), Rusnák, M. (Martin), Sacchi, M. (Marco), Sahakian, B. (Barbara), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sala, F. (Francesca), Sanchez-Pena, P. (Paola), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Santos, E. (Edgar), Sasse, N. (Nadine), Sasu, L. (Luminita), Savo, D. (Davide), Schipper, I.B. (Inger), Schlößer, B. (Barbara), Schmidt, S. (Silke), Schneider, A. (Annette), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Rico, F.S. (Frederik Schou), Schwendenwein, E. (Elisabeth), Schöll, M. (Michael), Sir, O. (özcan), Skandsen, T. (Toril), Smakman, L. (Lidwien), Smeets, D. (Dominique), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stegemann, K. (Katrin), Steinbüchel, N. (Nicole), Stevens, R. (Robert), Stewart, W. (William), Sundström, N. (Nina), Synnot, A. (Anneliese), Szabó, J. (József), Söderberg, J. (Jeannette), Taccone, F.S. (Fabio), Tamás, V. (Viktória), Tanskanen, P. (Päivi), Tascu, A. (Alexandru), Taylor, M.S. (Mark Steven), Te, A.B. (Ao Braden), Tenovuo, O. (Olli), Teodorani, G. (Guido), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Tshibanda, J.-F.L. (Jean-Flory Luaba), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Valeinis, E. (Egils), Hecke, W.V. (Wim Van), Praag, D.V. (Dominique Van), Dirk, V.R. (Van Roost), Vlierberghe, E.V. (Eline Van), Vyvere, T.V. (Thijs vande), Vanhaudenhuyse, A. (Audrey), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Vizzino, G. (Giacinta), Vleggeert-Lankamp, C.L.A.M. (Carmen), Vulekovic, P. (Peter), Vámos, Z. (Zoltán), Wade, D. (Derick), Wang, K.K.W. (Kevin K.W.), Wang, L. (Lei), Wildschut, E.D. (Enno), Williams, G. (Guy), Willumsen, L. (Lisette), Wilson, A. (Adam), Wilson, L. (Lindsay), Winkler, M.K.L. (Maren K.L.), Ylén, P. (Peter), Younsi, A. (Alexander), Zaaroor, M. (Menashe), Zhang, Z. (Zhiqun), Zheng, Z. (Zelong), Zumbo, F. (Fabrizio), de Lange, S. (Stefanie), De Ruiter, G.C.W. (Godard C.W.), den Boogert, H. (Hugo), van Dijck, J. (Jeroen), Essen, T.A. (T.) van, van Heugten, C.M. (Caroline M.), Jagt, M. (Mathieu) van der, and Naalt, J. (Joukje) van der
Abstract: Background: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. Methods: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Results: The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n=60, 91%) and designated level I trauma centers (n=44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n=58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n=32, 48%), whereas the others were considered more conservative (n=34, 52%). Conclusions: Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research.
Published: 2017
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41. Variation in structure and process of care in traumatic brain injury: Provider profiles of European Neurotrauma Centers participating in the CENTER-TBI study

Author: Cnossen, M.C. (Maryse), Polinder, S. (Suzanne), Lingsma, H.F. (Hester F.), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Adams, H. (Hadie), Alessandro, M. (Masala), Allanson, J.E. (Judith), Amrein, K. (Krisztina), Andaluz, N. (Norberto), Andelic, N. (Nada), Andrea, N. (Nanni), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Ardon, H. (Hilko), Audibert, G. (Gérard), Auslands, K. (Kaspars), Azouvi, P. (Philippe), Baciu, C. (Camelia), Bacon, A. (Andrew), Badenes, R. (Rafael), Baglin, T. (Trevor), Bartels, R. (Ronald), Barzó, P. (Pál), Bauerfeind, U. (Ursula), Beer, R. (Ronny), Belda, F.J. (Francisco Javier), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Bellier, R. (Rémy), Benali, H. (Habib), Benard, T. (Thierry), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beynon, C. (Christopher), Bilotta, F. (Federico), Binder, H. (Harald), Biqiri, E. (Erta), Blaabjerg, M. (Morten), Borgen, L.S. (Lund Stine), Bouzat, P. (Pierre), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brehar, F. (Felix), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Bučková, V. (Veronika), Calappi, E. (Emiliana), Cameron, P. (Peter), Carbayo, L.G. (Lozano Guillermo), Carise, E. (Elsa), Carpenter, C., Castaño-León, A.M. (Ana M.), Causin, F. (Francesco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Damas, F. (François), Damas, P. (Pierre), Dawes, H. (Helen), De Keyser, V. (Véronique), Della Corte, F. (Francesco), Depreitere, B. (Bart), Ding, S. (Shenghao), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dulière, G.-L. (Guy-Loup), Dzeko, A. (Adelaida), Eapen, G. (George), Engemann, H. (Heiko), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (V.), Feng, J. (Junfeng), Foks, K. (Kelly), Fossi, F. (Francesca), Francony, G. (Gilles), Frantzén, J. (Janek), Freo, U. (Ulderico), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Geleijns, K. (Karin), Ghuysen, A. (Alexandre), Giraud, B. (Benoit), Glocker, B. (Ben), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hertle, D. (Daniel), Hill, S. (Sean), Hoedemaekers, A. (Astrid), Hoefer, S. (Stefan), Hutchinson, P.J. (Peter J.), Håberg, A.K. (Asta Kristine), Jacobs, B.C. (Bart), Janciak, I. (Ivan), Janssens, K. (Koen), Jiang, J.-Y. (Ji-Yao), Jones, K. (Kelly), Kalala, J.-P. (Jean-Pierre), Kamnitsas, K. (Konstantinos), Karan, M. (Mladen), Karau, J. (Jana), Katila, A. (Ari), Kaukonen, M. (Maija), Keeling, D. (David), Kerforne, T. (Thomas), Ketharanathan, N. (Naomi), Kettunen, J. (Johannes), Kivisaari, R. (Riku), Kolias, A.G. (Angelos G.), Kolumbán, B. (Bálint), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kalovits, F. (Ferenc), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lauritzen, M. (Martin), Lecky, F.E. (Fiona), Ledig, C. (Christian), Lefering, R., Legrand, V. (Valerie), Lei, J. (Jin), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lozano, A. (Angels), Luddington, R. (Roger), Luijten-Arts, C. (Chantal), MacDonald, S. (Stephen), MacFayden, C. (Charles), Maegele, M. (Marc), Majdan, M. (Marek), Major, S. (Sebastian), Manara, A. (Alex), Manhes, P. (Pauline), Manley, G. (Geoffrey), Martin, D. (Didier), Martino, C. (Costanza), Maruenda, A. (Armando), Maréchal, H. (Hugues), Mastelova, D. (Dagmara), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menovsky, T. (Tomas), Morganti-Kossmann, C. (Cristina), Mulazzi, D. (Davide), Mutschler, M. (Manuel), Mühlan, H. (Holger), Negru, A. (Ancuta), Nelson, D. (David), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Oddo, M. (Mauro), Oldenbeuving, A. (Annemarie), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Patruno, A. (Adriana), Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Pichon, N. (Nicolas), Piilgaard, H. (Henning), Piippo, A. (Anna), Pili, F.S. (Floury Sébastien), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rehorčíková, V. (Veronika), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Rodier, N. (Nicolas), Roe, C. (Cecilie), Roise, O. (Olav), Roks, G. (Gerwin), Romegoux, P. (Pauline), Rosand, J. (Jonathan), Rosenfeld, J. (Jeffrey), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rostalski, T. (Tim), Rueckert, D.L. (Danie L.), Ruiz De Arcaute, F. (Felix), Rusnák, M. (Martin), Sacchi, M. (Marco), Sahakian, B. (Barbara), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sala, F. (Francesca), Sanchez-Pena, P. (Paola), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Santos, E. (Edgar), Sasse, N. (Nadine), Sasu, L. (Luminita), Savo, D. (Davide), Schipper, I.B. (Inger), Schlößer, B. (Barbara), Schmidt, S. (Silke), Schneider, A. (Annette), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Schöll, M. (Michael), Sir, O. (Özcan), Skandsen, T. (Toril), Smakman, L. (Lidwien), Smeets, D. (Dirk), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E.L. (Emmanue L.), Stanworth, S. (Simon), Stegemann, K. (Katrin), Steinbüchel, N. (Nicole), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Szabó, J. (József), Söderberg, J. (Jeannette), Taccone, F.S. (Fabio), Tamás, V. (Viktória), Tanskanen, P. (Päivi), Tascu, A. (Alexandru), Taylor, M.S. (Mark Steven), Te Ao, B. (Braden), Tenovuo, O. (Olli), Teodorani, G. (Guido), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Tshibanda, J.-F.L. (Jean-Flory Luaba), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Valeinis, E. (Egils), Hecke, W. (Wim) van, Van Praag, D. (Dominique), Van Roost, D. (Dirk), Van Vlierberghe, E. (Eline), Vande Vyvere, T. (Thijs), Vanhaudenhuyse, A. (Audrey), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Vizzino, G. (Giacinta), Vleggeert-Lankamp, C.L.A.M. (Carmen), Volovici, V. (Victor), Vulekovic, P. (Peter), Vámos, Z. (Zoltán), Wade, D. (Derick), Wang, K.K.W. (Kevin K.W.), Wang, L. (Lei), Wildschut, E. (Eno), Williams, G. (Guy), Willumsen, L. (Lisette), Wilson, A. (Adam), Wilson, L. (Lindsay), Winkler, M.K.L. (Maren K. L.), Ylén, P. (Peter), Younsi, A. (Alexander), Zaaroor, M. (Menashe), Zhang, Z. (Zhiqun), Zheng, Z. (Zelong), Zumbo, F. (Fabrizio), De Lange, S. (Stefanie), De Ruiter, G.C.W. (Godard C.W.), Den Boogert, H. (Hugo), Van Dijck, J. (Jeroen), Essen, T.A. (T.) van, van Heugten, C.M. (Caroline M.), Jagt, M. (Mathieu) van der, Naalt, J. (Joukje) van der, Cnossen, M.C. (Maryse), Polinder, S. (Suzanne), Lingsma, H.F. (Hester F.), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Adams, H. (Hadie), Alessandro, M. (Masala), Allanson, J.E. (Judith), Amrein, K. (Krisztina), Andaluz, N. (Norberto), Andelic, N. (Nada), Andrea, N. (Nanni), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Ardon, H. (Hilko), Audibert, G. (Gérard), Auslands, K. (Kaspars), Azouvi, P. (Philippe), Baciu, C. (Camelia), Bacon, A. (Andrew), Badenes, R. (Rafael), Baglin, T. (Trevor), Bartels, R. (Ronald), Barzó, P. (Pál), Bauerfeind, U. (Ursula), Beer, R. (Ronny), Belda, F.J. (Francisco Javier), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Bellier, R. (Rémy), Benali, H. (Habib), Benard, T. (Thierry), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beynon, C. (Christopher), Bilotta, F. (Federico), Binder, H. (Harald), Biqiri, E. (Erta), Blaabjerg, M. (Morten), Borgen, L.S. (Lund Stine), Bouzat, P. (Pierre), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brehar, F. (Felix), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Bučková, V. (Veronika), Calappi, E. (Emiliana), Cameron, P. (Peter), Carbayo, L.G. (Lozano Guillermo), Carise, E. (Elsa), Carpenter, C., Castaño-León, A.M. (Ana M.), Causin, F. (Francesco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Damas, F. (François), Damas, P. (Pierre), Dawes, H. (Helen), De Keyser, V. (Véronique), Della Corte, F. (Francesco), Depreitere, B. (Bart), Ding, S. (Shenghao), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dulière, G.-L. (Guy-Loup), Dzeko, A. (Adelaida), Eapen, G. (George), Engemann, H. (Heiko), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (V.), Feng, J. (Junfeng), Foks, K. (Kelly), Fossi, F. (Francesca), Francony, G. (Gilles), Frantzén, J. (Janek), Freo, U. (Ulderico), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Geleijns, K. (Karin), Ghuysen, A. (Alexandre), Giraud, B. (Benoit), Glocker, B. (Ben), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hertle, D. (Daniel), Hill, S. (Sean), Hoedemaekers, A. (Astrid), Hoefer, S. (Stefan), Hutchinson, P.J. (Peter J.), Håberg, A.K. (Asta Kristine), Jacobs, B.C. (Bart), Janciak, I. (Ivan), Janssens, K. (Koen), Jiang, J.-Y. (Ji-Yao), Jones, K. (Kelly), Kalala, J.-P. (Jean-Pierre), Kamnitsas, K. (Konstantinos), Karan, M. (Mladen), Karau, J. (Jana), Katila, A. (Ari), Kaukonen, M. (Maija), Keeling, D. (David), Kerforne, T. (Thomas), Ketharanathan, N. (Naomi), Kettunen, J. (Johannes), Kivisaari, R. (Riku), Kolias, A.G. (Angelos G.), Kolumbán, B. (Bálint), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kalovits, F. (Ferenc), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lauritzen, M. (Martin), Lecky, F.E. (Fiona), Ledig, C. (Christian), Lefering, R., Legrand, V. (Valerie), Lei, J. (Jin), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lozano, A. (Angels), Luddington, R. (Roger), Luijten-Arts, C. (Chantal), MacDonald, S. (Stephen), MacFayden, C. (Charles), Maegele, M. (Marc), Majdan, M. (Marek), Major, S. (Sebastian), Manara, A. (Alex), Manhes, P. (Pauline), Manley, G. (Geoffrey), Martin, D. (Didier), Martino, C. (Costanza), Maruenda, A. (Armando), Maréchal, H. (Hugues), Mastelova, D. (Dagmara), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menovsky, T. (Tomas), Morganti-Kossmann, C. (Cristina), Mulazzi, D. (Davide), Mutschler, M. (Manuel), Mühlan, H. (Holger), Negru, A. (Ancuta), Nelson, D. (David), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Oddo, M. (Mauro), Oldenbeuving, A. (Annemarie), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Patruno, A. (Adriana), Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Pichon, N. (Nicolas), Piilgaard, H. (Henning), Piippo, A. (Anna), Pili, F.S. (Floury Sébastien), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rehorčíková, V. (Veronika), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Rodier, N. (Nicolas), Roe, C. (Cecilie), Roise, O. (Olav), Roks, G. (Gerwin), Romegoux, P. (Pauline), Rosand, J. (Jonathan), Rosenfeld, J. (Jeffrey), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rostalski, T. (Tim), Rueckert, D.L. (Danie L.), Ruiz De Arcaute, F. (Felix), Rusnák, M. (Martin), Sacchi, M. (Marco), Sahakian, B. (Barbara), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sala, F. (Francesca), Sanchez-Pena, P. (Paola), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Santos, E. (Edgar), Sasse, N. (Nadine), Sasu, L. (Luminita), Savo, D. (Davide), Schipper, I.B. (Inger), Schlößer, B. (Barbara), Schmidt, S. (Silke), Schneider, A. (Annette), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Schöll, M. (Michael), Sir, O. (Özcan), Skandsen, T. (Toril), Smakman, L. (Lidwien), Smeets, D. (Dirk), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E.L. (Emmanue L.), Stanworth, S. (Simon), Stegemann, K. (Katrin), Steinbüchel, N. (Nicole), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Szabó, J. (József), Söderberg, J. (Jeannette), Taccone, F.S. (Fabio), Tamás, V. (Viktória), Tanskanen, P. (Päivi), Tascu, A. (Alexandru), Taylor, M.S. (Mark Steven), Te Ao, B. (Braden), Tenovuo, O. (Olli), Teodorani, G. (Guido), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Tshibanda, J.-F.L. (Jean-Flory Luaba), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Valeinis, E. (Egils), Hecke, W. (Wim) van, Van Praag, D. (Dominique), Van Roost, D. (Dirk), Van Vlierberghe, E. (Eline), Vande Vyvere, T. (Thijs), Vanhaudenhuyse, A. (Audrey), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Vizzino, G. (Giacinta), Vleggeert-Lankamp, C.L.A.M. (Carmen), Volovici, V. (Victor), Vulekovic, P. (Peter), Vámos, Z. (Zoltán), Wade, D. (Derick), Wang, K.K.W. (Kevin K.W.), Wang, L. (Lei), Wildschut, E. (Eno), Williams, G. (Guy), Willumsen, L. (Lisette), Wilson, A. (Adam), Wilson, L. (Lindsay), Winkler, M.K.L. (Maren K. L.), Ylén, P. (Peter), Younsi, A. (Alexander), Zaaroor, M. (Menashe), Zhang, Z. (Zhiqun), Zheng, Z. (Zelong), Zumbo, F. (Fabrizio), De Lange, S. (Stefanie), De Ruiter, G.C.W. (Godard C.W.), Den Boogert, H. (Hugo), Van Dijck, J. (Jeroen), Essen, T.A. (T.) van, van Heugten, C.M. (Caroline M.), Jagt, M. (Mathieu) van der, and Naalt, J. (Joukje) van der
Abstract: Introduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Conclusion: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.
Published: 2016
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42. Collaborative European neurotrauma effectiveness research in traumatic brain injury (CENTER-TBI): A prospective longitudinal observational study

Author: Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Citerio, G. (Giuseppe), Lecky, F.E. (Fiona), Manley, G. (Geoffrey), Hill, S. (Sean), Legrand, V. (Valerie), Sorgner, A. (Annina), Andelic, N. (Nada), Andreassen, L. (Lasse), Andrews, P.J.D. (Peter), Audibert, G. (Gérard), Audny, A. (Anke), Azouv, P. (Philippe), Barzo, P. (P.), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Brazinova, A. (Alexandra), Binder, H. (Harald), Brehar, F. (Felix), Buki, A. (Andras), Bullinger, M. (Monika), Cakmak, E. (Ela), Callebaut, I. (Ina), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carpenter, K.L.H. (Keri L.H.), Chieregato, A. (Arturo), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J. (Jamie), Cnossen, M.C. (Maryse), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fitzelier, C. (Claire), Damas, F. (François), Dawes, H. (Helen), De Keyser, V. (Véronique), De Luca, A. (Alessandra), De Ruiter, G.C.W. (Godard C.W.), De Witte, O. (Olivier), Corte, F.D. (Francesco), Demeter, B. (Béla), Depreitere, B. (Bart), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dreier, J.P. (Jens), Eapen, G. (George), Ercole, A. (Ari), Esser, P. (Patrick), Fabricius, M. (Martin), Feremans, L. (Len), Feigin, V.L. (V.), Fossi, F. (Francesca), Forsyth, F. (Faye), Florian, S. (Stefan), Frisvold, S.K. (Shirin Kordasti), Frosini, C. (Caterina), Furmanov, A. (Alex), Frantzén, J. (Janek), Gadda, D. (Davide), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Ghuysen, A. (Alexandre), Godbolt, A. (Alison), Gonšorová, V. (Veronika), Grigore, Z. (Zapulih), Gruen, R.L. (Russell), Haagsma, J.A. (Juanita), Hallaert, G. (Giorgio), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hoefer, S. (Stefan), Holling, M. (Markus), Hunfeld, M. (Maayke), Hutchinson, P.J. (Peter J.), Illéš, R. (Robert), Janssens, K. (Koen), Bovend'Eerdt, T.J.H. (Thamar J.H.), Jiang, J.-Y. (Ji-Yao), Jones, K.M. (Kelly M.), Kalala, J.-P. (Jean-Pierre), Kalovits, F. (Ferenc), Kasprian, G. (Gregor), Katila, A. (Ari), Ketharanathan, N. (Naomi), Kolias, A.G. (Angelos G.), Kolibay, F. (Felix), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lefering, R., Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lohkamp, L.-N. (Laura-Nanna), Lötjönen, J. (Jyrki), Lumenta, C. (Christianto), Lyttle, M.D. (Mark), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Maréchal, H. (Hugues), Martino, C. (Costanza), Mascia, L. (Luciana), Mauritz, W. (Walter), McMahon, C. (Catherine), Menovsky, T. (Tomas), Mitchell, P. (Patrick), Mladenov, N. (Nikolay), Morganti-Kossmann, C. (Cristina), Nelson, D. (David), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Oddo, M. (Mauro), Oresic, M. (Matej), Orzalesi, V. (Vanni), Outtrim, J.G. (Joanne G.), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Peul, W.C. (Wilco), Pichon, N. (Nicolas), Piippo, A. (Anna), Floury, S.P. (Sébastien Pili), Ples, H. (Horia), Polinder, S. (Suzanne), Preiksaitis, A. (Aidanas), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Reiner, M. (Michael), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roosenfeld, J. (Jeffrey), Rosand, J. (Jonathan), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Rynkowski, M.A. (Michal A.), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sandor, J. (Janos), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schou, R. (Rico), Skandsen, T. (Toril), Sonne, M. (Morten), Schwendenwein, E. (Elisabeth), Smeets, D. (Dirk), Smieleweski, P. (Peter), Söderberg, J. (Jeannette), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stefini, R. (Roberto), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Stummer, W. (Walter), Szabó, J. (József), Tascu, A. (Alexandru), Tenovuo, O. (Olli), Theadom, A. (Alice), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Unterberg, A. (Andreas), Vajkoczy, P. (Peter), Vargiolu, A. (Alessia), Naalt, J. (Joukje) van der, Essen, T.A. (T.) van, Hecke, W. (Wim) van, Van Praag, D. (Dominique), Van Roost, D. (Dirk), Vandenbulcke, T. (Tim), Vande Hauwe, L. (Luc), Jagt, M. (Mathieu) van der, Vega, E. (Emmanuel), Verheyden, J. (Jan), Verma, V. (Vishwajit), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Von Steinbüchel, N. (Nicole), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wildschut, E. (Eno), Williams, G. (Guy), Wilson, M. (Mark), Wilson, L. (Lindsay), Wolf, S. (Stefan), Ylén, P. (Peter), Zaaroor, M. (Menashe), Zolfaghari, P. (Parjam), Martin, D. (Didier), D'Orio, V. (Vincenzo), Damas, P. (Pierre), Luaba Tshibanda, J.-F. (Jean-Flory), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Citerio, G. (Giuseppe), Lecky, F.E. (Fiona), Manley, G. (Geoffrey), Hill, S. (Sean), Legrand, V. (Valerie), Sorgner, A. (Annina), Andelic, N. (Nada), Andreassen, L. (Lasse), Andrews, P.J.D. (Peter), Audibert, G. (Gérard), Audny, A. (Anke), Azouv, P. (Philippe), Barzo, P. (P.), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Brazinova, A. (Alexandra), Binder, H. (Harald), Brehar, F. (Felix), Buki, A. (Andras), Bullinger, M. (Monika), Cakmak, E. (Ela), Callebaut, I. (Ina), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carpenter, K.L.H. (Keri L.H.), Chieregato, A. (Arturo), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J. (Jamie), Cnossen, M.C. (Maryse), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fitzelier, C. (Claire), Damas, F. (François), Dawes, H. (Helen), De Keyser, V. (Véronique), De Luca, A. (Alessandra), De Ruiter, G.C.W. (Godard C.W.), De Witte, O. (Olivier), Corte, F.D. (Francesco), Demeter, B. (Béla), Depreitere, B. (Bart), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dreier, J.P. (Jens), Eapen, G. (George), Ercole, A. (Ari), Esser, P. (Patrick), Fabricius, M. (Martin), Feremans, L. (Len), Feigin, V.L. (V.), Fossi, F. (Francesca), Forsyth, F. (Faye), Florian, S. (Stefan), Frisvold, S.K. (Shirin Kordasti), Frosini, C. (Caterina), Furmanov, A. (Alex), Frantzén, J. (Janek), Gadda, D. (Davide), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Ghuysen, A. (Alexandre), Godbolt, A. (Alison), Gonšorová, V. (Veronika), Grigore, Z. (Zapulih), Gruen, R.L. (Russell), Haagsma, J.A. (Juanita), Hallaert, G. (Giorgio), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hoefer, S. (Stefan), Holling, M. (Markus), Hunfeld, M. (Maayke), Hutchinson, P.J. (Peter J.), Illéš, R. (Robert), Janssens, K. (Koen), Bovend'Eerdt, T.J.H. (Thamar J.H.), Jiang, J.-Y. (Ji-Yao), Jones, K.M. (Kelly M.), Kalala, J.-P. (Jean-Pierre), Kalovits, F. (Ferenc), Kasprian, G. (Gregor), Katila, A. (Ari), Ketharanathan, N. (Naomi), Kolias, A.G. (Angelos G.), Kolibay, F. (Felix), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lefering, R., Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lohkamp, L.-N. (Laura-Nanna), Lötjönen, J. (Jyrki), Lumenta, C. (Christianto), Lyttle, M.D. (Mark), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Maréchal, H. (Hugues), Martino, C. (Costanza), Mascia, L. (Luciana), Mauritz, W. (Walter), McMahon, C. (Catherine), Menovsky, T. (Tomas), Mitchell, P. (Patrick), Mladenov, N. (Nikolay), Morganti-Kossmann, C. (Cristina), Nelson, D. (David), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Oddo, M. (Mauro), Oresic, M. (Matej), Orzalesi, V. (Vanni), Outtrim, J.G. (Joanne G.), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perlbarg, V. (Vincent), Peul, W.C. (Wilco), Pichon, N. (Nicolas), Piippo, A. (Anna), Floury, S.P. (Sébastien Pili), Ples, H. (Horia), Polinder, S. (Suzanne), Preiksaitis, A. (Aidanas), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Reiner, M. (Michael), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roosenfeld, J. (Jeffrey), Rosand, J. (Jonathan), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Rynkowski, M.A. (Michal A.), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sandor, J. (Janos), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schou, R. (Rico), Skandsen, T. (Toril), Sonne, M. (Morten), Schwendenwein, E. (Elisabeth), Smeets, D. (Dirk), Smieleweski, P. (Peter), Söderberg, J. (Jeannette), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stefini, R. (Roberto), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Stummer, W. (Walter), Szabó, J. (József), Tascu, A. (Alexandru), Tenovuo, O. (Olli), Theadom, A. (Alice), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Unterberg, A. (Andreas), Vajkoczy, P. (Peter), Vargiolu, A. (Alessia), Naalt, J. (Joukje) van der, Essen, T.A. (T.) van, Hecke, W. (Wim) van, Van Praag, D. (Dominique), Van Roost, D. (Dirk), Vandenbulcke, T. (Tim), Vande Hauwe, L. (Luc), Jagt, M. (Mathieu) van der, Vega, E. (Emmanuel), Verheyden, J. (Jan), Verma, V. (Vishwajit), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Von Steinbüchel, N. (Nicole), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wildschut, E. (Eno), Williams, G. (Guy), Wilson, M. (Mark), Wilson, L. (Lindsay), Wolf, S. (Stefan), Ylén, P. (Peter), Zaaroor, M. (Menashe), Zolfaghari, P. (Parjam), Martin, D. (Didier), D'Orio, V. (Vincenzo), Damas, P. (Pierre), and Luaba Tshibanda, J.-F. (Jean-Flory)
Abstract: BACKGROUND: Current classification of traumatic brain injury (TBI) is suboptimal, and management is based on weak evidence, with little attempt to personalize treatment. A need exists for new precision medicine and stratified management approaches that incorporate emerging technologies. OBJECTIVE: To improve characterization and classification of TBI and to identify best clinical care, using comparative effectiveness research approaches. METHODS: This multicenter, longitudinal, prospective, observational study in 22 countries across Europe and Israel will collect detailed data from 5400 consenting patients, presenting within 24 hours of injury, with a clinical diagnosis of TBI and an indication for computed tomography. Broader registry-level data collection in approximately 20 000 patients will assess generalizability. Cross sectional comprehensive outcome assessments, including quality of life and neuropsychological testing, will be performed at 6 months. Longitudinal assessments will continue up to 24 months post TBI in patient subsets. Advanced neuroimaging and genomic and biomarker data will be used to improve characterization, and analyses will include neuroinformatics approaches to address variations in process and clinical care. Results will be integrated with living systematic reviews in a process of knowledge transfer. The study initiation was from October to December 2014, and the recruitment period was for 18 to 24 months. EXPECTED OUTCOMES: Collaborative European NeuroTrauma Effectiveness Research in TBI should provide novel multidimensional approaches to TBI characterization and classification, evidence to support treatment recommendations, and benchmarks for quality of care. Data and sample repositories will ensure opportunities for legacy research. DISCUSSION: Comparative effectiveness research provides an alternative to reductionistic clinical trials in restricted patient populations by exploiting differences in biology, care, and outcome to support
Published: 2015
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43. Lack of Consistency in Threat to Life from Single Injury Abbreviated Injury Scale (AIS) 4 Codes in Different Body Areas

Author: Woodford, M., primary, Bouamra, O., additional, Wrotchford, A., additional, Yates, D.W., additional, and Lecky, F.E., additional
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44. Prediction of outcome after moderate and severe traumatic brain injury: External validation of the International Mission on Prognosis and Analysis of Clinical Trials (IMPACT) and Corticoid Randomisation after Significant Head injury (CRASH) prognostic models

Author: Roozenbeek, B. (Bob), Lingsma, H.F. (Hester), Lecky, F.E. (Fiona), Lu, J. (Juan), Weir, J. (James), Butcher, I. (Isabella), McHugh, G.S. (Gillian), Murray, G.D. (Gordon), Perel, P. (Pablo), Maas, A.I.R. (Andrew), Steyerberg, E.W. (Ewout), Roozenbeek, B. (Bob), Lingsma, H.F. (Hester), Lecky, F.E. (Fiona), Lu, J. (Juan), Weir, J. (James), Butcher, I. (Isabella), McHugh, G.S. (Gillian), Murray, G.D. (Gordon), Perel, P. (Pablo), Maas, A.I.R. (Andrew), and Steyerberg, E.W. (Ewout)
Abstract: Objective: The International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomisation After Significant Head injury prognostic models predict outcome after traumatic brain injury but have not been compared in large datasets. The objective of this is study is to validate externally and compare the International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomisation after Significant Head injury prognostic models for prediction of outcome after moderate or severe traumatic brain injury. Design: External validation study. Patients: We considered five new datasets with a total of 9,036 patients, comprising three randomized trials and two observational series, containing prospectively collected individual traumatic brain injury patient data. Measurements and Main Results: Outcomes were mortality and unfavorable outcome, based on the Glasgow Outcome Score at 6 months after injury. To assess performance, we studied the discrimination of the models (by area under the receiver operating characteristic curves), and calibration (by comparison of the mean observed to predicted outcomes and calibration slopes). The highest discrimination was found in the Trauma Audit and Research Network trauma registry (area under the receiver operating characteristic curves between 0.83 and 0.87), and the lowest discrimination in the Pharmos trial (area under the receiver operating characteristic curves between 0.65 and 0.71). Although differences in predictor effects between development and validation populations were found (calibration slopes varying between 0.58 and 1.53), the differences in discrimination were largely explained by differences in case mix in the validation studies. Calibration was good, the fraction of observed outcomes generally agreed well with the mean predicted outcome. No meaningful differences were noted in performance between the International Mission on Prognosis and Analysis of Clinical Trials and Corticoid Randomis
Published: 2012
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45. The epidemiology of major injury in the UK

Author: Alexandrescu, R., primary, Woodford, M., additional, O’Brien, S.J., additional, and Lecky, F.E., additional
Published: 2009
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46. Analysis of injuries and deaths caused by firearms in England and Wales

Author: Davies, M.J., primary and Lecky, F.E., additional
Published: 2009
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47. The Effect of Alcohol on the Lactate /Pyruvate Ratio in Injured Patients

Author: Lecky, F.E., primary, Barton, R.N., additional, Rainey, T., additional, Maycock, P.F., additional, Little, R.A., additional, and Yates, D.W., additional
Published: 1997
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48. Trauma care in England and Wales: is this as good as it gets? Outcome has plateaued since 1994 but varies significantly at trust level

Author: Lecky, F.E.
Subjects: Management, Statistics, Company business management, Intensive care units -- Management -- Statistics, Hospital admission and discharge -- Statistics, Trauma centers -- Management -- Statistics, Hospitals -- Admission and discharge
Abstract: This edition publishes an analysis from the TARN database suggesting that the case mix fatality for major trauma patients reaching hospital alive has not improved in England and Wales since [...]
Published: 2002

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