Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis
dc.date.accessioned | 2021-04-19T20:27:19Z | |
dc.date.available | 2021-04-19T20:27:19Z | |
dc.date.created | 2021-02-08T19:38:44Z | |
dc.date.issued | 2020 | |
dc.identifier.citation | Huijbers, Jilske Wiegers, E Lingsma, Hester F Citerio, Giuseppe Maas, Andrew I.R. Menon, David K Ercole, Ari Nelson, David van der Jagt, Mathieu Steyerberg, Ewout Helbok, Raimund Lecky, Fiona Peul, Wilco Birg, Tatiana Zoerle, Tomaso Carbonara, Marco Stocchetti, Nino Andelic, Nada Andreassen, Lasse Lund, Stine Borgen Frisvold, Shirin Helseth, Eirik Røe, Cecilie Røise, Olav Sandrød, Oddrun Schirmer-Mikalsen, Kari Vik, Anne Åkerlund, Cecilia Amrein, Krisztina Brorsson, Camilla Azzolini, Maria Luisa Bartels, Ronald Beer, Ronny Bellander, Bo-Michael Benali, Habib Berardino, Maurizio Beretta, Luigi Beqiri, Erta Blaabjerg, Morten Buki, Andras Cabeleira, Manuel Caccioppola, Alessio Calappi, Emaliana Calvi, Maria Rosa Cameron, Peter Guillermo, Carbayo Lozano Sundström, Nina Tibboel, Dick Ples, Horia Sakowitz, Oliver Ziverte, Agate . Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis. Intensive Care Medicine. 2020, 46(5), 995-1004 | |
dc.identifier.uri | http://hdl.handle.net/10852/85365 | |
dc.description.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 treatments (MOR = 2.9, p < 0.001); and smaller in 6-month outcome (MOR = 1.2, p = 0.01). Conclusions: Half of contemporary TBI patients at the ICU have mild to moderate head injury. Substantial between-center variations exist in ICU stay and treatment policies, and less so in outcome. It remains unclear whether admission of short-stay patients represents appropriate prudence or inappropriate use of clinical resources. | |
dc.language | EN | |
dc.rights | Attribution-NonCommercial 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | |
dc.title | Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis | |
dc.type | Journal article | |
dc.creator.author | Huijbers, Jilske | |
dc.creator.author | Wiegers, E | |
dc.creator.author | Lingsma, Hester F | |
dc.creator.author | Citerio, Giuseppe | |
dc.creator.author | Maas, Andrew I.R. | |
dc.creator.author | Menon, David K | |
dc.creator.author | Ercole, Ari | |
dc.creator.author | Nelson, David | |
dc.creator.author | van der Jagt, Mathieu | |
dc.creator.author | Steyerberg, Ewout | |
dc.creator.author | Helbok, Raimund | |
dc.creator.author | Lecky, Fiona | |
dc.creator.author | Peul, Wilco | |
dc.creator.author | Birg, Tatiana | |
dc.creator.author | Zoerle, Tomaso | |
dc.creator.author | Carbonara, Marco | |
dc.creator.author | Stocchetti, Nino | |
dc.creator.author | Andelic, Nada | |
dc.creator.author | Andreassen, Lasse | |
dc.creator.author | Lund, Stine Borgen | |
dc.creator.author | Frisvold, Shirin | |
dc.creator.author | Helseth, Eirik | |
dc.creator.author | Røe, Cecilie | |
dc.creator.author | Røise, Olav | |
dc.creator.author | Sandrød, Oddrun | |
dc.creator.author | Schirmer-Mikalsen, Kari | |
dc.creator.author | Vik, Anne | |
dc.creator.author | Åkerlund, Cecilia | |
dc.creator.author | Amrein, Krisztina | |
dc.creator.author | Brorsson, Camilla | |
dc.creator.author | Azzolini, Maria Luisa | |
dc.creator.author | Bartels, Ronald | |
dc.creator.author | Beer, Ronny | |
dc.creator.author | Bellander, Bo-Michael | |
dc.creator.author | Benali, Habib | |
dc.creator.author | Berardino, Maurizio | |
dc.creator.author | Beretta, Luigi | |
dc.creator.author | Beqiri, Erta | |
dc.creator.author | Blaabjerg, Morten | |
dc.creator.author | Buki, Andras | |
dc.creator.author | Cabeleira, Manuel | |
dc.creator.author | Caccioppola, Alessio | |
dc.creator.author | Calappi, Emaliana | |
dc.creator.author | Calvi, Maria Rosa | |
dc.creator.author | Cameron, Peter | |
dc.creator.author | Guillermo, Carbayo Lozano | |
dc.creator.author | Sundström, Nina | |
dc.creator.author | Tibboel, Dick | |
dc.creator.author | Ples, Horia | |
dc.creator.author | Sakowitz, Oliver | |
dc.creator.author | Ziverte, Agate | |
cristin.unitcode | 185,53,42,10 | |
cristin.unitname | Avdeling for fysikalsk medisin og rehabilitering | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.cristin | 1887838 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Intensive Care Medicine&rft.volume=46&rft.spage=995&rft.date=2020 | |
dc.identifier.jtitle | Intensive Care Medicine | |
dc.identifier.volume | 46 | |
dc.identifier.issue | 5 | |
dc.identifier.startpage | 995 | |
dc.identifier.endpage | 1004 | |
dc.identifier.doi | https://doi.org/10.1007/s00134-020-05965-z | |
dc.identifier.urn | URN:NBN:no-88020 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 0342-4642 | |
dc.identifier.fulltext | Fulltext https://www.duo.uio.no/bitstream/handle/10852/85365/1/Changing%2Bcare%2Bpathways%2Band%2Bbetween.pdf | |
dc.type.version | PublishedVersion | |
dc.relation.project | EU/602150 | |
dc.relation.project | NFR/272789 |
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