1. Quality indicators for patients with traumatic brain injury in European intensive care units: A CENTER-TBI study
- Author
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Huijben, Jilske A., Wiegers, Eveline J. A., Ercole, Ari, De Keizer, Nicolette F., Maas, Andrew I. R., Steyerberg, Ewout W., Citerio, Giuseppe, Wilson, Lindsay, Polinder, Suzanne, Nieboer, Daan, Menon, David, Lingsma, Hester F., Van Der Jagt, Mathieu, Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Beer, Ronny, Bellander, Bo-Michael, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Beqiri, Erta, Blaabjerg, Morten, Lund, Stine Borgen, Brorsson, Camilla, Buki, Andras, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, De Keyser, Véronique, Degos, Vincent, Corte, Francesco Della, Den Boogert, Hugo, Depreitere, Bart, Dilvesi, Dula, Dixit, Abhishek, Dreier, Jens, Dulière, Guy-Loup, Ezer, Erzsébet, Fabricius, Martin, Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Galanaud, Damien, Gantner, Dashiell, Ghuysen, Alexandre, Giga, Lelde, Golubovic, Jagos, Gomez, Pedro A., Grossi, Francesca, Gupta, Deepak, Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Hutchinson, Peter J., Jankowski, Stefan, Johnson, Faye, Karan, Mladen, Kolias, Angelos G., Kondziella, Daniel, Koraropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lejeune, Aurelie, Lightfoot, Roger, Manara, Alex, Martino, Costanza, Maréchal, Hugues, Mattern, Julia, McMahon, Catherine, Menovsky, Tomas, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nyirádi, József, Ortolano, Fabrizio, Payen, Jean-François, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Ples, Horia, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rhodes, Jonathan, Richter, Sophie, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Sahuquillo, Juan, Sandrød, Oddrun, Sakowitz, Oliver, Sanchez-Porras, Renan, Schirmer-Mikalsen, Kari, Schou, Rico Frederik, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Tenovuo, Olli, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Vajkoczy, Peter, Vallance, Shirley, Valeinis, Egils, Vámos, Zoltán, Van Der Steen, Gregory, Van Dijck, Jeroen T. J. M., Van Essen, Thomas A., Van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, Voormolen, Daphne, Vulekovic, Petar, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Younsi, Alexander, Zeiler, Frederick A., Ziverte, Agate, Zoerle, Tommaso, Clusmann, Hans, Huijben, J. A., Wiegers, E. J. A., Ercole, A., De Keizer, N. F., Maas, A. I. R., Steyerberg, E. W., Citerio, G., Wilson, L., Polinder, S., Nieboer, D., Menon, D., Lingsma, H. F., Van Der Jagt, M., Akerlund, C., Amrein, K., Andelic, N., Andreassen, L., Audibert, G., Azouvi, P., Azzolini, M. L., Bartels, R., Beer, R., Bellander, B. -M., Benali, H., Berardino, M., Beretta, L., Beqiri, E., Blaabjerg, M., Lund, S. B., Brorsson, C., Buki, A., Cabeleira, M., Caccioppola, A., Calappi, E., Calvi, M. R., Cameron, P., Lozano, G. C., Carbonara, M., Castano-Leon, A. M., Cavallo, S., Chevallard, G., Chieregato, A., Coburn, M., Coles, J., Cooper, J. D., Correia, M., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Dark, P., De Keyser, V., Degos, V., Corte, F. D., Den Boogert, H., Depreitere, B., Dilvesi, D., Dixit, A., Dreier, J., Duliere, G. -L., Ezer, E., Fabricius, M., Foks, K., Frisvold, S., Furmanov, A., Galanaud, D., Gantner, D., Ghuysen, A., Giga, L., Golubovic, J., Gomez, P. A., Grossi, F., Gupta, D., Haitsma, I., Helbok, R., Helseth, E., Hutchinson, P. J., Jankowski, S., Johnson, F., Karan, M., Kolias, A. G., Kondziella, D., Koraropoulos, E., Koskinen, L. -O., Kovacs, N., Kowark, A., Lagares, A., Laureys, S., Lecky, F., Ledoux, D., Lejeune, A., Lightfoot, R., Manara, A., Martino, C., Marechal, H., Mattern, J., Mcmahon, C., Menovsky, T., Misset, B., Muraleedharan, V., Murray, L., Negru, A., Nelson, D., Newcombe, V., Nyiradi, J., Ortolano, F., Payen, J. -F., Perlbarg, V., Persona, P., Peul, W., Piippo-Karjalainen, A., Ples, H., Pomposo, I., Posti, J. P., Puybasset, L., Radoi, A., Ragauskas, A., Raj, R., Rhodes, J., Richter, S., Rocka, S., Roe, C., Roise, O., Rosenfeld, J. V., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Sahuquillo, J., Sandrod, O., Sakowitz, O., Sanchez-Porras, R., Schirmer-Mikalsen, K., Schou, R. F., Smielewski, P., Sorinola, A., Stamatakis, E., Stocchetti, N., Sundstrom, N., Takala, R., Tamas, V., Tamosuitis, T., Tenovuo, O., Thomas, M., Tibboel, D., Tolias, C., Trapani, T., Tudora, C. M., Vajkoczy, P., Vallance, S., Valeinis, E., Vamos, Z., Van Der Steen, G., Van Dijck, J. T. J. M., Van Essen, T. A., Van Wijk, R. P. J., Vargiolu, A., Vega, E., Vik, A., Vilcinis, R., Volovici, V., Voormolen, D., Vulekovic, P., Williams, G., Winzeck, S., Wolf, S., Younsi, A., Zeiler, F. A., Ziverte, A., Zoerle, T., Clusmann, H., Ragauskas, Arminas, Ročka, Saulius, Tamošuitis, Tomas, Vilcinis, Rimantas, Rocka, Saulius, Tamosuitis, Tomas, „Springer' grupė, Public Health, Neurosurgery, Intensive Care, Huijben, J, Wiegers, E, Ercole, A, de Keizer, N, Maas, A, Steyerberg, E, Citerio, G, Wilson, L, Polinder, S, Nieboer, D, Menon, D, Lingsma, H, van der Jagt, M, Huijben, Jilske A. [0000-0002-2892-5406], Citerio, Giuseppe [0000-0002-5374-3161], Apollo - University of Cambridge Repository, Huijben, Jilske A [0000-0002-2892-5406], Ercole, Ari [0000-0001-8350-8093], Medical Informatics, APH - Methodology, APH - Quality of Care, and APH - Digital Health
- Subjects
Adult ,Male ,benchmarking ,intensive care units ,quality indicators ,quality of health care ,traumatic brain injuries ,medicine.medical_specialty ,Quality management ,Traumatic brain injury ,Quality indicator ,Quality indicators ,Critical Care and Intensive Care Medicine ,Traumatic brain injuries ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,Brain Injuries, Traumatic ,medicine ,Humans ,Intensive care unit ,030212 general & internal medicine ,Quality Indicators, Health Care ,Intensive care units ,business.industry ,Data Collection ,Research ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Quality measurement ,Regression analysis ,lcsh:RC86-88.9 ,Odds ratio ,Middle Aged ,medicine.disease ,Random effects model ,Quality Improvement ,Europe ,Benchmarking ,Emergency medicine ,Quality of health care ,Female ,Human medicine ,business ,030217 neurology & neurosurgery - 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 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