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51. Mild Traumatic Brain Injury Disrupts Functional Dynamic Attractors of Healthy Mental States

Author

van der Naalt J, Andrew R. Mayer, van der Horn Hj, Victor M. Vergara, Flor A. Espinoza, and Vince D. Calhoun

Subjects
business.industry, Traumatic brain injury, Resting fmri, Functional connectivity, 05 social sciences, Human brain, medicine.disease, 050105 experimental psychology, 03 medical and health sciences, 0302 clinical medicine, Brain state, medicine.anatomical_structure, Attractor, medicine, 0501 psychology and cognitive sciences, Set (psychology), business, Neuroscience, 030217 neurology & neurosurgery, Dynamic functional connectivity
Abstract

The human brain has the ability of changing its wiring configuration by increasing or decreasing functional connectivity strength between specific areas. Variable but recurring configuration patterns in dynamic functional connectivity have been observed during resting fMRI experiments, patterns which are defined as dynamic brain states. The question arises whether in a regular healthy brain these states evolve in a random fashion or in a specific sequential order. The current work reveals both the specific state sequence in healthy brains, as well as the set of disruptions in this sequence produced by traumatic brain injury. The healthy sequence consists of oscillatory dynamic connectivity patterns that orbit an attractor state in a high dimensional space. Using discovery (96 subjects) and replication (74 subjects) cohorts, this study demonstrated that mild traumatic brain injury results in immediate orbital disruptions that recover over time. Brain dynamics enter a status of disrupted orbits right after injury, with partial recovery at 4 weeks, and full recovery at 3 months post-injury. In summary, our results describe an aspect of neuronal dysfunction in mild traumatic brain injury that is fully based on brain state dynamics, and different from traditional brain connectivity strength measures.

Published
2019

52. Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study (vol 161, pg 453, 2019)

Author

den Boogert H, Cnossen M, Lingsma H, Peul W, Ackerlund C, Adams H, Agnoletti V, Allanson J, Amrein K, Andaluz N, Andelic N, Andreassen L, Antun A, Anke A, Antoni A, Ardon H, Audibert G, Auslands K, Azouvi P, Azzolini M, Baciu C, Badenes R, Bartels R, Barzo P, Bauerfeind U, Beauvais R, Beer R, Belda F, Bellander B, Belli A, Bellier R, Benali H, Benard T, Berardino M, Beretta L, Beynon C, Bilotta F, Binder H, Biqiri E, Blaabjerg M, Bouzat P, Bragge P, Brazinova A, Brinck V, Brooker J, Brorsson C, Buki A, Bullinger M, Calappi E, Calvi M, Cameron P, Carbayo L, Carbonara M, Carise E, Carpenter K, Castano-Leon A, Causin F, Chevallard G, Chieregato A, Citerio G, Coburn M, Coles J, Coles-Kemp L, Collett J, Cooper J, Correia M, Covic A, Curry N, Czeiter E, Czosnyka M, Dahyot-Fizelier C, Damas F, Damas P, Dawes H, De Keyser V, Francesco D, Depreitere B, de Ruiter G, Dilvesi D, Ding S, Dippel D, Dixit A, Donoghue E, Dreier J, Duliere G, Eapen G, Engemann H, Ercole A, Esser P, Ezer E, Fabricius M, Feigin V, Feng J, Foks K, Fossi F, Francony G, Freo U, Frisvold S, Furmanov A, Gagliardo P, Galanaud D, Gantner D, Gao G, Geleijns K, George P, Ghuysen A, Giga L, Giraud B, Ben Glocker, Golubovic J, Gomez P, Grossi F, Gruen R, Gupta D, Haagsma J, Haitsma I, Hartings J, Helbok R, Helseth E, Hertle D, Hoedemaekers A, Hoefer S, Horton L, Huijben J, Hutchinson P, Haberg A, Jacobs B, Jankowski S, Jarrett M, Jelaca B, Jiang J, Jones K, Kamnitsas K, Karan M, Katila A, Kaukonen M, Kerforne T, Kivisaari R, Kolias A, Kolumban B, Kompanje E, Kolundzija K, Kondziella D, Koskinen L, Kovacs N, Lagares A, Lanyon L, Laureys S, Lecky F, Ledig C, Lefering R, Legrand V, Lei J, Levi L, Lightfoot R, Loeckx D, Lozano A, Maas A, MacDonald S, Maegele M, Majdan M, Major S, Manara A, Manley G, Martin D, Martin L, Martino C, Maruenda A, Marechal H, Masala A, Mattern J, McFadyen C, McMahon C, Melegh B, Menon D, Menovsky T, Morganti-Kossmann C, Mulazzi D, Muraleedharan V, Murray L, Muhlan H, Nair N, Negru A, Nelson D, Newcombe V, Nieboer D, Noirhomme Q, Nyiradi J, Oddo M, Oldenbeuving A, Oresic M, Ortolano F, Palotie A, Parizel P, Patruno A, Payen J, Perera N, Perlbarg V, Persona P, Piippo-Karjalainen A, Pili F, Pirinen M, Ples H, Poca M, Polinder S, Pomposo I, Posti J, Puybasset L, Radoi A, Ragauskas A, Raj R, Rambadagalla M, Real R, Rehorcikova V, Rhodes J, Ripatti S, Rocka S, Roe C, Roise O, Roks G, Rosand J, Rosenfeld J, Rosenlund C, Rosenthal G, Rossaint R, Rossi S, Rueckert D, Rusnak M, Sacchi M, Sahakian B, Sahuquillo J, Sakowitz O, Sala F, Sanchez-Porras R, Sandor J, Santos E, Sasu L, Savo D, Schaffer N, Schipper I, Schlosser B, Schmidt S, Schoechl H, Schoonman G, Schou R, Schwendenwein E, Scholl M, Sir O, Skandsen T, Smakman L, Smeets D, Smielewski P, Sorinola A, Stamatakis E, Stanworth S, Steinbuchel N, Stevanovic A, Stevens R, Stewart W, Steyerberg E, Stocchetti N, Sundstrom N, Synnot A, Taccone F, Takala R, Tamas V, Tanskanen P, Taylor M, Ao B, Tenovuo O, Telgmann R, Teodorani G, Theadom A, Thomas M, Tibboel D, Tolias C, Tshibanda J, Trapani T, Tudora C, Vajkoczy P, Vallance S, Valeinis E, Van der Steen G, van der Jagt M, van der Naalt J, van Dijck J, van Essen T, van Hecke W, van Heugten C, van Praag D, Vyvere T, Van Waesberghe J, Vanhaudenhuyse A, Vargiolu A, Vega E, Velt K, Verheyden J, Vespa P, Vik A, Vilcinis R, Vizzino G, Vleggeert-Lankamp C, Volovici V, Voormolen D, Vulekovic P, Vamos Z, Wade D, Wang K, Wang L, Wessels L, Wildschut E, Williams G, Wilson L, Winkler M, Wolf S, Ylen P, Younsi A, Zaaroor M, Yang Z, Ziverte A, Zumbo F, and CENTER-TBI Investigators

Published
2019

53. 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, Wiegers, E, Sewalt, C, Buki, A, Citerio, G, De Keyser, V, Ercole, A, Kunzmann, K, Lanyon, L, Lecky, F, Lingsma, H, Manley, G, Nelson, D, Peul, W, Stocchetti, N, von Steinbüchel, N, Vande Vyvere, T, Verheyden, J, Wilson, L, Maas, A, Menon, D, Ackerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Auslands, K, Azouvi, P, Azzolini, M, Badenes, R, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castaño-León, A, Chevallard, G, Chieregato, A, Cnossen, M, Coburn, M, Coles, J, Cooper, J, Correia, M, Čović, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dawes, H, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dijkland, S, Đilvesi, Đ, Dixit, A, Donoghue, E, Dreier, J, Dulière, G, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubović, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koraropoulos, E, Koskinen, L, Kovács, N, Lagares, A, Laureys, S, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lozano, A, Maegele, M, Majdan, M, Manara, A, Maréchal, H, Martino, C, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Mulazzi, D, Muraleedharan, V, Murray, L, Nair, N, Negru, A, Newcombe, V, Nieboer, D, Noirhomme, Q, Nyirádi, J, Oddo, M, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Piippo-Karjalainen, A, Pili Floury, S, Pirinen, M, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Rădoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Real, R, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnák, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schäfer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevanovic, A, Stevens, R, Stewart, W, Sundström, N, Synnot, A, Takala, R, Tamás, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Vajkoczy, P, Valeinis, E, Vallance, S, Vámos, Z, van der Naalt, J, Van der Steen, G, van Dijck, J, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Wijk, R, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Velt, K, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, Voormolen, D, Vulekovic, P, Wang, K, Williams, G, Winzeck, S, Wolf, S, Yang, Z, Ylén, P, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Steyerberg, Ewout W, Wiegers, Eveline, Sewalt, Charlie, Buki, Andras, Citerio, Giuseppe, De Keyser, Véronique, Ercole, Ari, Kunzmann, Kevin, Lanyon, Linda, Lecky, Fiona, Lingsma, Hester, Manley, Geoffrey, Nelson, David, Peul, Wilco, Stocchetti, Nino, von Steinbüchel, Nicole, Vande Vyvere, Thijs, Verheyden, Jan, Wilson, Lindsay, Maas, Andrew I R, Menon, David K, Ackerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Auslands, Kaspars, Azouvi, Philippe, Azzolini, Maria Luisa, Badenes, Rafael, Bartels, Ronald, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Castaño-León, Ana M, Chevallard, Giorgio, Chieregato, Arturo, Cnossen, Maryse, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D, Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dawes, Helen, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Dijkland, Simone, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L, Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubović, Jagoš, Gomez, Pedro A, Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L, Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J, Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Jones, Kelly, Karan, Mladen, Kolias, Angelos G, Kompanje, Erwin, Kondziella, Daniel, Koraropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Lagares, Alfonso, Laureys, Steven, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lozano, Angels, Maegele, Marc, Majdan, Marek, Manara, Alex, Maréchal, Hugues, Martino, Costanza, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menovsky, Tomas, Mulazzi, Davide, Muraleedharan, Visakh, Murray, Lynnette, Nair, Nandesh, Negru, Ancuta, Newcombe, Virginia, Nieboer, Daan, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Oresic, Matej, Ortolano, Fabrizio, Otesile, Olubukola, Palotie, Aarno, Parizel, Paul M, Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Piippo-Karjalainen, Anna, Pili Floury, Sébastien, Pirinen, Matti, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P, Puybasset, Louis, Rădoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Real, Ruben, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey V, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rueckert, Daniel, Rusnák, Martin, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevanovic, Ana, Stevens, Robert, Stewart, William, Sundström, Nina, Synnot, Anneliese, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Taylor, Mark Steven, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Timmers, Marjolijn, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Vajkoczy, Peter, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, van der Naalt, Joukje, Van der Steen, Gregory, van Dijck, Jeroen T J M, van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, van Wijk, Roel P J, Vanhaudenhuyse, Audrey, Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Vespa, Paul M, Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, Voormolen, Daphne, Vulekovic, Petar, Wang, Kevin K W, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A, Zelinkova, Veronika, Ziverte, Agate, Zoerle, Tommaso, Steyerberg, E, Wiegers, E, Sewalt, C, Buki, A, Citerio, G, De Keyser, V, Ercole, A, Kunzmann, K, Lanyon, L, Lecky, F, Lingsma, H, Manley, G, Nelson, D, Peul, W, Stocchetti, N, von Steinbüchel, N, Vande Vyvere, T, Verheyden, J, Wilson, L, Maas, A, Menon, D, Ackerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Auslands, K, Azouvi, P, Azzolini, M, Badenes, R, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castaño-León, A, Chevallard, G, Chieregato, A, Cnossen, M, Coburn, M, Coles, J, Cooper, J, Correia, M, Čović, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dawes, H, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dijkland, S, Đilvesi, Đ, Dixit, A, Donoghue, E, Dreier, J, Dulière, G, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubović, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koraropoulos, E, Koskinen, L, Kovács, N, Lagares, A, Laureys, S, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lozano, A, Maegele, M, Majdan, M, Manara, A, Maréchal, H, Martino, C, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Mulazzi, D, Muraleedharan, V, Murray, L, Nair, N, Negru, A, Newcombe, V, Nieboer, D, Noirhomme, Q, Nyirádi, J, Oddo, M, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Piippo-Karjalainen, A, Pili Floury, S, Pirinen, M, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Rădoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Real, R, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnák, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schäfer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevanovic, A, Stevens, R, Stewart, W, Sundström, N, Synnot, A, Takala, R, Tamás, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Vajkoczy, P, Valeinis, E, Vallance, S, Vámos, Z, van der Naalt, J, Van der Steen, G, van Dijck, J, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Wijk, R, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Velt, K, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, Voormolen, D, Vulekovic, P, Wang, K, Williams, G, Winzeck, S, Wolf, S, Yang, Z, Ylén, P, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Steyerberg, Ewout W, Wiegers, Eveline, Sewalt, Charlie, Buki, Andras, Citerio, Giuseppe, De Keyser, Véronique, Ercole, Ari, Kunzmann, Kevin, Lanyon, Linda, Lecky, Fiona, Lingsma, Hester, Manley, Geoffrey, Nelson, David, Peul, Wilco, Stocchetti, Nino, von Steinbüchel, Nicole, Vande Vyvere, Thijs, Verheyden, Jan, Wilson, Lindsay, Maas, Andrew I R, Menon, David K, Ackerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Auslands, Kaspars, Azouvi, Philippe, Azzolini, Maria Luisa, Badenes, Rafael, Bartels, Ronald, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Castaño-León, Ana M, Chevallard, Giorgio, Chieregato, Arturo, Cnossen, Maryse, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D, Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dawes, Helen, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Dijkland, Simone, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L, Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubović, Jagoš, Gomez, Pedro A, Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L, Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J, Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Jones, Kelly, Karan, Mladen, Kolias, Angelos G, Kompanje, Erwin, Kondziella, Daniel, Koraropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Lagares, Alfonso, Laureys, Steven, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lozano, Angels, Maegele, Marc, Majdan, Marek, Manara, Alex, Maréchal, Hugues, Martino, Costanza, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menovsky, Tomas, Mulazzi, Davide, Muraleedharan, Visakh, Murray, Lynnette, Nair, Nandesh, Negru, Ancuta, Newcombe, Virginia, Nieboer, Daan, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Oresic, Matej, Ortolano, Fabrizio, Otesile, Olubukola, Palotie, Aarno, Parizel, Paul M, Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Piippo-Karjalainen, Anna, Pili Floury, Sébastien, Pirinen, Matti, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P, Puybasset, Louis, Rădoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Real, Ruben, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey V, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rueckert, Daniel, Rusnák, Martin, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevanovic, Ana, Stevens, Robert, Stewart, William, Sundström, Nina, Synnot, Anneliese, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Taylor, Mark Steven, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Timmers, Marjolijn, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Vajkoczy, Peter, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, van der Naalt, Joukje, Van der Steen, Gregory, van Dijck, Jeroen T J M, van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, van Wijk, Roel P J, Vanhaudenhuyse, Audrey, Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Vespa, Paul M, Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, Voormolen, Daphne, Vulekovic, Petar, Wang, Kevin K W, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A, Zelinkova, Veronika, Ziverte, Agate, and Zoerle, Tommaso

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). Neuroimages and biospecimens were stored in repositories and outcome was assessed at 6 months after injury. We used the IMPACT core model for estimating the expected mortality and proportion with unfavourable Glasgow Outcome Scale Extended (GOSE) outcomes in patients with moderate or severe TBI (Glasgow Coma Scale [GCS] score ≤12). The core study was registered with ClinicalTrials.gov, number NCT02210221, and with Resource Identification Portal (RRID: SCR_015582). Findings: Data from 4509 patients from 18 countries, collected between Dec 9, 2014, and Dec 17, 2017, were analysed in the core study and from 22 782 patients in the registry. In the core study, 848 (19%) patients were in the ER stratum, 1523 (34%) in the admission stratum, and 2138 (47%) in the ICU stratum. In the ICU stratum, 720 (36%) patients had mild TBI (GCS score 13–15). Compared with the core cohort, the registry had a higher proportion of patients in the ER (9839 [43%]) and admission (8571 [38%]) strata, with more than 95% of patients classified as having mild TBI. Patients in the core study were older than those in previous studies (median age 50 years [IQR 30–66], 1254 [28%] aged >65 years)

Published
2019

54. 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, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., Van Der Naalt J., Cnossen, M, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., and Van Der Naalt J.

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

57. Dexamethasone therapy versus surgery for chronic subdural haematoma (DECSA trial): study protocol for a randomised controlled trial

Author

Miah, IP, Holl, Dana, Peul, WC, Walchenbach, R, Kruyt, ND, de Laat, K, Koot, RW, Volovici, Victor, Dirven, Clemens, Kooten, Fop, Kho, KH, den Hertog, HM, van der Naalt, J, Jacobs, B, Groen, RJM, Lingsma, Hester, Dammers, R., Jellema, K, van der Gaag, NA, Miah, IP, Holl, Dana, Peul, WC, Walchenbach, R, Kruyt, ND, de Laat, K, Koot, RW, Volovici, Victor, Dirven, Clemens, Kooten, Fop, Kho, KH, den Hertog, HM, van der Naalt, J, Jacobs, B, Groen, RJM, Lingsma, Hester, Dammers, R., Jellema, K, and van der Gaag, NA

Published
2018

58. Adjusting for confounding by indication in observational studies: a case study in traumatic brain injury

Author

Cnossen, MC, Essen, TA, Ceyisakar, Iris, Polinder, Suzanne, Andriessen, TM, van der Naalt, J, Haitsma, Iain, Horn, J, Franschman, G, Vos, PE, Peul, WC, Menon, DK, Maas, AIR, Steyerberg, Ewout, Lingsma, Hester, Cnossen, MC, Essen, TA, Ceyisakar, Iris, Polinder, Suzanne, Andriessen, TM, van der Naalt, J, Haitsma, Iain, Horn, J, Franschman, G, Vos, PE, Peul, WC, Menon, DK, Maas, AIR, Steyerberg, Ewout, and Lingsma, Hester

Published
2018

59. Herkenning van licht traumatisch hersenletsel

Author

van der Naalt, J., Draijer, W. L., van Bennekom, C. A. M., Coronel Institute of Occupational Health, and APH - Societal Participation & Health

Subjects
nervous system diseases
Abstract

Identification of patients with mild traumatic brain injury (TBI) is important since 85,000 patients visit the emergency department with a head trauma annually. Although most patients recover well, 15-20% of the patients with head trauma develop persistent symptoms that interfere with resumption of daily activities. It is particularly important to identify the clinical signs that define mild TBI. Presence of anterograde amnesia after the injury, for example, is an important clinical diagnostic sign to establish the diagnosis of TBI. Posttraumatic emotional distress may increase posttraumatic symptoms. General practitioners should be aware of the problems in this patient group and identify patients with mild TBI who are at risk of developing persistent symptoms that limit participation in society

Published
2017

60. Addendum richtlijn licht traumatisch hoofd-hersenletsel

Author

van den Brand, C L, van der Naalt, J, Hageman, G, Bienfait, H P, van der Kruijk, R A, Jellema, K, Emergency Medicine, and Molecular Neuroscience and Ageing Research

Subjects
Brain Injuries, Anticoagulants, Craniocerebral Trauma, Humans, Guidelines as Topic, Tomography, X-Ray Computed, Platelet Aggregation Inhibitors, Netherlands
Abstract

After introduction of the Dutch guideline for 'Care for patients with minor head/brain injury' (LTH guideline) in 2010, the number of CT scans has increased. Some of these scans were for patients with only trivial trauma and may not have been necessary. - In addition, since this guideline was implemented, there have been changes in the use of anticoagulants and platelet aggregation inhibitors. Non-vitamin-K-dependent oral anticoagulants (NOACs) and platelet aggregation inhibitors, or combinations of these, are prescribed more often. - These two factors have led the Netherlands Society of Neurology to initiate a request for modification of the LTH guideline for adults in two ways: (a) identification of minimal or trivial trauma for which no CT scan is required and (b) inclusion of NOACs and platelet aggregation inhibitors, or combinations of these, in the guideline.

Published
2017

64. Discrepancy between the initial assessment of injury severity and post hoc determination of injury severity in patients with apparently mild traumatic brain injury: a retrospective multicenter cohort analysis

Author

Bossers, S. M., primary, Pol, K. M., additional, Oude Ophuis, E. P. A., additional, Jacobs, B., additional, Visser, M. C., additional, Loer, S. A., additional, Boer, C., additional, van der Naalt, J., additional, and Schober, P., additional

Published
2017
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68. Acute Cerebral Perfusion CT Abnormalities Associated with Posttraumatic Amnesia in Mild Head Injury

Author

Metting, Zwany, Rodiger, L.a., De Jong, Bauke, Stewart, R.e., Kremer, Hubertus Petrus Henricus, Van Der Naalt, J., and Internal Medicine Specializations

Subjects
endocrine system, surgical procedures, operative, otorhinolaryngologic diseases, posttraumatic amnesia, perfusion computed tomography, mild head injury, urologic and male genital diseases, female genital diseases and pregnancy complications
Abstract

Posttraumatic amnesia (PTA) is a common symptom following traumatic brain injury. Although this transient memory deficit implies specific impairment of higher brain function, the actual pathophysiology of PTA is not well understood. The aim of this study was to assess regional cerebral hemodynamics with perfusion computed tomography (CT) in patients during PTA following mild head injury compared to patients with resolved PTA. A total of 74 patients with mild head injury without structural abnormalities on a non-contrast CT scan were included and compared to 25 healthy controls. Two patient groups were defined: (1) a PTA group that was scanned during the episode of PTA (n = 34), and (2) a post-PTA group scanned after resolution of PTA (n = 40). The PTA group had significantly reduced cerebral blood flow (CBF) in the frontal grey matter (41.78 [SD 7.4] versus 44.44 [SD 6.2] mL . 100 g(-1) . min(-1), p = 0.023), and caudate nucleus (44.59 [SD 6.2] versus 47.85 [SD 7.7] mL . 100 g(-1) . min(-1), p = 0.021), compared to the post-PTA group. Thus in patients with mild head injury, PTA is associated with cerebral perfusion abnormalities in specific cortical and subcortical regions.

Published
2010

69. P300 analysis techniques in cognitive impairment after brain injury: comparison with neuropsychological and imaging data

Author

Elting, J.w., Maurits, M.n., Van Weerden, T.w., Spikman, J., Van Der Naalt, J., De Keyser, Jacques, and Gerontology

Subjects
brain injury
Abstract

PRIMARY OBJECTIVE: To compare P300 source analysis with conventional analysis in patients with cognitive impairment after brain injury. METHODS AND PROCEDURES: P300 results were compared with neuropsychological test data and imaging data in 21 healthy control subjects and 33 patients with brain injury. Latency and amplitude parameters were obtained for both P300 analysis methods. Magnetic Resonance Imaging (MRI) was performed between 3-12 months after the injury. MAIN OUTCOMES AND RESULTS: For both P300 analysis methods, only amplitude parameters correlated with neuropsychological test data. Diagnostic accuracy was better with source analysis than conventional analysis, when compared to the VLT (p = 0.03) and the PASAT (p = 0.04, only for those patients with imaging abnormalities). Patients with normal MRI results and patients with MRI abnormalities had decreased mean P3A amplitude compared to controls. In patients with focal frontal or temporal injury, the presence of mediofrontal lesions was associated withP3A amplitude reduction, while orbitofrontal lesions tended to increase P3A amplitude. CONCLUSIONS: Source analysis of P300 resulted in improved detection of neuropsychological abnormality in patients with brain injury. It is advisable to analyse P300 results in conjunction with imaging results. This approach may further facilitate the interpretation and diagnostic applicability of source analysis P300 results in patients with brain injury.

Published
2008

72. Buikklachten en neurologische symptomen als vroege manifestatie van longkanker: een uiting van het anti-Hu-syndroom

Author

Wymenga, A N M, Slebos, D J, van der Naalt, J, van Putten, J W G, and Peters, F T M

Subjects
Lung Neoplasms/diagnosis, Nervous System Diseases/diagnosis, RNA-Binding Proteins/immunology, Middle Aged, Paraneoplastic Syndromes/diagnosis, Prognosis, Diagnosis, Differential, Nerve Tissue Proteins/immunology, ELAV Proteins, Carcinoma, Small Cell/diagnosis, Humans, Female, Gastrointestinal Diseases/diagnosis, Gastrointestinal Motility, Aged, Autoantibodies/analysis
Abstract

In two patients, women aged 73 and 46 years, gastrointestinal symptoms were initially not recognised as a paraneoplastic syndrome due to small-cell lung cancer. This led to redundant diagnostics as well as a delay in final diagnosis. The anti-Hu syndrome is characterised by the presence of anti-Hu antibodies and neurological symptoms. About a quarter of the patients with the anti-Hu syndrome will develop gastrointestinal motility disorders in the course of their illness. The primary tumour is usually a small-cell lung cancer. Whereas the presence of anti-Hu antibodies appears to be beneficial for the oncological prognosis, the neurological outcome is less favourable.

Published
2003

75. Comparison of serum S-100 protein levels following stroke and traumatic brain injury

Author

Elting, J W, de Jager, A E, Teelken, A W, Schaaf, M J, Maurits, N M, van der Naalt, J, Sibinga, C T, Sulter, Geert Albert, De Keyser, J, Gerontology, and Molecular Neuroscience and Ageing Research (MOLAR)

Subjects
Adult, Male, Time Factors, NEURON-SPECIFIC ENOLASE, PROLIFERATIVE RESPONSE, Cerebrovasc accident/blood/physiopathol/radiograph, ASTROGLIAL 5-HT1A RECEPTORS, MINOR HEAD-INJURY, SPONTANEOUS REPERFUSION, Middle Age, Transient/blood/physiopathology/radiography, CEREBROSPINAL-FLUID, Comparative Study, S-100, cardiovascular diseases, CEREBRAL INFARCTS, Aged, POSITIVE GLIAL-CELLS, Ischemic Attack, traumatic brain injury, TIA, Brain injuries/blood/physiopathology/radiography, S100 Proteins/blood, stroke, NERVOUS-SYSTEM, nervous system diseases, Brain Ischemia/blood/physiopathology/radiography, comparison, ISCHEMIC STROKE, Disease Progression, Female, Tomography X-Ray Computed/statistics & num. data, serum, Human
Abstract

Temporal changes in serum S-100 protein levels were compared between patients with ischemic stroke, transient ischemic attack (TIA) and traumatic brain injury (TBI). In addition, S-100 levels were correlated with clinical severity and outcome. Measurements were done with a LIA-mat Sangtec(R) 100 using an automated immunoluminometric assay. Serum S-100 was measured in 21 stroke patients, 18 TIA patients and ten TBI patients on days 1 (0-24 h), 2, 3, 4, 5 or 6 and 8 or 9. In a control group of 28 healthy volunteers one measurement was done. For the stroke and TIA patients, National Institutes of Health Stroke Scale (NIHSS) scores were obtained on admission and on day 10. For the TBI patients, Glasgow Coma Scale (GCS) scores were obtained on admission and Glasgow Outcome Scale (GOS) scores were obtained after 6 months:. Changes in serum S-100 levels over the first 3 days were significantly different between stroke and TBI patients (P = 0.014) and between stroke and TIA patients (P = 0.006). Peak concentrations of S-100 were most often observed on day 3 or 4 after stroke and on day 1 or 2 after TBI. In the stroke patients individual S-100 peak levels correlated well with the NIHSS score on admission (r = 0.58 P = 0.014) and the change in NIHSS score between day 10 and day 1 (r = 0.65, P = 0.005). In the TBI patients a good correlation between individual peak levels of S-100 and the GCS score on admission (r = -0.81, P = 0.010) and the GOS score 6 months after the trauma was found (r = -0.87, P = 0.004). We conclude that there is a significant difference in temporal changes of S-100 levels between ischemic stroke and TBI patients. This suggests different pathophysiological mechanisms. The results of this study further confirm that peak levels of serum S-100 correlate with neurological deficit resulting from either stroke or TBI. (C) 2000 Elsevier Science B.V. All rights reserved.

Published
2000

76. Acute behavioural disturbances related to imaging studies and outcome in mild-to-moderate head injury

Author

van der Naalt, J, Van Zomeren, AH, Sluiter, WJ, Minderhoud, JM, and Molecular Neuroscience and Ageing Research (MOLAR)

Subjects
REHABILITATION, TRAUMATIC BRAIN INJURY, AGITATION, SEQUELAE, PATIENT
Abstract

The frequency of behavioural disturbances early after injury in relation to outcome was prospectively investigated in a series of 67 patients with mild-to-moderate head injury (as defined by GCS on admission). In more than half of the patients, behavioural disturbances were observed. Restlessness occured in 40% of patients, whereas agitation was seen in 19% of patients. In all patients, restlessness and agitation disappeared before resolution of PTA. In multiple regression analysis, restlessness and PTA were found to be separate factors in predicting outcome. On imaging studies, twice as many lesions were seen in patients with restlessness and agitation (81% compared to 39%), mainly localized in the frontotemporal region. In two thirds of patients with early behavioural disturbances, residual emotional and cognitive impairments were seen 1 year after injury. This study suggests that behavioural disturbances in the early phase after injury are related to frontotemporal lesions and lends support for the view of the existence of a separate profile of patient behaviour in mild-to-moderate head injury.

Published
2000

77. Computed tomography and magnetic resonance imaging in mild to moderate head injury: Early and late imaging related to outcome

Author

van der Naalt, J, Hew, JM, van Zomeren, AH, Sluiter, WJ, Minderhoud, JM, Faculteit Medische Wetenschappen/UMCG, and Molecular Neuroscience and Ageing Research (MOLAR)

Subjects
DAMAGE, LESIONS, TRAUMATIC BRAIN INJURY, DISABILITY, COGNITIVE SEQUELAE, SCALE, MRI, CT
Abstract

Serial magnetic resonance imaging (MRI) and computed tomographic (CT) studies were performed in mild to moderate head injury to evaluate whether early and late imaging have additional value in predicting outcome in this category of patients. During 1-year follow-up of a series of 67 patients, a CT scan on admission was performed together with MRI studies within 1 to 3 months and 6 to 12 months after injury. With CT, intracranial lesions were seen in 62% of patients compared with 44% with early and 19% with late MRT, located predominantly in the frontal and temporal regions. More than half of the lesions revealed with CT resulted in focal atrophy on MRI, Outcome was found to be worse in patients with edema and lesions on CT. Likewise, abnormalities detected with MRI were associated with poor outcome scores. In multiple regression analysis, only lesions in the frontal regions detected with early MRI were found to be predictive of outcome. With late MRI, only focal atrophy in the frontotemporal regions was found to be predictive of outcome. The findings in this study suggests that MRI studies may be valuable for predicting long-term outcome in patients with mild to moderate HI.

Published
1999

79. Commotio en contusio cerebri

Author

van der Naalt, J

Subjects
Diagnosis, Differential, Trauma Severity Indices, Brain Injuries/diagnosis, Glasgow Outcome Scale, Humans, Recovery of Function, Prognosis, Craniocerebral Trauma/classification, Brain Concussion/diagnosis
Abstract

A summary of the presentation, diagnosis and therapy of head injury is given. The article is focussed on mild head injury, the most frequent type of head injury. The difference between concussion and contusion is explained. Symptoms and abnormalities found at neurological examination are discussed. The Glasgow Coma Scale is described as a tool to diagnose the severity of head injury. The value of additional radiological investigation is discussed. The therapy which depends on the severity of head injury and concomitant complications, is given. Information about eventual persisting complaints and deficits is important. After-care depends on the severity of the injury and the persistence of neurological signs and symptoms. Outcome measurement is done by the Glasgow Outcome Scale. It is emphasized that patients may exhibit persistent complaints although they return to work or school.

Published
1997

82. Schokken na het ontwaken; onschuldig?

Author

Bernsen, R A J A M, van der Naalt, J, and Boonstra, S

Subjects
Adult, Diagnosis, Differential, Male, Epilepsy, Tonic-Clonic/diagnosis, Epilepsies, Myoclonic/diagnosis, Humans, Female, Valproic Acid/therapeutic use
Published
1993

84. Vibration perception threshold, complaints and sensory examination in diabetic-patients

Author

van der Naalt, J., FIDLER, [No Value], OOSTERHUIS, HJGH, and Molecular Neuroscience and Ageing Research (MOLAR)

Subjects
NEUROPATHY, VIBRATION PERCEPTION, DIAGNOSIS, DIABETIC POLYNEUROPATHY, SENSATION, SENSORY EXAMINATION
Abstract

The vibration perception threshold (VPT) was investigated by means of a biothesiometer among 40 patients with insulin dependent diabetes mellitus. The age as well as the duration of the disease affected the VPT. However, a correlation between the VPT and the rate of metabolic control measured through the glycolysed Hb (HbA1c) could not be demonstrated. In early stages abnormalities were already detectable in the feet. The VPT was elevated in 13 of 20 patients with sensory complaints and in 4 of 20 patients without complaints. Routine neurological examinations such as light touch and pinprick sensation were less sensitive to diagnose neuropathy. In detecting early signs of diabetic neuropathy in an outpatient population the determination of the VPT is a sensitive tool.

Published
1991

91. Patients beyond salvation? Various categories of trauma patients with a minimal Glasgow Coma Score.

Author

Nijboer JM, van der Naalt J, ten Duis HJ, Nijboer, Johanna M M, van der Naalt, Joukje, and ten Duis, Hendrik-Jan

Abstract

Introduction: Trauma patients in an unresponsive state upon presentation to the Emergency Department have a poor prognosis. Rapid assessment of injuries combined with life-preserving therapy is required but defining the optimal strategy can be complicated when multiple organ systems are involved. This study analysed various categories of trauma patients with a Glasgow Coma Scale (GCS) of 3 on admission and evaluated the relation between injuries, clinical condition, treatment and outcome.Patients and Methods: A retrospective cohort-study, performed at a level 1 Trauma Center from 2002 to 2005. Trauma patients of all ages with GCS of 3 (without sedation) and Injury Severity Score (ISS) > or = 16 were included. The collected patient data comprised data on demographics, mechanism of injury, physiological condition on admission, diagnosis, ISS, treatment, admission to Intensive Care Unit, complications and outcome.Results: Ninety-seven patients were included and divided into three groups based on the pathology that caused the GCS of 3: traumatic brain injury N=48 (49%), anoxic brain injury N=27 (28%) and haemorrhagic shock N=22 (23%). The overall mortality was 81%; 91% of the haemorrhagic shock patients, 81% of the ABI patients and 77% of the TBI patients died. Eighteen patients survived of whom five patients (5%) made a good recovery. The pupillary light response and pH on admission were related to mortality. No relation with ISS, age or hypothermia was found.Discussion: Distinguishing salvageable patients from those beyond salvation remains problematic. This study illustrated the diversity of patients, their injuries and their condition upon presentation to the hospital as well as the limitations of therapy.Conclusion: Trauma patients with a GCS of 3 have a poor outcome. Despite aggressive treatment only 5% of the patients made a good recovery. Pupil reactivity and the pH on admission were found to be related to mortality. [ABSTRACT FROM AUTHOR]

Published
2010
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92. The interrater variability in clinical assessment of post-hypoxic myoclonus

Author

van Zijl, J. C., Beudel, M., Elting, J. -W. J., de Jong, B. M., van der Naalt, J., van den Bergh, W. M., Rossetti, A. O., Tijssen, M. A. J., Horn, J., Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE), Molecular Neuroscience and Ageing Research (MOLAR), and Movement Disorder (MD)

93. Fluid balance and outcome in critically ill patients with traumatic brain injury (CENTER-TBI and OzENTER-TBI)

Author

Eveline Janine Anna Wiegers, Hester Floor Lingsma, Jilske Antonia Huijben, David James Cooper, Giuseppe Citerio, Shirin Frisvold, Raimund Helbok, Andrew Ian Ramsay Maas, David Krishna Menon, Elizabeth Madeleine Moore, Nino Stocchetti, Diederik Willem Dippel, Ewout Willem Steyerberg, Mathieu van der Jagt, Joanne Brooker, Peter Bragge, Jeffrey Rosenfeld, Jamie D. Cooper, Ronny Beer, Herbert Schoechl, Martin Rusnák, Elisabeth Schwendenwein, Anna Antoni, Véronique De Keyser, Tomas Menovsky, Dominique Van Praag, Andrew I.R. Maas, Gregory Van der Steen, Paul M. Parizel, Thijs Vande Vyvere, Bart Depreitere, Wim Van Hecke, Jan Verheyden, Benoit Misset, Didier Ledoux, Steven Laureys, Alexandre Ghuysen, Hugues Maréchal, Guy-Loup Dulière, Guoyi Gao, Ji-yao Jiang, Daniel Kondziella, Martin Fabricius, Rico Frederik Schou, Morten Blaabjerg, Christina Rosenlund, Anna Piippo-Karjalainen, Rahul Raj, Matti Pirinen, Samuli Ripatti, Aarno Palotie, Peter Ylén, Jussi P. Posti, Olli Tenovuo, Riikka Takala, Jean-François Payen, Emmanuel Vega, Aurelie Lejeune, Gérard Audibert, Vincent Degos, Habib Benali, Damien Galanaud, Vincent Perlbarg, Louis Puybasset, Philippe Azouvi, Valerie Legrand, Claire Dahyot-Fizelier, Rolf Rossaint, Mark Steven Coburn, Ana Kowark, Hans Clusmann, Jens Dreier, Stefan Wolf, Peter Vajkoczy, Marc Maegele, Johannes Gratz, Nadine Schäfer, Rolf Lefering, Amra Covic, Nicole von Steinbüchel, Silke Schmidt, Monika Bullinger, Alexander Younsi, Andreas Unterberg, Julia Mattern, Oliver Sakowitz, Renan Sanchez-Porras, Natascha Perera, Romuald Beauvais, Janos Sandor, Endre Czeiter, Andras Buki, Erzsébet Ezer, Zoltán Vámos, Béla Melegh, Viktória Tamás, Abayomi Sorinola, Noémi Kovács, József Nyirádi, Krisztina Amrein, Pál Barzó, Deepak Gupta, Leon Levi, Guy Rosenthal, Alex Furmanov, Costanza Martino, Luigi Beretta, Maria Rosa Calvi, Maria Luisa Azzolini, Emiliana Calappi, Tommaso Zoerle, Fabrizio Ortolano, Marco Carbonara, Alessio Caccioppola, Alessia Vargiolu, Arturo Chieregato, Giorgio Chevallard, Francesco Della Corte, Francesca Grossi, Sandra Rossi, Paolo Persona, Maurizio Berardino, Simona Cavallo, Malinka Rambadagalla, Agate Ziverte, Lelde Giga, Egils Valeinis, Rimantas Vilcinis, Tomas Tamosuitis, Saulius Rocka, Arminas Ragauskas, Joukje van der Naalt, Bram Jacobs, Ewout W. Steyerberg, Ronald Bartels, Hugo den Boogert, Erwin Kompanje, Marjolijn Timmers, Kelly Foks, Iain Haitsma, Victor Volovici, Juanita A. Haagsma, Ana Mikolic, Hester Lingsma, Kimberley Velt, Jilske Huijben, Daphne Voormolen, Daan Nieboer, Eveline Wiegers, Charlie Sewalt, Benjamin Gravesteijn, Suzanne Polinder, Dick Tibboel, Roel van Wijk, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wilco Peul, Guus Schoonman, Kelly Jones, Valery L. Feigin, Braden Te Ao, Alice Theadom, Eirik Helseth, Cecilie Roe, Olav Roise, Nada Andelic, Lasse Andreassen, Audny Anke, Anne Vik, Toril Skandsen, Horia Ples, Cristina Maria Tudora, Ancuta Negru, Peter Vulekovic, Đula Đilvesi, Mladen Karan, Jagoš Golubovic, Veronika Rehorcíková, Mark Steven Taylor, Alexandra Brazinova, Marek Majdan, Juan Sahuquillo, Andreea Radoi, Guillermo Carbayo Lozano, Inigo Pomposo, Alfonso Lagares, Pedro A. Gomez, Ana M. Castaño-León, Pablo Gagliardo, Matej Oresic, Bo-Michael Bellander, Linda Lanyon, Pradeep George, Visakh Muraleedharan, David Nelson, Cecilia Ackerlund, Lars-Owe Koskinen, Nina Sundström, Camilla Brorsson, Antonio Belli, Alex Manara, Matt Thomas, Marek Czosnyka, Peter Smielewski, Manuel Cabeleira, Jonathan Coles, Sylvia Richardson, Frederick A. Zeiler, Emmanuel Stamatakis, Guy Williams, David Menon, Ari Ercole, Abhishek Dixit, Virginia Newcombe, Sophie Richter, Charles McFadyen, Peter J. Hutchinson, Angelos G. Kolias, Hadie Adams, Marta Correia, Jonathan Rhodes, William Stewart, Catherine McMahon, Daniel Rueckert, Ben Glocker, Christos Tolias, Helen Dawes, Patrick Esser, Caroline van Heugten, Nicola Curry, Simon Stanworth, Fiona Lecky, Olubukola Otesile, Faye Johnson, Paul Dark, Stefan Jankowski, Roger Lightfoot, Lindsay Wilson, Lindsay Horton, Robert Stevens, Jonathan Rosand, Geoffrey Manley, Mike Jarrett, Vibeke Brinck, Kevin K.W. Wang, Zhihui Yang, Paul M. Vespa, Russell L. Gruen, Peter Cameron, Emma Donoghue, Dashiell Gantner, Russel Gruen, Lynette Murray, Jeffrey V. Rosenfeld, Dinesh Varma, Tony Trapani, Shirley Vallance, Cristopher MacIsaac, Andrea Jordan, Wiegers, E. J. A., Lingsma, H. F., Huijben, J. A., Cooper, D. J., Citerio, G., Frisvold, S., Helbok, R., Maas, A. I. R., Menon, D. K., Moore, E. M., Stocchetti, N., Dippel, D. W., Steyerberg, E. W., van der Jagt, M., Brooker, J., Bragge, P., Rosenfeld, J., Cooper, J. D., Beer, R., Schoechl, H., Rusnak, M., Schwendenwein, E., Antoni, A., De Keyser, V., Menovsky, T., Van Praag, D., Van der Steen, G., Parizel, P. M., Vande Vyvere, T., Depreitere, B., Van Hecke, W., Verheyden, J., Misset, B., Ledoux, D., Laureys, S., Ghuysen, A., Marechal, H., Duliere, G. -L., Gao, G., Jiang, J. -Y., Kondziella, D., Fabricius, M., Schou, R. F., Blaabjerg, M., Rosenlund, C., Piippo-Karjalainen, A., Raj, R., Pirinen, M., Ripatti, S., Palotie, A., Ylen, P., Posti, J. P., Tenovuo, O., Takala, R., Payen, J. -F., Vega, E., Lejeune, A., Audibert, G., Degos, V., Benali, H., Galanaud, D., Perlbarg, V., Puybasset, L., Azouvi, P., Legrand, V., Dahyot-Fizelier, C., Rossaint, R., Coburn, M. S., Kowark, A., Clusmann, H., Dreier, J., Wolf, S., Vajkoczy, P., Maegele, M., Gratz, J., Schafer, N., Lefering, R., Covic, A., von Steinbuchel, N., Schmidt, S., Bullinger, M., Younsi, A., Unterberg, A., Mattern, J., Sakowitz, O., Sanchez-Porras, R., Perera, N., Beauvais, R., Sandor, J., Czeiter, E., Buki, A., Ezer, E., Vamos, Z., Melegh, B., Tamas, V., Sorinola, A., Kovacs, N., Nyiradi, J., Amrein, K., Barzo, P., Gupta, D., Levi, L., Rosenthal, G., Furmanov, A., Martino, C., Beretta, L., Calvi, M. R., Azzolini, M. L., Calappi, E., Zoerle, T., Ortolano, F., Carbonara, M., Caccioppola, A., Vargiolu, A., Chieregato, A., Chevallard, G., Della Corte, F., Grossi, F., Rossi, S., Persona, P., Berardino, M., Cavallo, S., Rambadagalla, M., Ziverte, A., Giga, L., Valeinis, E., Vilcinis, R., Tamosuitis, T., Rocka, S., Ragauskas, A., van der Naalt, J., Jacobs, B., Bartels, R., den Boogert, H., Kompanje, E., Timmers, M., Foks, K., Haitsma, I., Volovici, V., Haagsma, J. A., Mikolic, A., Lingsma, H., Velt, K., Huijben, J., Voormolen, D., Nieboer, D., Wiegers, E., Sewalt, C., Gravesteijn, B., Polinder, S., Tibboel, D., van Wijk, R., van Dijck, J. T. J. M., van Essen, T. A., Peul, W., Schoonman, G., Jones, K., Feigin, V. L., Te Ao, B., Theadom, A., Helseth, E., Roe, C., Roise, O., Andelic, N., Andreassen, L., Anke, A., Vik, A., Skandsen, T., Ples, H., Tudora, C. M., Negru, A., Vulekovic, P., Dilvesi, D., Karan, M., Golubovic, J., Rehorcikova, V., Taylor, M. S., Brazinova, A., Majdan, M., Sahuquillo, J., Radoi, A., Carbayo Lozano, G., Pomposo, I., Lagares, A., Gomez, P. A., Castano-Leon, A. M., Gagliardo, P., Oresic, M., Bellander, B. -M., Lanyon, L., George, P., Muraleedharan, V., Nelson, D., Ackerlund, C., Koskinen, L. -O., Sundstrom, N., Brorsson, C., Belli, A., Manara, A., Thomas, M., Czosnyka, M., Smielewski, P., Cabeleira, M., Coles, J., Richardson, S., Zeiler, F. A., Stamatakis, E., Williams, G., Menon, D., Ercole, A., Dixit, A., Newcombe, V., Richter, S., Mcfadyen, C., Hutchinson, P. J., Kolias, A. G., Adams, H., Correia, M., Rhodes, J., Stewart, W., Mcmahon, C., Rueckert, D., Glocker, B., Tolias, C., Dawes, H., Esser, P., van Heugten, C., Curry, N., Stanworth, S., Lecky, F., Otesile, O., Johnson, F., Dark, P., Jankowski, S., Lightfoot, R., Wilson, L., Horton, L., Stevens, R., Rosand, J., Manley, G., Jarrett, M., Brinck, V., Wang, K. K. W., Yang, Z., Vespa, P. M., Gruen, R. 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V., Varma, D., Trapani, T., Vallance, S., Macisaac, C., Jordan, A., Public Health, Neurology, Intensive Care, Neurosurgery, Erasmus MC other, Pediatric Surgery, CENTER-TBI Collaboration Group, OzENTER-TBI Collaboration Group, Molecular Neuroscience and Ageing Research (MOLAR), Psychology 3, Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Wiegers, E, Lingsma, H, Huijben, J, Cooper, D, Citerio, G, Frisvold, S, Helbok, R, Maas, A, Menon, D, Moore, E, Stocchetti, N, Dippel, D, Steyerberg, E, van der Jagt, M, Brooker, J, Bragge, P, Rosenfeld, J, Cooper, J, Beer, R, Schoechl, H, Rusnák, M, Schwendenwein, E, Antoni, A, De Keyser, V, Menovsky, T, Van Praag, D, Van der Steen, G, Parizel, P, Vande Vyvere, T, Depreitere, B, Van Hecke, W, Verheyden, J, Misset, B, Ledoux, D, Laureys, S, Ghuysen, A, Maréchal, H, Dulière, G, Gao, G, Jiang, J, Kondziella, D, Fabricius, M, Schou, R, Blaabjerg, M, Rosenlund, C, Piippo-Karjalainen, A, Raj, R, Pirinen, M, Ripatti, S, Palotie, A, Ylén, P, Posti, J, Tenovuo, O, Takala, R, Payen, J, Vega, E, Lejeune, A, Audibert, G, Degos, V, Benali, H, Galanaud, D, Perlbarg, V, Puybasset, L, Azouvi, P, Legrand, V, Dahyot-Fizelier, C, Rossaint, R, Coburn, M, Kowark, A, Clusmann, H, Dreier, J, Wolf, S, Vajkoczy, P, Maegele, M, Gratz, J, Schäfer, N, Lefering, R, Covic, A, von Steinbüchel, N, Schmidt, S, Bullinger, M, Younsi, A, Unterberg, A, Mattern, J, Sakowitz, O, Sanchez-Porras, R, Perera, N, Beauvais, R, Sandor, J, Czeiter, E, Buki, A, Ezer, E, Vámos, Z, Melegh, B, Tamás, V, Sorinola, A, Kovács, N, Nyirádi, J, Amrein, K, Barzó, P, Gupta, D, Levi, L, Rosenthal, G, Furmanov, A, Martino, C, Beretta, L, Calvi, M, Azzolini, M, Calappi, E, Zoerle, T, Ortolano, F, Carbonara, M, Caccioppola, A, Vargiolu, A, Chieregato, A, Chevallard, G, Della Corte, F, Grossi, F, Rossi, S, Persona, P, Berardino, M, Cavallo, S, Rambadagalla, M, Ziverte, A, Giga, L, Valeinis, E, Vilcinis, R, Tamosuitis, T, Rocka, S, Ragauskas, A, van der Naalt, J, Jacobs, B, Bartels, R, den Boogert, H, Kompanje, E, Timmers, M, Foks, K, Haitsma, I, Volovici, V, Haagsma, J, Mikolic, A, Velt, K, Voormolen, D, Nieboer, D, Sewalt, C, Gravesteijn, B, Polinder, S, Tibboel, D, van Wijk, R, van Dijck, J, van Essen, T, Peul, W, Schoonman, G, Jones, K, Feigin, V, Te Ao, B, Theadom, A, Helseth, E, Roe, C, Roise, O, Andelic, N, Andreassen, L, Anke, A, Vik, A, Skandsen, T, Ples, H, Tudora, C, Negru, A, Vulekovic, P, Đilvesi, Đ, Karan, M, Golubovic, J, Rehorcíková, V, Taylor, M, Brazinova, A, Majdan, M, Sahuquillo, J, Radoi, A, Carbayo Lozano, G, Pomposo, I, Lagares, A, Gomez, P, Castaño-León, A, Gagliardo, P, Oresic, M, Bellander, B, Lanyon, L, George, P, Muraleedharan, V, Nelson, D, Ackerlund, C, Koskinen, L, Sundström, N, Brorsson, C, Belli, A, Manara, A, Thomas, M, Czosnyka, M, Smielewski, P, Cabeleira, M, Coles, J, Richardson, S, Zeiler, F, Stamatakis, E, Williams, G, Ercole, A, Dixit, A, Newcombe, V, Richter, S, Mcfadyen, C, Hutchinson, P, Kolias, A, Adams, H, Correia, M, Rhodes, J, Stewart, W, Mcmahon, C, Rueckert, D, Glocker, B, Tolias, C, Dawes, H, Esser, P, van Heugten, C, Curry, N, Stanworth, S, Lecky, F, Otesile, O, Johnson, F, Dark, P, Jankowski, S, Lightfoot, R, Wilson, L, Horton, L, Stevens, R, Rosand, J, Manley, G, Jarrett, M, Brinck, V, Wang, K, Yang, Z, Vespa, P, Gruen, R, Cameron, P, Donoghue, E, Gantner, D, Murray, L, Varma, D, Trapani, T, Vallance, S, Macisaac, C, and Jordan, A

Subjects
medicine.medical_specialty, Fluid balance and outcome in critically ill patients traumatic brain injury, Icu mortality, Traumatic brain injury, Critically ill, business.industry, INTRACRANIAL-PRESSURE, Glasgow Outcome Scale, Odds ratio, medicine.disease, GUIDELINES, Intensive care unit, law.invention, law, Emergency medicine, medicine, MANAGEMENT, Observational study, Neurology (clinical), Human medicine, business, Balance (ability)
Abstract

Background Fluid therapy-the administration of fluids to maintain adequate organ tissue perfusion and oxygenation-is essential in patients admitted to the intensive care unit (ICU) with traumatic brain injury. We aimed to quantify the variability in fluid management policies in patients with traumatic brain injury and to study the effect of this variability on patients' outcomes.Methods We did a prospective, multicentre, comparative effectiveness study of two observational cohorts: CENTER-TBI in Europe and OzENTER-TBI in Australia. Patients from 55 hospitals in 18 countries, aged 16 years or older with traumatic brain injury requiring a head CT, and admitted to the ICU were included in this analysis. We extracted data on demographics, injury, and clinical and treatment characteristics, and calculated the mean daily fluid balance (difference between fluid input and loss) and mean daily fluid input during ICU stay per patient. We analysed the association of fluid balance and input with ICU mortality and functional outcome at 6 months, measured by the Glasgow Outcome Scale Extended (GOSE). Patient-level analyses relied on adjustment for key characteristics per patient, whereas centre-level analyses used the centre as the instrumental variable.Findings 2125 patients enrolled in CENTER-TBI and OzENTER-TBI between Dec 19, 2014, and Dec 17, 2017, were eligible for inclusion in this analysis. The median age was 50 years (IQR 31 to 66) and 1566 (74%) of patients were male. The median of the mean daily fluid input ranged from 1middot48 L (IQR 1middot12 to 2middot09) to 4middot23 L (3middot78 to 4middot94) across centres. The median of the mean daily fluid balance ranged from -0middot85 L (IQR -1middot51 to -0middot49) to 1middot13 L (0middot99 to 1middot37) across centres. In patient-level analyses, a mean positive daily fluid balance was associated with higher ICU mortality (odds ratio [OR] 1middot10 [95% CI 1middot07 to 1middot12] per 0middot1 L increase) and worse functional outcome (1middot04 [1middot02 to 1middot05] per 0middot1 L increase); higher mean daily fluid input was also associated with higher ICU mortality (1middot05 [1middot03 to 1middot06] per 0middot1 L increase) and worse functional outcome (1middot04 [1middot03 to 1middot04] per 1-point decrease of the GOSE per 0middot1 L increase). Centre-level analyses showed similar associations of higher fluid balance with ICU mortality (OR 1middot17 [95% CI 1middot05 to 1middot29]) and worse functional outcome (1middot07 [1middot02 to 1middot13]), but higher fluid input was not associated with ICU mortality (OR 0middot95 [0middot90 to 1middot00]) or worse functional outcome (1middot01 [0middot98 to 1middot03]).Interpretation In critically ill patients with traumatic brain injury, there is significant variability in fluid management, with more positive fluid balances being associated with worse outcomes. These results, when added to previous evidence, suggest that aiming for neutral fluid balances, indicating a state of normovolaemia, contributes to improved outcome. Copyright (C) 2021 Elsevier Ltd. All rights reserved.

Published
2021

99. Werk en inkomen

Author

Miedema, H. S., van Velzen, J. M., van Bennekom, C. A. M., van der Naalt, J., editor, and Jacobs, B., editor

Published
2022
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