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101. Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury

Author: Van Praag, Dominique L.G., Wouters, Kristien, Van Den Eede, Filip, Wilson, Lindsay, Maas, Andrew I.R., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Ceyisakar, Iris, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Fabricius, Martin, Kondziella, Daniel, Van Praag, Dominique L.G., Wouters, Kristien, Van Den Eede, Filip, Wilson, Lindsay, Maas, Andrew I.R., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Ceyisakar, Iris, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Fabricius, Martin, and Kondziella, Daniel
Abstract: Introduction: Neurocognitive problems associated with posttraumatic stress disorder (PTSD) can interact with impairment resulting from traumatic brain injury (TBI). Research question: We aimed to identify neurocognitive problems associated with probable PTSD following TBI in a civilian sample. Material and methods: The study is part of the CENTER-TBI project (Collaborative European Neurotrauma Effectiveness Research) that aims to better characterize TBI. For this cross-sectional study, we included patients of all severities aged over 15, and a Glasgow Outcome Score Extended (GOSE) above 3. Participants were assessed at six months post-injury on the PTSD Checklist-5 (PCL-5), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Primary analysis was a complete case analysis. Regression analyses were performed to investigate the association between the PCL-5 and cognition. Results: Of the 1134 participants included in the complete case analysis, 13.5% screened positive for PTSD. Probable PTSD was significantly associated with higher TMT-(B-A) (OR = 1.35, 95% CI: 1.14–1.60, p < .001) and lower RAVLT-delayed recall scores (OR = 0.74, 95% CI: 0.61–0.91, p = .004) after controlling for age, sex, psychiatric history, baseline Glasgow Coma Scale and education. Discussion and conclusion: Poorer performance on cognitive tests assessing task switching and, to a lesser extent, delayed verbal recall is associated with probable PTSD in civilians who have suffered TBI.
Published: 2022

102. Surgery versus conservative treatment for traumatic acute subdural haematoma:a prospective, multicentre, observational, comparative effectiveness study

Author: van Essen, Thomas A., Lingsma, Hester F., Pisică, Dana, Singh, Ranjit D., Volovici, Victor, den Boogert, Hugo F., Younsi, Alexander, Peppel, Lianne D., Heijenbrok-Kal, Majanka H., Ribbers, Gerard M., Walchenbach, Robert, Menon, David K., Hutchinson, Peter, Depreitere, Bart, Steyerberg, Ewout W., Maas, Andrew I.R., de Ruiter, Godard C.W., Peul, Wilco C., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Fabricius, Martin, Kondziella, Daniel, van Essen, Thomas A., Lingsma, Hester F., Pisică, Dana, Singh, Ranjit D., Volovici, Victor, den Boogert, Hugo F., Younsi, Alexander, Peppel, Lianne D., Heijenbrok-Kal, Majanka H., Ribbers, Gerard M., Walchenbach, Robert, Menon, David K., Hutchinson, Peter, Depreitere, Bart, Steyerberg, Ewout W., Maas, Andrew I.R., de Ruiter, Godard C.W., Peul, Wilco C., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Fabricius, Martin, and Kondziella, Daniel
Abstract: Background: Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma. Methods: We did a prospective, observational, comparative effectiveness study using data from participants enrolled in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We included patients with no pre-existing severe neurological disorders who presented with acute subdural haematoma within 24 h of traumatic brain injury. Using an instrumental variable analysis, we compared outcomes between centres according to treatment preference for acute subdural haematoma (acute surgical evacuation or initial conservative treatment), measured by the case-mix-adjusted percentage of acute surgery per centre. The primary endpoint was functional outcome at 6 months as rated with the Glasgow Outcome Scale Extended, which was estimated with ordinal regression as a common odds ratio (OR) and adjusted for prespecified confounders. Variation in centre preference was quantified with the median OR (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). Findings: Between Dec 19, 2014 and Dec 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI, of whom 1407 (31%) presented with acute subdural haematoma and were included in our study. Acute surgical evacuation was done in 336 (24%) patients, by craniotomy in 245 (73%) of those patients and by decompressive craniectomy in 91 (27%). Delayed decompressive craniectomy or craniotomy after initial conservative treatment (n=982) occurred in 107 (11%) patients. The percentage of patients who underwent acute surgery ranged from 5·6% to 51·5% (IQR 12·3–35·9) between cent
Published: 2022

103. Comparative effectiveness of intracranial hypertension management guided by ventricular versus intraparenchymal pressure monitoring:a CENTER-TBI study

Author: Volovici, Victor, Pisică, Dana, Gravesteijn, Benjamin Y., Dirven, Clemens M.F., Steyerberg, Ewout W., Ercole, Ari, Stocchetti, Nino, Nelson, David, Menon, David K., Citerio, Giuseppe, van der Jagt, Mathieu, Maas, Andrew I.R., Haitsma, Iain, Lingsma, Hester F., 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, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Foks, Kelly, Tibboel, Dick, Voormolen, Daphne, van Essen, Thomas A., Volovici, Victor, Pisică, Dana, Gravesteijn, Benjamin Y., Dirven, Clemens M.F., Steyerberg, Ewout W., Ercole, Ari, Stocchetti, Nino, Nelson, David, Menon, David K., Citerio, Giuseppe, van der Jagt, Mathieu, Maas, Andrew I.R., Haitsma, Iain, Lingsma, Hester F., 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, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Foks, Kelly, Tibboel, Dick, Voormolen, Daphne, and van Essen, Thomas A.
Abstract: Objective: To compare outcomes between patients with primary external ventricular device (EVD)–driven treatment of intracranial hypertension and those with primary intraparenchymal monitor (IP)–driven treatment. Methods: The CENTER-TBI study is a prospective, multicenter, longitudinal observational cohort study that enrolled patients of all TBI severities from 62 participating centers (mainly level I trauma centers) across Europe between 2015 and 2017. Functional outcome was assessed at 6 months and a year. We used multivariable adjusted instrumental variable (IV) analysis with “center” as instrument and logistic regression with covariate adjustment to determine the effect estimate of EVD on 6-month functional outcome. Results: A total of 878 patients of all TBI severities with an indication for intracranial pressure (ICP) monitoring were included in the present study, of whom 739 (84%) patients had an IP monitor and 139 (16%) an EVD. Patients included were predominantly male (74% in the IP monitor and 76% in the EVD group), with a median age of 46 years in the IP group and 48 in the EVD group. Six-month GOS-E was similar between IP and EVD patients (adjusted odds ratio (aOR) and 95% confidence interval [CI] OR 0.74 and 95% CI [0.36–1.52], adjusted IV analysis). The length of intensive care unit stay was greater in the EVD group than in the IP group (adjusted rate ratio [95% CI] 1.70 [1.34–2.12], IV analysis). One hundred eighty-seven of the 739 patients in the IP group (25%) required an EVD due to refractory ICPs. Conclusion: We found no major differences in outcomes of patients with TBI when comparing EVD-guided and IP monitor–guided ICP management. In our cohort, a quarter of patients that initially received an IP monitor required an EVD later for ICP control. The prevalence of complications was higher in the EVD group. Protocol: The core study is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (RRID: SCR_015582).
Published: 2022

104. Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI

Author: Ewout W Steyerberg, Eveline Wiegers, Charlie Sewalt, Andras Buki, Giuseppe Citerio, Véronique De Keyser, Ari Ercole, Kevin Kunzmann, Linda Lanyon, Fiona Lecky, Hester Lingsma, Geoffrey Manley, David Nelson, Wilco Peul, Nino Stocchetti, Nicole von Steinbüchel, Thijs Vande Vyvere, Jan Verheyden, Lindsay Wilson, Andrew I R Maas, David K Menon, Cecilia Ackerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Kaspars Auslands, Philippe Azouvi, Maria Luisa Azzolini, Rafael Badenes, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Ana M Castaño-León, Giorgio Chevallard, Arturo Chieregato, Maryse Cnossen, Mark Coburn, Jonathan Coles, Jamie D Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Helen Dawes, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Simone Dijkland, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubović, Pedro A Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Kelly Jones, Mladen Karan, Angelos G Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Koraropoulos, Lars-Owe Koskinen, Noémi Kovács, Alfonso Lagares, Steven Laureys, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Angels Lozano, Marc Maegele, Marek Majdan, Alex Manara, Hugues Maréchal, Costanza Martino, Julia Mattern, Catherine McMahon, Béla Melegh, Tomas Menovsky, Davide Mulazzi, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, Virginia Newcombe, Daan Nieboer, Quentin Noirhomme, József Nyirádi, Mauro Oddo, Matej Oresic, Fabrizio Ortolano, Olubukola Otesile, Aarno Palotie, Paul M Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Anna Piippo-Karjalainen, Sébastien Pili Floury, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P Posti, Louis Puybasset, Andreea Rădoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Ruben Real, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Ana Stevanovic, Robert Stevens, William Stewart, Nina Sundström, Anneliese Synnot, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolijn Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Peter Vajkoczy, Egils Valeinis, Shirley Vallance, Zoltán Vámos, Joukje van der Naalt, Gregory Van der Steen, Jeroen T J M van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Roel P J van Wijk, Audrey Vanhaudenhuyse, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Paul M Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Daphne Voormolen, Petar Vulekovic, Kevin K W Wang, Guy Williams, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Molecular Neuroscience and Ageing Research (MOLAR), Steyerberg, Ew, 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 Steinbuchel, N, Vande, Vyvere T, Verheyden, J, Wilson, L, Maas, Air, Menon, DK (CENTER-TBI Participants and Investigator), Beretta, L, Public Health, Ercole, Ari [0000-0001-8350-8093], Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, CENTER-TBI Participants Investigators, Steyerberg, E, von Steinbüchel, N, Vande Vyvere, T, 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, 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, Section Neuropsychology, Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, and RS: FPN NPPP I
Subjects: Male, NEUROTRAUMA EFFECTIVENESS RESEARCH, Glasgow Outcome Scale, ALCOHOL, Cohort Studies, Traumatic brain injury, 0302 clinical medicine, Patient Admission, Quality of life, QUALITY-OF-LIFE, Brain Injuries, Traumatic/classification, Brain Injuries, Traumatic, Longitudinal Studies, Prospective Studies, Registries, Israel, Prospective cohort study, SCALE, Middle Aged, Prognosis, 3. Good health, Europe, Intensive Care Units, Critical Pathways, Female, Cohort study, Adult, medicine.medical_specialty, 03 medical and health sciences, Case mix index, SDG 3 - Good Health and Well-being, medicine, Humans, Glasgow Coma Scale, Traumatic/classification, Psychiatry, Critical Care Outcomes, Diagnosis-Related Groups, Aged, business.industry, MORTALITY, 030208 emergency & critical care medicine, El Niño, Brain Injuries, Human medicine, Neurology (clinical), business, 030217 neurology & neurosurgery
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), 462 (11%) had serious comorbidities, 772 (18%) were taking anticoagulant or antiplatelet medication, and alcohol was contributory in 1054 (25%) TBIs. MRI and blood biomarker measurement enhanced characterisation of injury severity and type. Substantial inter-country differences existed in care pathways and practice. Incomplete recovery at 6 months (GOSE
Published: 2019

105. Time course of the Bioelectrical Impedance Vector Analysis and muscular ultrasound in critically ill patients

Author: Formenti, Paolo, primary, Coppola, Silvia, additional, Umbrello, Michele, additional, Froio, Sara, additional, Caccioppola, Alessio, additional, De Giorgis, Valentina, additional, Galanti, Valentina, additional, Lusardi, Andrea Clarissa, additional, Ferrari, Erica, additional, Noè, Donatella, additional, Carnier, Simone, additional, Folli, Franco, additional, and Chiumello, Davide, additional
Published: 2022
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106. A genome-wide association study of outcome from traumatic brain injury

Author: Kals, Mart, primary, Kunzmann, Kevin, additional, Parodi, Livia, additional, Radmanesh, Farid, additional, Wilson, Lindsay, additional, Izzy, Saef, additional, Anderson, Christopher D., additional, Puccio, Ava M., additional, Okonkwo, David O., additional, Temkin, Nancy, additional, Steyerberg, Ewout W., additional, Stein, Murray B., additional, Manley, Geoff T., additional, Maas, Andrew I.R., additional, Richardson, Sylvia, additional, Diaz-Arrastia, Ramon, additional, Palotie, Aarno, additional, Ripatti, Samuli, additional, Rosand, Jonathan, additional, Menon, David K., additional, Åkerlund, Cecilia, additional, Amrein, Krisztina, additional, Andelic, Nada, additional, Andreassen, Lasse, additional, Anke, Audny, additional, Antoni, Anna, additional, Audibert, Gérard, additional, Azouvi, Philippe, additional, Azzolini, Maria Luisa, additional, Bartels, Ronald, additional, Barzó, Pál, additional, Beauvais, Romuald, additional, Beer, Ronny, additional, Bellander, Bo-Michael, additional, Belli, Antonio, additional, Benali, Habib, additional, Berardino, Maurizio, additional, Beretta, Luigi, additional, Blaabjerg, Morten, additional, Bragge, Peter, additional, Brazinova, Alexandra, additional, Brinck, Vibeke, additional, Brooker, Joanne, additional, Brorsson, Camilla, additional, Buki, Andras, additional, Bullinger, Monika, additional, Cabeleira, Manuel, additional, Caccioppola, Alessio, additional, Calappi, Emiliana, additional, Calvi, Maria Rosa, additional, Cameron, Peter, additional, Lozano, Guillermo Carbayo, additional, Carbonara, Marco, additional, Cavallo, Simona, additional, Chevallard, Giorgio, additional, Chieregato, Arturo, additional, Citerio, Giuseppe, additional, Clusmann, Hans, additional, Coburn, Mark, additional, Coles, Jonathan P., additional, Cooper, Jamie D., additional, Correia, Marta, additional, Čović, Amra, additional, Curry, Nicola, additional, Czeiter, Endre, additional, Czosnyka, Marek, additional, DahyotFizelier, Claire, additional, Dark, Paul, additional, Dawes, Helen, additional, De Keyser, Véronique, additional, Degos, Vincent, additional, Corte, Francesco Della, additional, Boogert, Hugo den, additional, Depreitere, Bart, additional, Đilvesi, Đula, additional, Dixit, Abhishek, additional, Donoghue, Emma, additional, Dreier, Jens, additional, Dulière, GuyLoup, additional, Ercole, Ari, additional, Esser, Patrick, additional, Ezer, Erzsébet, additional, Fabricius, Martin, additional, Feigin, Valery L., additional, Foks, Kelly, additional, Frisvold, Shirin, additional, Furmanov, Alex, additional, Gagliardo, Pablo, additional, Galanaud, Damien, additional, Gantner, Dashiell, additional, Gao, Guoyi, additional, George, Pradeep, additional, Ghuysen, Alexandre, additional, Giga, Lelde, additional, Glocker, Ben, additional, Golubovic, Jagoš, additional, Gomez, Pedro A., additional, Gratz, Johannes, additional, Gravesteijn, Benjamin, additional, Grossi, Francesca, additional, Gruen, Russell L., additional, Gupta, Deepak, additional, Haagsma, Juanita A., additional, Haitsma, Iain, additional, Helbok, Raimund, additional, Helseth, Eirik, additional, Horton, Lindsay, additional, Huijben, Jilske, additional, Hutchinson, Peter J.A., additional, Jacobs, Bram, additional, Jankowski, Stefan, additional, Jarrett, Mike, additional, Jiang, Jiyao, additional, Johnson, Faye, additional, Jones, Kelly, additional, Karan, Mladen, additional, Kolias, Angelos G., additional, Kompanje, Erwin, additional, Kondziella, Daniel, additional, Kornaropoulos, Evgenios, additional, Koskinen, LarsOwe, additional, Kovács, Noémi, additional, Kowark, Ana, additional, Lagares, Alfonso, additional, Lanyon, Linda, additional, Laureys, Steven, additional, Lecky, Fiona, additional, Ledoux, Didier, additional, Lefering, Rolf, additional, Legrand, Valerie, additional, Lejeune, Aurelie, additional, Levi, Leon, additional, Lightfoot, Roger, additional, Lingsma, Hester, additional, CastañoLeón, Ana M., additional, Maegele, Marc, additional, Majdan, Marek, additional, Manara, Alex, additional, Martino, Costanza, additional, Maréchal, Hugues, additional, Mattern, Julia, additional, McMahon, Catherine, additional, Melegh, Béla, additional, Menovsky, Tomas, additional, Mikolic, Ana, additional, Misset, Benoit, additional, Muraleedharan, Visakh, additional, Murray, Lynnette, additional, Negru, Ancuta, additional, Nelson, David, additional, Newcombe, Virginia F.J., additional, Nieboer, Daan, additional, Nyirádi, József, additional, Olubukola, Otesile, additional, Oresic, Matej, additional, Ortolano, Fabrizio, additional, Parizel, Paul M., additional, Payen, JeanFrançois, additional, Perera, Natascha, additional, Perlbarg, Vincent, additional, Persona, Paolo, additional, Peul, Wilco, additional, Piippo-Karjalainen, Anna, additional, Pirinen, Matti, additional, Pisica, Dana, additional, Ples, Horia, additional, Polinder, Suzanne, additional, Pomposo, Inigo, additional, Posti, Jussi P., additional, Puybasset, Louis, additional, Radoi, Andreea, additional, Ragauskas, Arminas, additional, Raj, Rahul, additional, Rambadagalla, Malinka, additional, Helmrich, Isabel Retel, additional, Rhodes, Jonathan, additional, Richter, Sophie, additional, Rocka, Saulius, additional, Roe, Cecilie, additional, Roise, Olav, additional, Rosenfeld, Jeffrey V., additional, Rosenlund, Christina, additional, Rosenthal, Guy, additional, Rossaint, Rolf, additional, Rossi, Sandra, additional, Rueckert, Daniel, additional, Rusnák, Martin, additional, Sahuquillo, Juan, additional, Sakowitz, Oliver, additional, SanchezPorras, Renan, additional, Sandor, Janos, additional, Schäfer, Nadine, additional, Schmidt, Silke, additional, Schoechl, Herbert, additional, Schoonman, Guus, additional, Schou, Rico Frederik, additional, Schwendenwein, Elisabeth, additional, Sewalt, Charlie, additional, Skandsen, Toril, additional, Smielewski, Peter, additional, Sorinola, Abayomi, additional, Stamatakis, Emmanuel, additional, Stanworth, Simon, additional, Stevens, Robert, additional, Stewart, William, additional, Stocchetti, Nino, additional, Sundström, Nina, additional, Takala, Riikka, additional, Tamás, Viktória, additional, Tamosuitis, Tomas, additional, Taylor, Mark Steven, additional, Ao, Braden Te, additional, Tenovuo, Olli, additional, Theadom, Alice, additional, Thomas, Matt, additional, Tibboel, Dick, additional, Timmers, Marjolein, additional, Tolias, Christos, additional, Trapani, Tony, additional, Tudora, Cristina Maria, additional, Unterberg, Andreas, additional, Vajkoczy, Peter, additional, Vallance, Shirley, additional, Valeinis, Egils, additional, Vámos, Zoltán, additional, van der Jagt, Mathieu, additional, van der Steen, Gregory, additional, van der Naalt, Joukje, additional, van Dijck, Jeroen T.J.M., additional, van Essen, Thomas A., additional, Van Hecke, Wim, additional, van Heugten, Caroline, additional, Van Praag, Dominique, additional, van Veen, Ernest, additional, Vyvere, Thijs Vande, additional, van Wijk, Roel P.J., additional, Vargiolu, Alessia, additional, Vega, Emmanuel, additional, Velt, Kimberley, additional, Verheyden, Jan, additional, Vespa, Paul M., additional, Vik, Anne, additional, Vilcinis, Rimantas, additional, Volovici, Victor, additional, von Steinbüchel, Nicole, additional, Voormolen, Daphne, additional, Vulekovic, Petar, additional, Wang, Kevin K.W., additional, Wiegers, Eveline, additional, Williams, Guy, additional, Winzeck, Stefan, additional, Wolf, Stefan, additional, Yang, Zhihui, additional, Ylén, Peter, additional, Younsi, Alexander, additional, Zeiler, Frederick A., additional, Zelinkova, Veronika, additional, Ziverte, Agate, additional, Zoerle, Tommaso, additional, Frantzén, Janek, additional, Katila, Ari, additional, Maanpää, Henna-Rikka, additional, Tallus, Jussi, additional, Adeoye, Opeolu, additional, Badjatia, Neeraj, additional, Boase, Kim, additional, Barber, Jason, additional, Bodien, Yelena, additional, Chesnut, Randall, additional, Corrigan, John D., additional, Crawford, Karen, additional, Dikmen, Sureyya, additional, Duhaime, Ann-Christine, additional, Ellenbogen, Richard, additional, Feeser, Ramana, additional, Ferguson, Adam R., additional, Foreman, Brandon, additional, Gardner, Raquel, additional, Gaudette, Etienne, additional, Giacino, Joseph, additional, Goldman, Dana, additional, Gonzalez, Luis, additional, Gopinath, Shankar, additional, Gullapalli, Rao, additional, Hemphill, Claude, additional, Hotz, Gillian, additional, Jain, Sonia, additional, Keene, Dirk, additional, Korley, Frederick K., additional, Kramer, Joel, additional, Kreitzer, Natalie, additional, Levin, Harvey, additional, Lindsell, Chris, additional, Machamer, Joan, additional, Madden, Christopher, additional, Manley, Geoffrey T., additional, Martin, Alastair, additional, McAllister, Thomas, additional, McCrea, Michael, additional, Merchant, Randall, additional, Mukherjee, Pratik, additional, Nelson, Lindsay, additional, Ngwenya, Laura B, additional, Noel, Florence, additional, Nolan, Amber, additional, Okonkwo, David, additional, Palacios, Eva, additional, Perl, Daniel, additional, Puccio, Ava, additional, Rabinowitz, Miri, additional, Robertson, Claudia, additional, Sander, Angelle, additional, Satris, Gabriella, additional, Schnyer, David, additional, Seabury, Seth, additional, Sherer, Mark, additional, Stein, Murray, additional, Taylor, Sabrina, additional, Toga, Arthur, additional, Valadka, Alex, additional, Vassar, Mary, additional, Yue, John K., additional, Yuh, Esther, additional, and Zafonte, Ross, additional
Published: 2022
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107. Effect of frailty on 6-month outcome after traumatic brain injury: a multicentre cohort study with external validation

Author: Galimberti, Stefania, primary, Graziano, Francesca, additional, Maas, Andrew I R, additional, Isernia, Giulia, additional, Lecky, Fiona, additional, Jain, Sonia, additional, Sun, Xiaoying, additional, Gardner, Raquel C, additional, Taylor, Sabrina R, additional, Markowitz, Amy J, additional, Manley, Geoffrey T, additional, Valsecchi, Maria Grazia, additional, Bellelli, Giuseppe, additional, Citerio, Giuseppe, additional, Ackerlund, Cecilia, additional, Adams, Hadie, additional, Amrein, Krisztina, additional, Andelic, Nada, additional, Andreassen, Lasse, additional, Anke, Audny, additional, Antoni, Anna, additional, Audibert, Gérard, additional, Azouvi, Philippe, additional, Azzolini, Maria Luisa, additional, Bartels, Ronald, additional, Barzó, Pál, additional, Beauvais, Romuald, additional, Beer, Ronny, additional, Bellander, Bo-Michael, additional, Belli, Antonio, additional, Benali, Habib, additional, Berardino, Maurizio, additional, Beretta, Luigi, additional, Blaabjerg, Morten, additional, Bragge, Peter, additional, Brazinova, Alexandra, additional, Brinck, Vibeke, additional, Brooker, Joanne, additional, Brorsson, Camilla, additional, Buki, Andras, additional, Bullinger, Monika, additional, Cabeleira, Manuel, additional, Caccioppola, Alessio, additional, Calappi, Emiliana, additional, Calvi, Maria Rosa, additional, Cameron, Peter, additional, Carbayo Lozano, Guillermo, additional, Carbonara, Marco, additional, Castaño-León, Ana M., additional, Cavallo, Simona, additional, Chevallard, Giorgio, additional, Chieregato, Arturo, additional, Clusmann, Hans, additional, Coburn, Mark Steven, additional, Coles, Jonathan, additional, Cooper, Jamie D., additional, Correia, Marta, additional, Covic, Amra, additional, Curry, Nicola, additional, Czeiter, Endre, additional, Czosnyka, Marek, additional, Dahyot-Fizelier, Claire, additional, Dark, Paul, additional, Dawes, Helen, additional, De Keyser, Véronique, additional, Degos, Vincent, additional, Della Corte, Francesco, additional, den Boogert, Hugo, additional, Depreitere, Bart, additional, Đilvesi, Đula, additional, Dixit, Abhishek, additional, Donoghue, Emma, additional, Dreier, Jens, additional, Dulière, Guy-Loup, additional, Ercole, Ari, additional, Esser, Patrick, additional, Ezer, Erzsébet, additional, Fabricius, Martin, additional, Feigin, Valery L., additional, Foks, Kelly, additional, Frisvold, Shirin, additional, Furmanov, Alex, additional, Gagliardo, Pablo, additional, Galanaud, Damien, additional, Gantner, Dashiell, additional, Gao, Guoyi, additional, George, Pradeep, additional, Ghuysen, Alexandre, additional, Giga, Lelde, additional, Glocker, Ben, additional, Golubovic, Jagoš, additional, Gomez, Pedro A., additional, Gratz, Johannes, additional, Gravesteijn, Benjamin, additional, Grossi, Francesca, additional, Gruen, Russell L., additional, Gupta, Deepak, additional, Haagsma, Juanita A., additional, Haitsma, Iain, additional, Helbok, Raimund, additional, Helseth, Eirik, additional, Horton, Lindsay, additional, Huijben, Jilske, additional, Hutchinson, Peter J., additional, Jacobs, Bram, additional, Jankowski, Stefan, additional, Jarrett, Mike, additional, Jiang, Ji-yao, additional, Johnson, Faye, additional, Jones, Kelly, additional, Karan, Mladen, additional, Kolias, Angelos G., additional, Kompanje, Erwin, additional, Kondziella, Daniel, additional, Koskinen, Lars-Owe, additional, Kovács, Noémi, additional, Kowark, Ana, additional, Lagares, Alfonso, additional, Lanyon, Linda, additional, Laureys, Steven, additional, Ledoux, Didier, additional, Lefering, Rolf, additional, Legrand, Valerie, additional, Lejeune, Aurelie, additional, Levi, Leon, additional, Lightfoot, Roger, additional, Lingsma, Hester, additional, Maegele, Marc, additional, Majdan, Marek, additional, Manara, Alex, additional, Maréchal, Hugues, additional, Martino, Costanza, additional, Mattern, Julia, additional, McFadyen, Charles, additional, McMahon, Catherine, additional, Melegh, Béla, additional, Menon, David, additional, Menovsky, Tomas, additional, Mikolic, Ana, additional, Misset, Benoit, additional, Muraleedharan, Visakh, additional, Murray, Lynnette, additional, Negru, Ancuta, additional, Nelson, David, additional, Newcombe, Virginia, additional, Nieboer, Daan, additional, Nyirádi, József, additional, Oresic, Matej, additional, Ortolano, Fabrizio, additional, Otesile, Olubukola, additional, Palotie, Aarno, additional, Parizel, Paul M., additional, Payen, Jean-François, additional, Perera, Natascha, additional, Perlbarg, Vincent, additional, Persona, Paolo, additional, Peul, Wilco, additional, Piippo-Karjalainen, Anna, additional, Pirinen, Matti, additional, Pisica, Dana, additional, Ples, Horia, additional, Polinder, Suzanne, additional, Pomposo, Inigo, additional, Posti, Jussi P., additional, Puybasset, Louis, additional, Radoi, Andreea, additional, Ragauskas, Arminas, additional, Raj, Rahul, additional, Rambadagalla, Malinka, additional, Rehorčíková, Veronika, additional, Retel Helmrich, Isabel, additional, Rhodes, Jonathan, additional, Richardson, Sylvia, additional, Richter, Sophie, additional, Ripatti, Samuli, additional, Rocka, Saulius, additional, Roe, Cecilie, additional, Roise, Olav, additional, Rosenfeld, Jeffrey, additional, Rosenlund, Christina, additional, Rosenthal, Guy, additional, Rossaint, Rolf, additional, Rossi, Sandra, additional, Rueckert, Daniel, additional, Rusnák, Martin, additional, Sahuquillo, Juan, additional, Sakowitz, Oliver, additional, Sanchez-Porras, Renan, additional, Sandor, Janos, additional, Schäfer, Nadine, additional, Schmidt, Silke, additional, Schoechl, Herbert, additional, Schoonman, Guus, additional, Schou, Rico Frederik, additional, Schwendenwein, Elisabeth, additional, Sewalt, Charlie, additional, Singh, Ranjit D., additional, Skandsen, Toril, additional, Smielewski, Peter, additional, Sorinola, Abayomi, additional, Stamatakis, Emmanuel, additional, Stanworth, Simon, additional, Stevens, Robert, additional, Stewart, William, additional, Steyerberg, Ewout W., additional, Stocchetti, Nino, additional, Sundström, Nina, additional, Takala, Riikka, additional, Tamás, Viktória, additional, Tamosuitis, Tomas, additional, Taylor, Mark Steven, additional, Te Ao, Braden, additional, Tenovuo, Olli, additional, Theadom, Alice, additional, Thomas, Matt, additional, Tibboel, Dick, additional, Timmers, Marjolijn, additional, Tolias, Christos, additional, Trapani, Tony, additional, Tudora, Cristina Maria, additional, Unterberg, Andreas, additional, Vajkoczy, Peter, additional, Valeinis, Egils, additional, Vallance, Shirley, additional, Vámos, Zoltán, additional, van der Jagt, Mathieu, additional, van der Naalt, Joukje, additional, Van der Steen, Gregory, additional, van Dijck, Jeroen T.J.M., additional, van Erp, Inge A., additional, van Essen, Thomas A., additional, Van Hecke, Wim, additional, van Heugten, Caroline, additional, Van Praag, Dominique, additional, van Veen, Ernest, additional, van Wijk, Roel, additional, Vande Vyvere, Thijs, additional, Vargiolu, Alessia, additional, Vega, Emmanuel, additional, Velt, Kimberley, additional, Verheyden, Jan, additional, Vespa, Paul M., additional, Vik, Anne, additional, Vilcinis, Rimantas, additional, Volovici, Victor, additional, von Steinbüchel, Nicole, additional, Voormolen, Daphne, additional, Vulekovic, Peter, additional, Wang, Kevin K.W., additional, Wiegers, Eveline, additional, Williams, Guy, additional, Wilson, Lindsay, additional, Wolf, Stefan, additional, Yang, Zhihui, additional, Ylén, Peter, additional, Younsi, Alexander, additional, Zeiler, Frederick A., additional, Ziverte, Agate, additional, Zoerle, Tommaso, additional, Adeoye, Opeolu, additional, Badjatia, Neeraj, additional, Barber, Jason, additional, Bergin, Michael, additional, Boase, Kim, additional, Bodien, Yelena, additional, Chesnut, Randall, additional, Corrigan, John, additional, Crawford, Karen, additional, Diaz-Arrastia, Ramon, additional, Dikmen, Sureyya, additional, Duhaime, Ann-Christine, additional, Ellenbogen, Richard, additional, Feeser, Venkata, additional, Ferguson, Adam R, additional, Foreman, Brandon, additional, Gaudette, Etienne, additional, Giacino, Joseph, additional, Gonzalez, Luis, additional, Gopinath, Shankar, additional, Grandhi, Ramesh, additional, Gullapalli, Rao, additional, Hemphill, Claude, additional, Hotz, Gillian, additional, Huie, Russell, additional, Jha, Ruchira, additional, Keene, C. Dirk, additional, Kitagawa, Ryan, additional, Korley, Frederick, additional, Kramer, Joel, additional, Kreitzer, Natalie, additional, Levin, Harvey, additional, Lindsell, Chris, additional, Machamer, Joan, additional, Madden, Christopher, additional, Martin, Alastair, additional, McAllister, Thomas, additional, McCrea, Michael, additional, Merchant, Randall, additional, Mukherjee, Pratik, additional, Nelson, Lindsay, additional, Ngwenya, Laura B., additional, Noel, Florence, additional, Nolan, Amber, additional, Okonkwo, David, additional, Palacios, Eva, additional, Perl, Daniel, additional, Puccio, Ava, additional, Rabinowitz, Miri, additional, Robertson, Claudia, additional, Rodgers, Richard Ben, additional, Rosand, Jonathan, additional, Rosenthal, Eric, additional, Sander, Angelle, additional, Sandsmark, Danielle, additional, Sugar, Gabriella, additional, Schneider, Andrea, additional, Schnyer, David, additional, Seabury, Seth, additional, Sherer, Mark, additional, Stein, Murray, additional, Temkin, Nancy, additional, Toga, Arthur, additional, Torres-Espin, Abel, additional, Valadka, Alex, additional, Vassar, Mary, additional, Wang, Kevin, additional, Wang, Vincent, additional, Yue, John K., additional, Yuh, Esther, additional, and Zafonte, Ross, additional
Published: 2022
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108. Impact of Antithrombotic Agents on Radiological Lesion Progression in Acute Traumatic Brain Injury

Author: Mathieu, François, Güting, Helge, Gravesteijn, Benjamin, Monteiro, Miguel, Glocker, Ben, Kornaropoulos, Evgenios N., Kamnistas, Konstantinos, Robertson, Claudia S., Levin, Harvey, Whitehouse, Daniel P., Das, Tilak, Lingsma, Hester F., Maegele, Marc, Newcombe, Virginia F.j., Menon, David K., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Luisa Azzolini, Maria, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Fabricius, Martin, Kondziella, Daniel, Nelson, David, Mathieu, Françoi, Güting, Helge, Gravesteijn, Benjamin, Monteiro, Miguel, Glocker, Ben, Kornaropoulos, Evgenios N, Kamnistas, Konstantino, Robertson, Claudia S, Levin, Harvey, Whitehouse, Daniel P, Das, Tilak, Lingsma, Hester F, Maegele, Marc, Newcombe, Virginia F J, Menon, David K (Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Investigators and Participants), Beretta, Luigi, Newcombe, Virginia [0000-0001-6044-9035], Apollo - University of Cambridge Repository, Mathieu, F, Güting, H, Gravesteijn, B, Monteiro, M, Glocker, B, Kornaropoulos, E, Kamnistas, K, Robertson, C, Levin, H, Whitehouse, D, Das, T, Lingsma, H, Citerio, G, Molecular Neuroscience and Ageing Research (MOLAR), Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Psychiatrie & Neuropsychologie, and Public Health
Subjects: Male, 030506 rehabilitation, Neurologi, INTRACEREBRAL HEMORRHAGE, PREINJURY WARFARIN, SEGMENTATION, Glasgow Outcome Scale, antiplatelet, Cohort Studies, 0302 clinical medicine, Brain Injuries, Traumatic, Antithrombotic, ANTIPLATELET AGENTS, Aged, 80 and over, RISK, OUTCOMES, traumatic brain injury, Head injury, Middle Aged, Clopidogrel, Intracranial Hemorrhage, Traumatic, 3. Good health, Neurology, CLOPIDOGREL, Disease Progression, anticoagulant, antiplatelet, intracranial hemorrhage, traumatic brain injury, Female, medicine.symptom, 0305 other medical science, Cohort study, medicine.drug, medicine.medical_specialty, Traumatic brain injury, Lesion, 03 medical and health sciences, ANTICOAGULATION, Internal medicine, medicine, Humans, Propensity Score, Aged, Intracerebral hemorrhage, business.industry, MORTALITY, anticoagulant, HEAD-INJURY, Anticoagulants, medicine.disease, Case-Control Studies, Neurology (clinical), Tomography, X-Ray Computed, business, Platelet Aggregation Inhibitors, 030217 neurology & neurosurgery, intracranial hemorrhage
Abstract: An increasing number of elderly patients are being affected by traumatic brain injury (TBI) and a significant proportion are on pre-hospital antithrombotic therapy for cardio- or cerebrovascular indications. We have quantified the impact of antiplatelet/anticoagulant (APAC) agents on radiological lesion progression in acute TBI, using a novel, semi-automated approach to volumetric lesion measurement, and explored the impact of use on clinical outcomes in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. We used a 1:1 propensity-matched cohort design, matching controls to APAC users based on demographics, baseline clinical status, pre-injury comorbidities, and injury severity. Subjects were selected from a pool of patients enrolled in CENTER-TBI with computed tomography (CT) scan at admission and repeated within 7 days of injury. We calculated absolute changes in volume of intraparenchymal, extra-axial, intraventricular, and total intracranial hemorrhage (ICH) between scans, and compared volume of hemorrhagic progression, proportion of patients with significant degree of progression (>25% of initial volume), proportion with new ICH on follow-up CT, as well as clinical course and outcomes. A total of 316 patients were included (158 APAC users; 158 controls). The mean volume of progression was significantly higher in the APAC group for extra-axial (3.1 vs. 1.3 mL, p = 0.01), but not intraparenchymal (3.8 vs. 4.6 mL, p = 0.65), intraventricular (0.2 vs. 0.0 mL, p = 0.79), or total intracranial hemorrhage (ICH; 7.0 vs. 6.0 mL, p = 0.08). More patients had significant hemorrhage growth (54.1 vs. 37.0%, p = 0.003) and delayed ICH (4 of 18 vs. none; p = 0.04) in the APAC group compared with controls, but this was not associated with differences in length of stay (LOS), rates of neurosurgical intervention, mortality or Glasgow Outcome Scale Extended (GOS-E) score at 6 months. Pre-injury use of antithrombotic agents was associated with greater expansion of extra-axial lesions, higher rates of significant hemorrhagic progression, and higher risk of delayed traumatic ICH, but this was not associated with worse clinical course or functional outcomes., Funding Agencies:Cambridge Commonwealth Trust Academy of Medical Sciences/The Health Foundation Clinician Scientist Fellowship National Institute for Health Research (NIHR)
Published: 2020

109. Oesophageal pressure and respiratory muscle ultrasonographic measurements indicate inspiratory effort during pressure support ventilation

Author: Davide Chiumello, Alessio Caccioppola, M. Guanziroli, Paolo Formenti, Silvia Coppola, Andrea C Lusardi, and Michele Umbrello
Subjects: Adult, Male, medicine.medical_specialty, Critical Care, Critical Illness, Diaphragm, Pressure support ventilation, Positive-Pressure Respiration, 03 medical and health sciences, Work of breathing, Esophagus, 0302 clinical medicine, 030202 anesthesiology, Internal medicine, medicine, Respiratory muscle, Humans, Aged, Ultrasonography, Work of Breathing, Aged, 80 and over, business.industry, Oesophageal pressure, Middle Aged, Respiratory Muscles, Diaphragm (structural system), Anesthesiology and Pain Medicine, medicine.anatomical_structure, Parasternal line, Cardiology, Female, business, Intercostal muscle
Abstract: Background Bedside measures of patient effort are essential to properly titrate the level of pressure support ventilation. We investigated whether the tidal swing in oesophageal (ΔPes) and transdiaphragmatic pressure (ΔPdi), and ultrasonographic changes in diaphragm (TFdi) and parasternal intercostal (TFic) thickening are reliable estimates of respiratory effort. The effect of diaphragm dysfunction was also considered. Methods Twenty-one critically ill patients were enrolled: age 73 (14) yr, BMI 27 (7) kg m−2, and Pao2/Fio2 33.3 (9.2) kPa. A three-level pressure support trial was performed: baseline, 25% (PS-medium), and 50% reduction (PS-low). We recorded the oesophageal and transdiaphragmatic pressure–time products (PTPs), work of breathing (WOB), and diaphragm and intercostal ultrasonography. Diaphragm dysfunction was defined by the Gilbert index. Results Pressure support was 9.0 (1.6) cm H2O at baseline, 6.7 (1.3) (PS-medium), and 4.4 (1.0) (PS-low). ΔPes was significantly associated with the oesophageal PTP (R2=0.868; P Conclusions ΔPes and ΔPdi are adequate estimates of inspiratory effort. Diaphragm ultrasonography is a reliable indicator of inspiratory effort in the absence of diaphragm dysfunction. Additional measurement of parasternal intercostal thickening may discriminate a low inspiratory effort or a high effort in the presence of a dysfunctional diaphragm.
Published: 2020

110. Optic Nerve Sheath Diameter is not Related to Intracranial Pressure in Subarachnoid Hemorrhage Patients

Author: Tatiana Birg, Fabio Triulzi, Sabrina Avignone, Alessio Caccioppola, Elisa R. Zanier, Tommaso Zoerle, Eleonora D’Angelo, Nino Stocchetti, Giorgio Conte, Fabrizio Ortolano, and Marco Carbonara
Subjects: Optic nerve sheath, medicine.medical_specialty, Subarachnoid hemorrhage, Neurology, integumentary system, medicine.diagnostic_test, business.industry, Ultrasound, 030208 emergency & critical care medicine, Magnetic resonance imaging, Critical Care and Intensive Care Medicine, medicine.disease, Intensive care unit, nervous system diseases, law.invention, 03 medical and health sciences, 0302 clinical medicine, Cerebrospinal fluid, law, Medicine, Neurology (clinical), business, Nuclear medicine, 030217 neurology & neurosurgery, Intracranial pressure
Abstract: Intracranial pressure (ICP) monitoring is essential after subarachnoid hemorrhage (SAH) to prevent secondary brain insults and to tailor individualized treatments. Optic nerve sheath diameter (ONSD), measured using ultrasound (US), could serve as a noninvasive bedside tool to estimate ICP, avoiding the risks of hemorrhage or infection related to intracranial catheters. The aims of this study were twofold: first, to explore the reliability of US for measuring ONSD; second, to establish whether the US-ONSD can be considered a proxy for ICP in SAH patients early after bleeding. For the first aim, we compared the ONSD measurements given by magnetic resonance imaging (MRI-ONSD) with the US-ONSD findings. For the second aim, we analyzed the relationship between US-ONSD measurements and ICP values. Adult patients with diagnosis of aneurysmal SAH and external ventricular drainage system (EVD) were included. Ten patients were examined by MRI to assess ONSD, and the results were compared to the diameter given by US. In 20 patients, the US-ONSD values were related to ICP measured simultaneously through EVD. In ten of these patients, we explored the changes in the US-ONSD at the time of controlled and fairly rapid changes in ICP after cerebrospinal fluid (CSF) drainage. US-ONSD measurements at the bedside were accurate, very similar to the diameters measured by MRI (the mean difference in the Bland–Altman plot was 0.08 mm, 95% limits of agreement: − 1.13; + 1.23 mm). No clear relationship was detectable between the ICP and US-ONSD, and a linear regression model showed an angular coefficient very close to 0 (p > 0.05). US-ONSD and ICP values were in agreement after CSF drainage and shifts in ICP in a limited number of patients. US-ONSD measurement does not accurately estimate ICP in SAH patients in the intensive care unit.
Published: 2020

111. Internal clock and the surgical ICU patient

Author: Silvia Coppola, Davide Chiumello, and Alessio Caccioppola
Subjects: Critical Care, Sedation, medicine.medical_treatment, Period (gene), Circadian clock, Chronobiology Disorders, Melatonin, 03 medical and health sciences, 0302 clinical medicine, Intensive care, Humans, Medicine, Postoperative Period, Circadian rhythm, Mechanical ventilation, Narration, business.industry, 030208 emergency & critical care medicine, Intensive Care Units, Anesthesiology and Pain Medicine, 030228 respiratory system, Anesthesia, Delirium, medicine.symptom, business, medicine.drug
Abstract: Purpose of review The alteration of circadian rhythms in the postoperative period has been demonstrated to influence the outcomes. With this narrative review we would revise how anesthesia, surgery and intensive care can interfere with the circadian clock, how this could impact on the postsurgical period and how to limit the disruption of the internal clock. Recent findings Anesthesia affects the clock in relation to the day-time administration and the type of anesthetics, N-methyl-D-aspartate receptor antagonists or gamma-aminobutyric acid receptors agonists. Surgery causes stress and trauma with consequent alteration in the circadian release of cortisol, cytokines and melatonin. ICU represents a further challenge for the patient internal clock because of sedation, immobility, mechanical ventilation and alarms noise. Summary The synergic effect of anesthesia, surgery and postoperative intensive care on circadian rhythms require a careful approach to the patient considering a role for therapies and interventions aimed to re-establish the normal circadian rhythms. Over time, approach like the Awakening and Breathing Coordination, Delirium Monitoring and Management, Early Mobility and Family engagement and empowerment bundle can implement the clinical practice.
Published: 2020

112. End -of -life practices in traumatic brain injury patients: Report of a questionnaire from the CENTER-TBI study

Author: van Veen, Ernest, van der Jagt, Mathieu, Citerio, Guiseppe, Stocchetti, Nino, Epker, Jelle, Gommers, Diederik, Burdorf, Lex, Menon, David K, Maas, Andrew I.R., Lingsma, Hester F, Kompanje, Erwin J.O., Andelic, Nada, Andreassen, Lasse, Anke, Audny, Frisvold, Shirin, Helseth, Eirik, Røe, Cecilie, Røise, Olav, Skandsen, Toril, Vik, Anne, Åkerlund, Cecilia, Amrein, Krisztina, Antoni, Anna, Audibert, Gerard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzo, Pal, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, van Veen, E, van der Jagt, M, Citerio, G, Stocchetti, N, Epker, J, Gommers, D, Burdorf, L, Menon, D, Maas, A, Lingsma, H, Kompanje, E, Intensive Care, Public Health, and CENTER-TBI Investigators Participa
Subjects: medicine.medical_specialty, Withdrawing life-sustaining measure, Neurologi, Traumatic brain injury, Decision Making, Comparative effectiveness research, Critical Care and Intensive Care Medicine, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Neurological Damage, Surveys and Questionnaires, Brain Injuries, Traumatic, medicine, Humans, Practice Patterns, Physicians', Study Completed, Withholding treatment, Withholding Treatment, business.industry, Withdrawing life-sustaining measures, 030208 emergency & critical care medicine, Middle Aged, medicine.disease, Intensive care unit, humanities, Death, Europe, Palliative Therapy, Intensive Care Units, Critical care, 030228 respiratory system, Neurology, Emergency medicine, Human medicine, business, End-of-life
Abstract: Purpose: We aimed to study variation regarding speci fic end -of -life (EoL) practices in the intensive care unit (ICU) in traumatic brain injury (TBI) patients. Materials and methods: Respondents from 67 hospitals participating in The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study completed several questionnaires on man- agement of TBI patients. Results: In 60% of the centers, ?50% of all patients with severe neurological damage dying in the ICU, die after withdrawal of life -sustaining measures (LSM). The decision to withhold/withdraw LSM was made following multidisciplinary consensus in every center. Legal representatives/relatives played a role in the decision - making process in 81% of the centers. In 82% of the centers, age played a role in the decision to withhold/with- draw LSM. Furthermore, palliative therapy was initiated in 79% of the centers after the decision to withdraw LSM was made. Last, withholding/withdrawing LSM was, generally, more often considered after more time had passed, in a patient with TBI, who remained in a very poor prognostic condition. Conclusion: We found variation regarding EoL practices in TBI patients. These results provide insight into variabil- ity regarding important issues pertaining to EoL practices in TBI, which can be useful to stimulate discussions on EoL practices, comparative effectiveness research, and, ultimately, development of recommendations. ? 2020 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
Published: 2020

113. Relationship of admission blood proteomic biomarkers levels to lesion type and lesion burden in traumatic brain injury: A CENTER-TBI study

Author: Whitehouse, Daniel, Monteiro, Miguel, Czeiter, Endre, Vyvere, Thijs Vande, Valerio, Fernanda, Ye, Zheng, Amrein, Krisztina, Kamnitsas, Konstantinos, Xu, Haiyan, Yang, Zhihui, Verheyden, Jan, Newcombe, Virginia F.J., Andelic, Nada, Andreassen, Lasse, Vik, Anne, Anke, Audny Gabriele Wagner, Helseth, Eirik, Skandsen, Toril, Røe, Cecilie, Røise, Olav, Frisvold, Shirin, Antoni, Anna, Audibert, Gerard, Azouvi, Philippe, Azzolini, Maria Luisa, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Castaño-León, Ana M., Public Health, Newcombe, Virginia [0000-0001-6044-9035], Apollo - University of Cambridge Repository, Engineering & Physical Science Research Council (E, and Commission of the European Communities
Subjects: Male, Proteomics, Traumatic, CENTER-TBI Participants and Investigators, Medicine (General), Brain injury, Traumatic, 1103 Clinical Sciences, Neuroimaging, General Medicine, Article, General Biochemistry, Genetics and Molecular Biology, 1117 Public Health and Health Services, R5-920, nervous system, Brain Injuries, Traumatic, Humans, Medicine, Human medicine, Prospective Studies, Brain injury, Tomography, X-Ray Computed, Computed tomography, Biomarkers
Abstract: Background: We aimed to understand the relationship between serum biomarker concentration and lesion type and volume found on computed tomography (CT) following all severities of TBI. Methods: Concentrations of six serum biomarkers (GFAP, NFL, NSE, S100B, t-tau and UCH-L1) were measured in samples obtained
Published: 2022

114. Dynamic hyperinflation and intrinsic positive end-expiratory pressure in ARDS patients

Author: Alessio Caccioppola, Miriam Gotti, Erica Ferrari, Paolo Formenti, Davide Chiumello, Sara Froio, and Silvia Coppola
Subjects: medicine.medical_specialty, ARDS, Respiratory rate, Respiratory mechanics, Respiratory physiology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Gas exchange, Medicine, Respiratory system, Dynamic hyperinflation, Positive end-expiratory pressure, Tidal volume, Acute respiratory distress syndrome, business.industry, Intrinsic positive end-expiratory pressure, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, respiratory system, medicine.disease, respiratory tract diseases, 030228 respiratory system, Breathing, Cardiology, business, therapeutics, circulatory and respiratory physiology
Abstract: Background In ARDS patients, changes in respiratory mechanical properties and ventilatory settings can cause incomplete lung deflation at end-expiration. Both can promote dynamic hyperinflation and intrinsic positive end-expiratory pressure (PEEP). The aim of this study was to investigate, in a large population of ARDS patients, the presence of intrinsic PEEP, possible associated factors (patients’ characteristics and ventilator settings), and the effects of two different external PEEP levels on the intrinsic PEEP. Methods We made a secondary analysis of published data. Patients were ventilated with a tidal volume of 6–8 mL/kg of predicted body weight, sedated, and paralyzed. After a recruitment maneuver, a PEEP trial was run at 5 and 15 cmH2O, and partitioned mechanics measurements were collected after 20 min of stabilization. Lung computed tomography scans were taken at 5 and 45 cmH2O. Patients were classified into two groups according to whether or not they had intrinsic PEEP at the end of an expiratory pause. Results We enrolled 217 sedated, paralyzed patients: 87 (40%) had intrinsic PEEP with a median of 1.1 [1.0–2.3] cmH2O at 5 cmH2O of PEEP. The intrinsic PEEP significantly decreased with higher PEEP (1.1 [1.0–2.3] vs 0.6 [0.0–1.0] cmH2O; p 2O of PEEP; 480 [430–540] vs 510 [430–590] mL at 15 cmH2O) in patients with intrinsic PEEP, while the respiratory rate was significantly higher (18 [15–20] vs 15 [13–19] bpm at 5 cmH2O of PEEP; 18 [15–20] vs 15 [13–19] bpm at 15 cmH2O). At both PEEP levels, the total airway resistance and compliance of the respiratory system were not different in patients with and without intrinsic PEEP. The total lung gas volume and lung recruitability were also not different between patients with and without intrinsic PEEP (respectively 961 [701–1535] vs 973 [659–1433] mL and 15 [0–32] % vs 22 [0–36] %). Conclusions In sedated, paralyzed ARDS patients without a known obstructive disease, the amount of intrinsic PEEP during lung-protective ventilation is negligible and does not influence respiratory mechanical properties.
Published: 2019

115. Management of arterial partial pressure of carbon dioxide in the frst week after traumatic brain injury: results from the CENTER-TBI study

Author: Citerio, Giuseppe, Robba, Chiara, Rebora, Paola, Petrosino, Matteo, Rossi, elenora, Malgeri, L, Stocchetti, Nino, Galimberti, Stefania, Menon, David K., Andelic, Nada, Andreassen, Lasse, Anke, Audny Gabriele Wagner, Frisvold, Shirin, Helseth, Eirik, Røe, Cecilie, Røise, Olav, Skandsen, Toril, Vik, Anne, Åkerlund, Cecilia, Amrein, Krisztina, Antoni, Anna, Audibert, Gerard, Azouvi, Philippe, Azzolini, Maria luisa, Bartels, Ronald, Barzo, Pal, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brinck, Vibeke, Brazinova, Alexandra, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria rosa, Cameron, Peter, Lozano, Guillermo carbayo, Chevallard, Giorgio, Carbonara, Marco, Chieregato, Arturo, Cnossen, Maryse, Coburn, Mark, Citerio, G, Robba, C, Rebora, P, Petrosino, M, Rossi, E, Malgeri, L, Stocchetti, N, Galimberti, S, Menon, D, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, „Springer' grupė, Åkerlund, Cecilia, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, G Kolias, Angelos, Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Amrein, Krisztina, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Andelic, Nada, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, Maas, Andrew I. R., Castaño-León, Ana M., Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Andreassen, Lasse, Martino, Costanza, Maréchal, Hugues, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menon, David, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Anke, Audny, Murray, Lynnette, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Olubukola, Otesile, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Antoni, Anna, Parizel, Paul M., Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Pirinen, Matti, Pisica, Dana, Ples, Horia, Audibert, Gérard, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Raj, Rahul, Rambadagalla, Malinka, Helmrich, Isabel Retel, Rhodes, Jonathan, Azouvi, Philippe, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Azzolini, Maria Luisa, Rossaint, Rolf, Rossi, Sandra, Martin Rusnák, Daniel Rueckert, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Bartels, Ronald, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Sewalt, Charlie, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevens, Robert, Barzó, Pál, Stewart, William, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Taylor, Mark Steven, Te Ao, Braden, Tenovuo, Olli, Beauvais, Romuald, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Timmers, Marjolein, Tolias, Christos, Trapani, Tony, Maria Tudora, Cristina, Unterberg, Andreas, Vajkoczy, Peter, Vallance, Shirley, Beer, Ronny, Valeinis, Egils, Vámos, Zoltán, van der Jagt, Mathieu, Van der Steen, Gregory, Naalt, Joukje van der, van Dijck, Jeroen T. J. M., van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, Bellander, Bo-Michael, van Veen, Ernest, Vyvere, Thijs Vande, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Belli, Antonio, Volovici, Victor, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Petar, K W Wang, Kevin K. W., Wiegers, Eveline, Williams, Guy, Wilson, Lindsay, Winzeck, Stefan, Wolf, Stefan, Benali, Habib, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A., Zelinkova, Veronika, Ziverte, Agate, Zoerle, Tommaso, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Carbayo Lozano, Guillermo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Covic, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Ðilvesi, Ðula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, 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, Golubovic, 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, Ročka, Saulius, Tamošuitis, Tomas, Citerio, G., Robba, C., Rebora, P., Petrosino, M., Rossi, E., Malgeri, L., Stocchetti, N., Galimberti, S., Menon D. K., (Center-TBI participants and investigators), Beretta, L., Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, and Molecular Neuroscience and Ageing Research (MOLAR)
Subjects: medicine.medical_specialty, Intracranial Pressure, Traumatic brain injury, Original, Intracranial pressure, Partial Pressure, Critical Care and Intensive Care Medicine, GUIDELINES, carbon dioxide, hyperventilation, intracranial pressure, outcome, traumatic brain injury, law.invention, Cohort Studies, law, Anesthesiology, Hyperventilation, Brain Injuries, Traumatic, Medicine, Humans, Arterial Pressure, Prospective Studies, Outcome, Hypocapnia, business.industry, Brain Injuries, Traumatic/complications, HEAD-INJURY, Brain, Carbon Dioxide, medicine.disease, Intensive care unit, respiratory tract diseases, Carbon dioxide, Anesthesia, Breathing, Observational study, medicine.symptom, business, Cohort study, circulatory and respiratory physiology
Abstract: Intensive care medicine 47(9), 961-973 (2021). doi:10.1007/s00134-021-06470-7, Published by Springer, Berlin
Published: 2021

116. Questionnaires vs Interviews for the Assessment of Global Functional Outcomes After Traumatic Brain Injury

Author: Horton, lindsay, Rhodes, Jonathan, Menon, David K., Maas, Andrew I. R., Wilson, Lindsay, Andelic, Nada, Andreassen, Lasse, Anke, Audny Gabriele Wagner, Frisvold, Shirin, Helseth, Eirik, Røe, Cecilie, Røise, Olav, Skandsen, Toril, Vik, Anne, Åkerlund, Cecilia, Amrein, Krisztina, Antoni, Anna, Audibert, Gerard, Azouvi, Philippe, Azzolini, Maria luisa, Bartels, Ronald, Barzo, Pal, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria rosa, Cameron, Peter, Lozano, Guillermo carbayo, Carbonara, Marco, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Cnossen, Maryse, Coburn, Mark, Psychology 3, Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Molecular Neuroscience and Ageing Research (MOLAR), Trapani, Tony, Barzó, Pál, Gupta, Deepak, Levi, Leon, Rosenthal, Guy, Furmanov, Alex, Martino, Costanza, Beretta, Luigi, Calvi, Maria Rosa, Azzolini, Maria Luisa, Stocchetti, Nino, Vallance, Shirley, Calappi, Emiliana, Zoerle, Tommaso, Ortolano, Fabrizio, Carbonara, Marco, Caccioppola, Alessio, Citerio, Giuseppe, Vargiolu, Alessia, Chieregato, Arturo, Chevallard, Giorgio, Della Corte, Francesco, Murray, Lynnette, Grossi, Francesca, Rossi, Sandra, Persona, Paolo, Berardino, Maurizio, Cavallo, Simona, Rambadagalla, Malinka, Ziverte, Agate, Giga, Lelde, Valeinis, Egils, Vilcinis, Rimantas, Brooker, Joanne, Tamosuitis, Tomas, Rocka, Saulius, Ragauskas, Arminas, van der Naalt, Joukje, Jacobs, Bram, Steyerberg, Ewout W., Bartels, Ronald, den Boogert, Hugo, Kompanje, Erwin, Timmers, Marjolijn, Bragge, Peter, Foks, Kelly, Haitsma, Iain, Volovici, Victor, van der Jagt, Mathieu, Haagsma, Juanita A., Mikolic, Ana, Lingsma, Hester, Velt, Kimberley, Huijben, Jilske, Voormolen, Daphne, Rosenfeld, Jeffrey, Nieboer, Daan, Wiegers, Eveline, van Veen, Ernest, Pisica, Dana, Retel Helmrich, Isabel, Sewalt, Charlie, Gravesteijn, Benjamin, Polinder, Suzanne, Tibboel, Dick, van Wijk, Roel, Cooper, Jamie D., van Dijck, Jeroen T. J. M., van Essen, Thomas A., Peul, Wilco, Schoonman, Guus, Jones, Kelly, Feigin, Valery L., Te Ao, Braden, Theadom, Alice, Helseth, Eirik, Roe, Cecilie, Helbok, Raimund, Roise, Olav, Andelic, Nada, Frisvold, Shirin, Andreassen, Lasse, Anke, Audny, Vik, Anne, Skandsen, Toril, Ples, Horia, Tudora, Cristina Maria, Negru, Ancuta, Beer, Ronny, Vulekovic, Peter, Ðilvesi, Ðula, Karan, Mladen, Golubovic, Jagoš, Rehorcíková, Veronika, Taylor, Mark Steven, Brazinova, Alexandra, Majdan, Marek, Sahuquillo, Juan, Radoi, Andreea, Schoechl, Herbert, Carbayo Lozano, Guillermo, Pomposo, Inigo, Lagares, Alfonso, Gomez, Pedro A., Castaño-León, Ana M., Gagliardo, Pablo, Oresic, Matej, Bellander, Bo-Michael, Lanyon, Linda, George, Pradeep, Rusnák, Martin, Muraleedharan, Visakh, Nelson, David, Ackerlund, Cecilia, Koskinen, Lars-Owe, Sundström, Nina, Brorsson, Camilla, Belli, Antonio, Manara, Alex, Thomas, Matt, Czosnyka, Marek, Schwendenwein, Elisabeth, Smielewski, Peter, Cabeleira, Manuel, Coles, Jonathan, Richardson, Sylvia, Zeiler, Frederick A., Stamatakis, Emmanuel, Williams, Guy, Menon, David, Ercole, Ari, Dixit, Abhishek, Antoni, Anna, Newcombe, Virginia, Richter, Sophie, McFadyen, Charles, Hutchinson, Peter J., Kolias, Angelos G., Adams, Hadie, Correia, Marta, Rhodes, Jonathan, Stewart, William, McMahon, Catherine, De Keyser, Véronique, Rueckert, Daniel, Glocker, Ben, Tolias, Christos, Dawes, Helen, Esser, Patrick, van Heugten, Caroline, Curry, Nicola, Stanworth, Simon, Lecky, Fiona, Otesile, Olubukola, Menovsky, Tomas, Johnson, Faye, Dark, Paul, Jankowski, Stefan, Lightfoot, Roger, Wilson, Lindsay, Horton, Lindsay, Stevens, Robert, Rosand, Jonathan, Manley, Geoffrey, Jarrett, Mike, Van Praag, Dominique, Brinck, Vibeke, Wang, Kevin K. W., Yang, Zhihui, Vespa, Paul M., Maas, Andrew I. R., Van der Steen, Gregory, Parizel, Paul M., Vande Vyvere, Thijs, Depreitere, Bart, Van Hecke, Wim, Verheyden, Jan, Misset, Benoit, Ledoux, Didier, Laureys, Steven, Ghuysen, Alexandre, Maréchal, Hugues, Dulière, Guy-Loup, Gao, Guoyi, Jiang, Ji-yao, Kondziella, Daniel, Fabricius, Martin, Schou, Rico Frederik, Blaabjerg, Morten, Rosenlund, Christina, Piippo-Karjalainen, Anna, Raj, Rahul, Pirinen, Matti, Ripatti, Samuli, Palotie, Aarno, Ylén, Peter, Posti, Jussi P., Tenovuo, Olli, Takala, Riikka, Payen, Jean-François, Vega, Emmanuel, Lejeune, Aurelie, Audibert, Gérard, Degos, Vincent, Gruen, Russell L., Benali, Habib, Galanaud, Damien, Perlbarg, Vincent, Puybasset, Louis, Azouvi, Philippe, Legrand, Valerie, Dahyot-Fizelier, Claire, Rossaint, Rolf, Coburn, Mark Steven, Kowark, Ana, Cameron, Peter, Clusmann, Hans, Dreier, Jens, Wolf, Stefan, Vajkoczy, Peter, Maegele, Marc, Gratz, Johannes, Schäfer, Nadine, Lefering, Rolf, Covic, Amra, von Steinbüchel, Nicole, Donoghue, Emma, Schmidt, Silke, Bullinger, Monika, Younsi, Alexander, Unterberg, Andreas, Mattern, Julia, Sakowitz, Oliver, Sanchez-Porras, Renan, Perera, Natascha, Beauvais, Romuald, Sandor, Janos, Gantner, Dashiell, Czeiter, Endre, Buki, Andras, Ezer, Erzsébet, Vámos, Zoltán, Melegh, Béla, Tamás, Viktória, Sorinola, Abayomi, Kovács, Noémi, Nyirádi, József, Amrein, Krisztina, Tamošuitis, Tomas, American Medical Association, Horton, L., Rhodes, J., Menon, D. K., Maas, A. I. R., Wilson L., (Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) Participants and Investigators), Beretta, L., Ročka, Saulius, Horton, L, Rhodes, J, Menon, D, Maas, A, Wilson, L, and Citerio, G
Subjects: Male, Neurologi, INTRACEREBRAL HEMORRHAGE, MULTICENTER, Glasgow Outcome Scale, CENTER-TBI, Cohort Studies, computer assisted tomography, Quality of life, Surveys and Questionnaires, Brain Injuries, Traumatic, Outcome Assessment, Health Care, Clinical endpoint, Surveys and Questionnaire, adult, aged, cohort analysis, decision making, disease severity, female, functional status assessment, generalized anxiety disorder-7, Original Investigation, Brain Injuries, Traumatic/rehabilitation, Outcome Assessment, Health Care/methods, General Medicine, Middle Aged, EARLY SURGERY, Online Only, Neurology, AGREEMENT, RELIABILITY, Female, TRIAL, COEFFICIENT, Surveys and Questionnaires/statistics & numerical data, Human, Cohort study, Adult, medicine.medical_specialty, Interviews as Topic/statistics & numerical data, Traumatic brain injury, Reproducibility of Result, Follow-Up Studie, Interviews as Topic, INITIAL CONSERVATIVE TREATMENT, medicine, Humans, Aged, business.industry, Research, Gold standard, HEAD-INJURY, Reproducibility of Results, medicine.disease, Clinical trial, Structured interview, Quality of Life, Physical therapy, Human medicine, Cohort Studie, business, Follow-Up Studies
Abstract: This cohort study compares global functional outcome ratings of the Glasgow Outcome Scale–Extended administered as a structured interview vs a questionnaire to patients with traumatic brain injury., Key Points Question Does interviewing have added value compared with questionnaires in the assessment of functional outcomes in clinical research on traumatic brain injury (TBI)? Findings In this cohort study of 3691 individuals with TBI, there was good agreement between interview and questionnaire methods of assessing TBI outcomes, and correlations with baseline factors and patient-reported outcomes were similar between the methods. The core outcome information from interviews and questionnaires was found to be substantially similar. Meaning These findings suggest that in appropriate settings, questionnaires can be used to assess global functional outcomes after TBI and may offer substantial practical advantages compared with interviews., Importance An interview is considered the gold standard method of assessing global functional outcomes in clinical trials among patients with acute traumatic brain injury (TBI). However, several multicenter clinical trials have used questionnaires completed by a patient or caregiver to assess the primary end point. Objective To examine agreement between interview and questionnaire formats for assessing TBI outcomes and to consider whether an interview has advantages. Design, Setting, and Participants This cohort study used data from patients enrolled in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project from December 2014 to December 2017. Data were analyzed from December 2020 to April 2021. Included patients were aged 16 years or older with TBI and a clinical indication for computed tomography imaging. Outcome assessments were completed using both an interview and a questionnaire at follow-up 3 and 6 months after injury. Exposures Traumatic brain injury of all severities. Main Outcomes and Measures Ratings on the Glasgow Outcome Scale–Extended (GOSE) administered as a structured interview rated by an investigator and as a questionnaire completed by patients or caregivers and scored centrally were compared, and the strength of agreement was evaluated using weighted κ statistics. Secondary outcomes included comparison of different sections of the GOSE assessments and the association of GOSE ratings with baseline factors and patient-reported mental health, health-related quality of life, and TBI symptoms. Results Among the 3691 eligible individuals in the CENTER-TBI study, both GOSE assessment formats (interview and questionnaire) were completed by 994 individuals (26.9%) at 3 months after TBI (654 [65.8%] male; median age, 53 years [IQR, 33-66 years]) and 628 (17.0%) at 6 months (409 [65.1%] male; median age, 51 years [IQR, 31-64 years]). Outcomes of the 2 assessment methods agreed well at both 3 months (weighted κ, 0.77; 95% CI, 0.73-0.80) and 6 months (weighted κ, 0.82; 95% CI, 0.78-0.86). Furthermore, item-level agreement between the 2 methods was good for sections regarding independence in everyday activities (κ, 0.70-0.79 across both time points) and moderate for sections regarding subjective aspects of functioning such as relationships and symptoms (κ, 0.41-0.51 across both time points). Compared with questionnaires, interviews recorded more problems with work (294 [30.5%] vs 233 [24.2%] at 3 months and 161 [26.8%] vs 136 [22.7%] at 6 months), fewer limitations in social and leisure activities (330 [33.8%] vs 431 [44.1%] at 3 months and 179 [29.7%] vs 219 [36.4%] at 6 months), and more symptoms (524 [53.6%] vs 324 [33.1%] at 3 months and 291 [48.4%] vs 179 [29.8%] at 6 months). Interviewers sometimes assigned an overall rating based on judgment rather than interview scoring rules, particularly for patients with potentially unfavorable TBI outcomes. However, for both formats, correlations with baseline factors (ρ, −0.13 to 0.42) and patient-reported outcomes (ρ, 0.29 to 0.65) were similar in strength. Conclusions and Relevance In this cohort study, GOSE ratings obtained by questionnaire and interview methods were in good agreement. The similarity of associations of the ratings obtained by both GOSE methods with baseline factors and other TBI outcome measures suggests that despite some apparent differences, the core information collected by both interviews and questionnaires was similar. The findings support the use of questionnaires in studies in which this form of contact may offer substantial practical advantages compared with interviews.
Published: 2021

117. Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury

Author: Van Praag, Dominique L.G., primary, Wouters, Kristien, additional, Van Den Eede, Filip, additional, Wilson, Lindsay, additional, Maas, Andrew I.R., additional, Åkerlund, Cecilia, additional, Amrein, Krisztina, additional, Andelic, Nada, additional, Andreassen, Lasse, additional, Anke, Audny, additional, Antoni, Anna, additional, Audibert, Gérard, additional, Azouvi, Philippe, additional, Azzolini, Maria Luisa, additional, Bartels, Ronald, additional, Barzó, Pál, additional, Beauvais, Romuald, additional, Beer, Ronny, additional, Bellander, Bo-Michael, additional, Belli, Antonio, additional, Benali, Habib, additional, Berardino, Maurizio, additional, Beretta, Luigi, additional, Blaabjerg, Morten, additional, Bragge, Peter, additional, Brazinova, Alexandra, additional, Brinck, Vibeke, additional, Brooker, Joanne, additional, Brorsson, Camilla, additional, Buki, Andras, additional, Bullinger, Monika, additional, Cabeleira, Manuel, additional, Caccioppola, Alessio, additional, Calappi, Emiliana, additional, Calvi, Maria Rosa, additional, Cameron, Peter, additional, Lozano, Guillermo Carbayo, additional, Carbonara, Marco, additional, Cavallo, Simona, additional, Chevallard, Giorgio, additional, Chieregato, Arturo, additional, Citerio, Giuseppe, additional, Ceyisakar, Iris, additional, Clusmann, Hans, additional, Coburn, Mark, additional, Coles, Jonathan, additional, Cooper, Jamie D., additional, Correia, Marta, additional, Čović, Amra, additional, Curry, Nicola, additional, Czeiter, Endre, additional, Czosnyka, Marek, additional, Dahyot-Fizelier, Claire, additional, Dark, Paul, additional, Dawes, Helen, additional, De Keyser, Véronique, additional, Degos, Vincent, additional, Della Corte, Francesco, additional, Boogert, Hugo den, additional, Depreitere, Bart, additional, Đilvesi, Đula, additional, Dixit, Abhishek, additional, Donoghue, Emma, additional, Dreier, Jens, additional, Dulière, Guy-Loup, additional, Ercole, Ari, additional, Esser, Patrick, additional, Ezer, Erzsébet, additional, Fabricius, Martin, additional, Feigin, Valery L., additional, Foks, Kelly, additional, Frisvold, Shirin, additional, Furmanov, Alex, additional, Gagliardo, Pablo, additional, Galanaud, Damien, additional, Gantner, Dashiell, additional, Gao, Guoyi, additional, George, Pradeep, additional, Ghuysen, Alexandre, additional, Giga, Lelde, additional, Glocker, Ben, additional, Golubovic, Jagoš, additional, Gomez, Pedro A., additional, Gratz, Johannes, additional, Gravesteijn, Benjamin, additional, Grossi, Francesca, additional, Gruen, Russell L., additional, Gupta, Deepak, additional, Haagsma, Juanita A., additional, Haitsma, Iain, additional, Helbok, Raimund, additional, Helseth, Eirik, additional, Horton, Lindsay, additional, Huijben, Jilske, additional, Hutchinson, Peter J., additional, Jacobs, Bram, additional, Jankowski, Stefan, additional, Jarrett, Mike, additional, Jiang, Ji-yao, additional, Johnson, Faye, additional, Jones, Kelly, additional, Karan, Mladen, additional, Kolias, Angelos G., additional, Kompanje, Erwin, additional, Kondziella, Daniel, additional, Koraropoulos, Evgenios, additional, Koskinen, Lars-Owe, additional, Kovács, Noémi, additional, Kowark, Ana, additional, Lagares, Alfonso, additional, Lanyon, Linda, additional, Laureys, Steven, additional, Lecky, Fiona, additional, Ledoux, Didier, additional, Lefering, Rolf, additional, Legrand, Valerie, additional, Lejeune, Aurelie, additional, Levi, Leon, additional, Lightfoot, Roger, additional, Lingsma, Hester, additional, Castaño-León, Ana M., additional, Maegele, Marc, additional, Majdan, Marek, additional, Manara, Alex, additional, Manley, Geoffrey, additional, Martino, Costanza, additional, Maréchal, Hugues, additional, Mattern, Julia, additional, McMahon, Catherine, additional, Melegh, Béla, additional, Menon, David, additional, Menovsky, Tomas, additional, Mikolic, Ana, additional, Misset, Benoit, additional, Muraleedharan, Visakh, additional, Murray, Lynnette, additional, Negru, Ancuta, additional, Nelson, David, additional, Newcombe, Virginia, additional, Nieboer, Daan, additional, Nyirádi, József, additional, Olubukola, Otesile, additional, Oresic, Matej, additional, Ortolano, Fabrizio, additional, Palotie, Aarno, additional, Parizel, Paul M., additional, Payen, Jean-François, additional, Perera, Natascha, additional, Perlbarg, Vincent, additional, Persona, Paolo, additional, Peul, Wilco, additional, Piippo-Karjalainen, Anna, additional, Pirinen, Matti, additional, Ples, Horia, additional, Polinder, Suzanne, additional, Pomposo, Inigo, additional, Posti, Jussi P., additional, Puybasset, Louis, additional, Radoi, Andreea, additional, Ragauskas, Arminas, additional, Raj, Rahul, additional, Rambadagalla, Malinka, additional, Rhodes, Jonathan, additional, Richardson, Sylvia, additional, Richter, Sophie, additional, Ripatti, Samuli, additional, Rocka, Saulius, additional, Roe, Cecilie, additional, Roise, Olav, additional, Rosand, Jonathan, additional, Rosenfeld, Jeffrey V., additional, Rosenlund, Christina, additional, Rosenthal, Guy, additional, Rossaint, Rolf, additional, Rossi, Sandra, additional, Rueckert, Daniel, additional, Rusnák, Martin, additional, Sahuquillo, Juan, additional, Sakowitz, Oliver, additional, Sanchez-Porras, Renan, additional, Sandor, Janos, additional, Schäfer, Nadine, additional, Schmidt, Silke, additional, Schoechl, Herbert, additional, Schoonman, Guus, additional, Schou, Rico Frederik, additional, Schwendenwein, Elisabeth, additional, Sewalt, Charlie, additional, Skandsen, Toril, additional, Smielewski, Peter, additional, Sorinola, Abayomi, additional, Stamatakis, Emmanuel, additional, Stanworth, Simon, additional, Stevens, Robert, additional, Stewart, William, additional, Steyerberg, Ewout W., additional, Stocchetti, Nino, additional, Sundström, Nina, additional, Synnot, Anneliese, additional, Takala, Riikka, additional, Tamás, Viktória, additional, Tamosuitis, Tomas, additional, Taylor, Mark Steven, additional, Ao, Braden Te, additional, Tenovuo, Olli, additional, Theadom, Alice, additional, Thomas, Matt, additional, Tibboel, Dick, additional, Timmers, Marjolein, additional, Tolias, Christos, additional, Trapani, Tony, additional, Tudora, Cristina Maria, additional, Unterberg, Andreas, additional, Vajkoczy, Peter, additional, Vallance, Shirley, additional, Valeinis, Egils, additional, Vámos, Zoltán, additional, van der Jagt, Mathieu, additional, Van der Steen, Gregory, additional, van der Naalt, Joukje, additional, van Dijck, Jeroen T.J.M., additional, van Essen, Thomas A., additional, Van Hecke, Wim, additional, van Heugten, Caroline, additional, Van Praag, Dominique, additional, Vyvere, Thijs Vande, additional, van Wijk, Roel P.J., additional, Vargiolu, Alessia, additional, Vega, Emmanuel, additional, Velt, Kimberley, additional, Verheyden, Jan, additional, Vespa, Paul M., additional, Vik, Anne, additional, Vilcinis, Rimantas, additional, Volovici, Victor, additional, von Steinbüchel, Nicole, additional, Voormolen, Daphne, additional, Vulekovic, Petar, additional, Wang, Kevin K.W., additional, Wiegers, Eveline, additional, Williams, Guy, additional, Winzeck, Stefan, additional, Wolf, Stefan, additional, Yang, Zhihui, additional, Ylén, Peter, additional, Younsi, Alexander, additional, Zeiler, Frederick A., additional, Zelinkova, Veronika, additional, Ziverte, Agate, additional, and Zoerle, Tommaso, additional
Published: 2022
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118. Tra essere e voler essere. Un'analisi sistematica del curricolo australiano in materia di Educazione alla cittadinanza globale

Author: Caccioppola, Federica, primary
Published: 2022
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119. Use of the Ventrain Ventilation Device and an Airway Exchange Catheter to Manage Hypoxemia During Thoracic Surgery and One-Lung Ventilation

Author: Piccioni, F., primary, Caccioppola, A., additional, Rosboch, G.L., additional, Templeton, W., additional, and Valenza, F., additional
Published: 2021
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120. Electrolytes, albumin and acid base equilibrium during laparoscopic surgery

Author: Serena Baio, Tommaso Pozzi, Claudia Bianco, Davide Chiumello, Andrea C Lusardi, Giovanni Sabbatini, and Alessio Caccioppola
Subjects: Laparoscopic surgery, medicine.medical_specialty, Urinary system, medicine.medical_treatment, Sodium, Urology, Settore MED/41 - Anestesiologia, chemistry.chemical_element, chemistry.chemical_compound, Electrolytes, Albumins, medicine, Humans, Acid-Base Equilibrium, Creatinine, business.industry, Acid-base equilibrium, Water-electrolyte balance, Water-Electrolyte Balance, Laparoscopy, Albumin, Colorectal surgery, Anesthesiology and Pain Medicine, chemistry, Circulatory system, Albuminuria, medicine.symptom, business
Abstract: Background Surgery, causing inflammation, disrupts endothelial permeability leading to movement of fluids and albumin across the vascular barrier. Fluid therapy for restoring circulatory homeostasis may lead to positive fluid balance which has been shown to increase morbidity and mortality in surgical patients. The current investigation aims to describe physio-pathological changes in circulating albumin, fluid and electrolyte balance, and acidbase equilibrium in a cohort of patients undergoing laparoscopic surgery under general anesthesia. Methods Single-center prospective observational study. Patients undergoing laparoscopic colorectal surgery were screened for eligibility.. Before surgery the baseline fasting conditions were homogenized. Hemoglobin, urinary and plasmatic were collected before surgery and then at pre-defined timepoints. Albumin/Creatinine ratio was measured before and after surgery. Expected and actual circulating Sodium concentrations were compared according to a physiological theoretical model. Assessment and quantification of changes in major electrolytes, albumin and acid-base balance was defined as the primary outcome of the study. Results 38 patients were enrolled in the protocol. Patients had a positive electrolytes (Na+ 295 [244-375] mmol, Cl- 234 [195-295] mmol, K+ 16.8 [12.0-21.4] mmol) and fluid balance (2165 [1727-2728] ml). The positive fluid balance was associated with stable chloride (105 [103-107], end study vs 103 [102-106] mmol/L, baseline, p=ns) and potassium (4.2 [3.8-4.4], end study vs 4.1 [3.6-4.4] mmol/L, baseline, p=ns) levels, but sodium concentrations decreased over time (138 [137-140], end study vs 139 [138-141] mmol/L, baseline, p Conclusions Data from patients undergoing colorectal laparoscopic surgery showed a positive fluid balance, decreased circulating albumin and increased albuminuria. A positive sodium balance was not always associated with an increase in sodium plasma concentration.
Published: 2021

121. 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

122. Quality indicators for patients with traumatic brain injury in European intensive care units: A CENTER-TBI study

Author: 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

123. Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury

Author: Benjamin Y. Gravesteijn, Daan Nieboer, Ari Ercole, Hester F. Lingsma, David Nelson, Ben van Calster, Ewout W. Steyerberg, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Maryse Cnossen, Mark Coburn, Jonathan Coles, D. Jamie Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier Guy-Loup Dulière, Patrick Esser, Erzsébet Ezer Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett Ji-yao Jiang, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Koraropoulos, Lars-Owe Koskinen, Noémi Kovács, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I.R. Maas, Ana M. Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Davide Mulazzi, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, Virginia Newcombe, Quentin Noirhomme, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Ruben Real, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Ana Kowark, Robert Stevens, William Stewart, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Gregory Van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Audrey Vanhaudenhuyse, Roel P.J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederik A. Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Gravesteijn, B. Y., Nieboer, D., Ercole, A., Lingsma, H. F., Nelson, D., van Calster, B., Steyerberg E. W., (CENTER-TBI collaborators), Beretta, L., Ercole, Ari [0000-0001-8350-8093], Apollo - University of Cambridge Repository, Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Psychiatrie & Neuropsychologie, Molecular Neuroscience and Ageing Research (MOLAR), Gravesteijn, B, Nieboer, D, Ercole, A, Lingsma, H, Nelson, D, van Calster, B, Steyerberg, E, Akerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, 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, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Lozano, G, Carbonara, M, Chevallard, G, Chieregato, A, Citerio, G, Cnossen, M, Coburn, M, Coles, J, Cooper, D, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dawes, Ragauskas, Arminas, Ročka, Saulius, Tamošuitis, Tomas, Vilcinis, Rimantas, Public Health, Tamosuitis, Tomas, „Elsevier Science' grupė, Academic Medical Center, Centre of Excellence in Complex Disease Genetics, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Genomics of Neurological and Neuropsychiatric Disorders, HUS Neurocenter, Statistical and population genetics, Department of Mathematics and Statistics, Biostatistics Helsinki, Clinicum, Helsinki University Hospital Area, Neurokirurgian yksikkö, Samuli Olli Ripatti / Principal Investigator, and Complex Disease Genetics
Subjects: Male, Epidemiology, Medical Biotechnology (with a focus on Cell Biology (including Stem Cell Biology), Molecular Biology, Microbiology, Biochemistry or Biopharmacy), Logistic regression, computer.software_genre, Data science, Machine Learning, 0302 clinical medicine, Traumatic brain injury, Brain Injuries, Traumatic, Medicine, 030212 general & internal medicine, Decision Making, Computer-Assisted, Glasgow Outcome Scale, Regression analysis, Middle Aged, Prognosis, 3142 Public health care science, environmental and occupational health, Regression, Random forest, Female, TUTORIAL, Cohort study, Algorithm, Algorithms, Adult, BIG DATA, Prognosi, cohort study, data science, machine learning, prediction, prognosis, traumatic brain injury, Machine learning, VALIDATION, 03 medical and health sciences, VDP::Teknologi: 500::Medisinsk teknologi: 620, Humans, VDP::Medisinske Fag: 700, Glasgow Coma Scale, Medicinsk bioteknologi (med inriktning mot cellbiologi (inklusive stamcellsbiologi), molekylärbiologi, mikrobiologi, biokemi eller biofarmaci), Models, Statistical, business.industry, CARE, 3141 Health care science, VDP::Medical disciplines: 700, Logistic Models, Cohort study, Data science, Machine learning, Prediction, Prognosis, Traumatic brain injury, Artificial intelligence, Gradient boosting, business, Prediction, computer, 030217 neurology & neurosurgery, Predictive modelling, VDP::Technology: 500::Medical technology: 620
Abstract: OBJECTIVE: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. STUDY DESIGN AND SETTING: We performed logistic (LR), lasso, and ridge regression with key baseline predictors in the IMPACT-II database (15 studies, n=11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks, and were trained using the same predictors. To assess generalizability of predictions, we performed internal, internal-external, and external validation on the recent CENTER-TBI study (patients with GCS, Data used in preparation of this manuscript were obtained in the context of CENTER-TBI, a large collaborative project with the support of the European Union 7th Framework program (EC grant 602150). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), the OneMind (USA) and the Integra LifeSciences Corporation (USA). The funder had no role in the study design, enrollment, collection of data, writing, or publication decisions.
Published: 2020

124. Tracheal intubation in traumatic brain injury: a multicentre prospective observational study

Author: Benjamin Yael Gravesteijn, Charlie Aletta Sewalt, Daan Nieboer, David Krishna Menon, Andrew Maas, Fiona Lecky, Markus Klimek, Hester Floor Lingsma, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Iris Ceyisakar, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Koraropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I.R. Maas, Ana M. Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Roel P.J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, CENTER-TBI Collaborators, Gravesteijn, B, Sewalt, C, Nieboer, D, Menon, D, Maas, A, Lecky, F, Klimek, M, Lingsma, H, Akerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, 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, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Lozano, G, Carbonara, M, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Ceyisakar, I, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, 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, Golubovic, J, Gomez, P, Gratz, J, 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, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koraropoulos, E, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Castano-Leon, A, Maegele, M, Majdan, M, Manara, A, Manley, G, Martino, C, Marechal, H, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Newcombe, V, Nyiradi, J, Olubukola, O, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, 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, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Steyerberg, E, Stocchetti, N, Sundstrom, N, Synnot, A, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Vajkoczy, P, Vallance, S, Valeinis, E, Vamos, Z, van der Jagt, M, Van der Steen, G, van der Naalt, J, van Dijck, J, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, Vyvere, T, van Wijk, R, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Winzeck, S, Wolf, S, Yang, Z, Ylen, P, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Gravesteijn, Benjamin Yael, Sewalt, Charlie Aletta, Nieboer, Daan, Menon, David Krishna, Maas, Andrew, Lecky, Fiona, Klimek, Marku, Lingsma, Hester Floor (Center TBI Collaborators), Beretta, Luigi, Molecular Neuroscience and Ageing Research (MOLAR), Ragauskas, Arminas, Ročka, Saulius, Tamošuitis, Tomas, Vilcinis, Rimantas, Centre of Excellence in Complex Disease Genetics, Research Programs Unit, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Genomics of Neurological and Neuropsychiatric Disorders, HUS Neurocenter, Neurokirurgian yksikkö, Helsinki Institute for Information Technology, Statistical and population genetics, Department of Mathematics and Statistics, Biostatistics Helsinki, Clinicum, Helsinki University Hospital Area, Samuli Olli Ripatti / Principal Investigator, Complex Disease Genetics, Anesthesiology, Public Health, Neurology, Neurosurgery, Intensive Care, Pediatric Surgery, Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Psychiatrie & Neuropsychologie, Tamosuitis, Tomas, and „Elsevier Science' grupė
Subjects: Male, Medicin och hälsovetenskap, Neurologi, medicine.medical_treatment, CENTER-TBI, GUIDELINES, Medical and Health Sciences, DECREASED SURVIVAL, 0302 clinical medicine, Neuroscience and Neuroanaesthesia, HYPOTENSION, Brain Injuries, Traumatic, Medicine, Intubation, RAPID-SEQUENCE INTUBATION, 030212 general & internal medicine, Prospective Studies, tracheal intubation, Prospective cohort study, neurological outcome, OUTCOMES, Trauma Severity Indices, Abbreviated Injury Scale, traumatic brain injury, Head injury, Middle Aged, prehospital, PREHOSPITAL ENDOTRACHEAL INTUBATION, 3. Good health, Europe, Neurology, Anesthesia, effectiveness, Europe, neurological outcome, prehospital, tracheal intubation, traumatic brain injury, Female, Adult, Anestesi och intensivvård, Traumatic brain injury, effectiveness, 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, MANAGEMENT, Intubation, Intratracheal, Humans, Aged, POSITIVE-PRESSURE VENTILATION, Anesthesiology and Intensive Care, business.industry, Tracheal intubation, Glasgow Coma Scale, HEAD-INJURY, 030208 emergency & critical care medicine, Odds ratio, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Human medicine, business
Abstract: Contains fulltext : 226032.pdf (Publisher’s version ) (Open Access) BACKGROUND: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. METHODS: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. RESULTS: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio=1.01; 95% confidence interval, 0.79-1.28; P=0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio=0.86; 95% confidence interval, 0.65-1.13; P=0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P=0.009 and P=0.02, respectively), whereas in-hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P=0.01): in-hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. CONCLUSION: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that extracranial injury should influence the decision in the prehospital setting, and level of consciousness in the in-hospital setting. CLINICAL TRIAL REGISTRATION: NCT02210221.
Published: 2020

125. Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis

Author: Huijben, Jilske A., Wiegers, Eveline J. A., Lingsma, Hester F., Citerio, Giuseppe, Maas, Andrew I. R., Menon, David K., Ercole, Ari, Nelson, David, van der Jagt, Mathieu, Steyerberg, Ewout W., Helbok, Raimund, Lecky, Fiona, Peul, Wilco, Birg, Tatiana, Zoerle, Tommaso, Carbonara, Marco, Stocchetti, Nino, 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, 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, DeKeyser, Véronique, Degos, Vincent, Della Corte, Francesco, 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, Helseth, Eirik, Hutchinson, Peter J., Jankowski, Stefan, Johnson, Faye, Karan, Mladen, Kolias, AngelosG., Kondziella, Daniel, Koraropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Laureys, Steven, 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, Newcombe, Virginia, Nyirádi, József, Ortolano, Fabrizio, Payen, Jean-François, Perlbarg, Vincent, Persona, Paolo, 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, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Tenovuo, Olli, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Trapani, Tony, Tudora, CristinaMaria, Vajkoczy, Peter, Vallance, Shirley, Valeinis, Egils, Vámos, Zoltán, Van der Steen, Gregory, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, Vulekovic, Petar, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Younsi, Alexander, Zeiler, Frederick A., Clusmann, Agate Ziverte Hans, Voormolen, Daphne, van Dijck, Jeroen T. J. M., van Essen, Thomas A., Ragauskas, Arminas, Ročka, Saulius, Tamošuitis, Tomas, Vilcinis, Rimantas, Tamosuitis, Tomas, „Springer' grupė, CTR-TBI Investigators Participants, Huijben, J, Wiegers, E, Lingsma, H, Citerio, G, Maas, A, Menon, D, Ercole, A, Nelson, D, van der Jagt, M, Steyerberg, E, Helbok, R, Lecky, F, Peul, W, Birg, T, Zoerle, T, Carbonara, M, Stocchetti, N, Huijben, Jilske A. [0000-0002-2892-5406], Apollo - University of Cambridge Repository, Huijben, Jilske A [0000-0002-2892-5406], Huijben, J. A., Wiegers, E. J. A., Lingsma, H. F., Citerio, G., Maas, A. I. R., Menon, D. K., Ercole, A., Nelson, D., van der Jagt, M., Steyerberg, E. W., Helbok, R., Lecky, F., Peul, W., Birg, T., Zoerle, T., Carbonara, M., Stocchetti, N., 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., 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., Dekeyser, V., Degos, V., Della Corte, F., 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., 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., 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., Newcombe, V., Nyiradi, J., Ortolano, F., Payen, J. -F., Perlbarg, V., Persona, P., 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., 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 Wijk, R. P. J., Vargiolu, A., Vega, E., Vik, A., Vilcinis, R., Volovici, V., Vulekovic, P., Williams, G., Winzeck, S., Wolf, S., Younsi, A., Zeiler, F. A., Clusmann, A. Z. H., Voormolen, D., van Dijck, J. T. J. M., van Essen, T. A., Public Health, and Intensive Care
Subjects: medicine.medical_specialty, Critical Care, Neurologi, Traumatic brain injury, Original, Intracranial pressure, Population, Critical Care and Intensive Care Medicine, Intensive care unit, Traumatic brain injury, Intracranial pressure, Outcome, law.invention, 03 medical and health sciences, 0302 clinical medicine, law, Intensive care, Anesthesiology, Brain Injuries, Traumatic, Medicine, Humans, Glasgow Coma Scale, Intensive care unit, Israel, education, Outcome, education.field_of_study, business.industry, 030208 emergency & critical care medicine, Odds ratio, Middle Aged, medicine.disease, 3. Good health, Europe, Intensive Care Units, 030228 respiratory system, Neurology, Emergency medicine, Human medicine, business
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
Published: 2020

126. Electrolytes, albumin and acid base equilibrium during laparoscopic surgery

Author: SABBATINI, Giovanni, primary, CACCIOPPOLA, Alessio, additional, LUSARDI, Andrea C., additional, POZZI, Tommaso, additional, BIANCO, Claudia, additional, BAIO, Serena, additional, and CHIUMELLO, Davide, additional
Published: 2021
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127. Fluid balance and outcome in critically ill patients with traumatic brain injury (CENTER-TBI and OzENTER-TBI): a prospective, multicentre, comparative effectiveness study

Author: Wiegers, Eveline Janine Anna, primary, Lingsma, Hester Floor, additional, Huijben, Jilske Antonia, additional, Cooper, David James, additional, Citerio, Giuseppe, additional, Frisvold, Shirin, additional, Helbok, Raimund, additional, Maas, Andrew Ian Ramsay, additional, Menon, David Krishna, additional, Moore, Elizabeth Madeleine, additional, Stocchetti, Nino, additional, Dippel, Diederik Willem, additional, Steyerberg, Ewout Willem, additional, van der Jagt, Mathieu, additional, Brooker, Joanne, additional, Bragge, Peter, additional, Rosenfeld, Jeffrey, additional, Cooper, Jamie D., additional, Beer, Ronny, additional, Schoechl, Herbert, additional, Rusnák, Martin, additional, Schwendenwein, Elisabeth, additional, Antoni, Anna, additional, De Keyser, Véronique, additional, Menovsky, Tomas, additional, Van Praag, Dominique, additional, Maas, Andrew I.R., additional, Van der Steen, Gregory, additional, Parizel, Paul M., additional, Vande Vyvere, Thijs, additional, Depreitere, Bart, additional, Van Hecke, Wim, additional, Verheyden, Jan, additional, Misset, Benoit, additional, Ledoux, Didier, additional, Laureys, Steven, additional, Ghuysen, Alexandre, additional, Maréchal, Hugues, additional, Dulière, Guy-Loup, additional, Gao, Guoyi, additional, Jiang, Ji-yao, additional, Kondziella, Daniel, additional, Fabricius, Martin, additional, Schou, Rico Frederik, additional, Blaabjerg, Morten, additional, Rosenlund, Christina, additional, Piippo-Karjalainen, Anna, additional, Raj, Rahul, additional, Pirinen, Matti, additional, Ripatti, Samuli, additional, Palotie, Aarno, additional, Ylén, Peter, additional, Posti, Jussi P., additional, Tenovuo, Olli, additional, Takala, Riikka, additional, Payen, Jean-François, additional, Vega, Emmanuel, additional, Lejeune, Aurelie, additional, Audibert, Gérard, additional, Degos, Vincent, additional, Benali, Habib, additional, Galanaud, Damien, additional, Perlbarg, Vincent, additional, Puybasset, Louis, additional, Azouvi, Philippe, additional, Legrand, Valerie, additional, Dahyot-Fizelier, Claire, additional, Rossaint, Rolf, additional, Coburn, Mark Steven, additional, Kowark, Ana, additional, Clusmann, Hans, additional, Dreier, Jens, additional, Wolf, Stefan, additional, Vajkoczy, Peter, additional, Maegele, Marc, additional, Gratz, Johannes, additional, Schäfer, Nadine, additional, Lefering, Rolf, additional, Covic, Amra, additional, von Steinbüchel, Nicole, additional, Schmidt, Silke, additional, Bullinger, Monika, additional, Younsi, Alexander, additional, Unterberg, Andreas, additional, Mattern, Julia, additional, Sakowitz, Oliver, additional, Sanchez-Porras, Renan, additional, Perera, Natascha, additional, Beauvais, Romuald, additional, Sandor, Janos, additional, Czeiter, Endre, additional, Buki, Andras, additional, Ezer, Erzsébet, additional, Vámos, Zoltán, additional, Melegh, Béla, additional, Tamás, Viktória, additional, Sorinola, Abayomi, additional, Kovács, Noémi, additional, Nyirádi, József, additional, Amrein, Krisztina, additional, Barzó, Pál, additional, Gupta, Deepak, additional, Levi, Leon, additional, Rosenthal, Guy, additional, Furmanov, Alex, additional, Martino, Costanza, additional, Beretta, Luigi, additional, Calvi, Maria Rosa, additional, Azzolini, Maria Luisa, additional, Calappi, Emiliana, additional, Zoerle, Tommaso, additional, Ortolano, Fabrizio, additional, Carbonara, Marco, additional, Caccioppola, Alessio, additional, Vargiolu, Alessia, additional, Chieregato, Arturo, additional, Chevallard, Giorgio, additional, Della Corte, Francesco, additional, Grossi, Francesca, additional, Rossi, Sandra, additional, Persona, Paolo, additional, Berardino, Maurizio, additional, Cavallo, Simona, additional, Rambadagalla, Malinka, additional, Ziverte, Agate, additional, Giga, Lelde, additional, Valeinis, Egils, additional, Vilcinis, Rimantas, additional, Tamosuitis, Tomas, additional, Rocka, Saulius, additional, Ragauskas, Arminas, additional, van der Naalt, Joukje, additional, Jacobs, Bram, additional, Steyerberg, Ewout W., additional, Bartels, Ronald, additional, den Boogert, Hugo, additional, Kompanje, Erwin, additional, Timmers, Marjolijn, additional, Foks, Kelly, additional, Haitsma, Iain, additional, Volovici, Victor, additional, Haagsma, Juanita A., additional, Mikolic, Ana, additional, Lingsma, Hester, additional, Velt, Kimberley, additional, Huijben, Jilske, additional, Voormolen, Daphne, additional, Nieboer, Daan, additional, Wiegers, Eveline, additional, Sewalt, Charlie, additional, Gravesteijn, Benjamin, additional, Polinder, Suzanne, additional, Tibboel, Dick, additional, van Wijk, Roel, additional, van Dijck, Jeroen T.J.M., additional, van Essen, Thomas A., additional, Peul, Wilco, additional, Schoonman, Guus, additional, Jones, Kelly, additional, Feigin, Valery L., additional, Te Ao, Braden, additional, Theadom, Alice, additional, Helseth, Eirik, additional, Roe, Cecilie, additional, Roise, Olav, additional, Andelic, Nada, additional, Andreassen, Lasse, additional, Anke, Audny, additional, Vik, Anne, additional, Skandsen, Toril, additional, Ples, Horia, additional, Tudora, Cristina Maria, additional, Negru, Ancuta, additional, Vulekovic, Peter, additional, Đilvesi, Đula, additional, Karan, Mladen, additional, Golubovic, Jagoš, additional, Rehorcíková, Veronika, additional, Taylor, Mark Steven, additional, Brazinova, Alexandra, additional, Majdan, Marek, additional, Sahuquillo, Juan, additional, Radoi, Andreea, additional, Carbayo Lozano, Guillermo, additional, Pomposo, Inigo, additional, Lagares, Alfonso, additional, Gomez, Pedro A., additional, Castaño-León, Ana M., additional, Gagliardo, Pablo, additional, Oresic, Matej, additional, Bellander, Bo-Michael, additional, Lanyon, Linda, additional, George, Pradeep, additional, Muraleedharan, Visakh, additional, Nelson, David, additional, Ackerlund, Cecilia, additional, Koskinen, Lars-Owe, additional, Sundström, Nina, additional, Brorsson, Camilla, additional, Belli, Antonio, additional, Manara, Alex, additional, Thomas, Matt, additional, Czosnyka, Marek, additional, Smielewski, Peter, additional, Cabeleira, Manuel, additional, Coles, Jonathan, additional, Richardson, Sylvia, additional, Zeiler, Frederick A., additional, Stamatakis, Emmanuel, additional, Williams, Guy, additional, Menon, David, additional, Ercole, Ari, additional, Dixit, Abhishek, additional, Newcombe, Virginia, additional, Richter, Sophie, additional, McFadyen, Charles, additional, Hutchinson, Peter J., additional, Kolias, Angelos G., additional, Adams, Hadie, additional, Correia, Marta, additional, Rhodes, Jonathan, additional, Stewart, William, additional, McMahon, Catherine, additional, Rueckert, Daniel, additional, Glocker, Ben, additional, Tolias, Christos, additional, Dawes, Helen, additional, Esser, Patrick, additional, van Heugten, Caroline, additional, Curry, Nicola, additional, Stanworth, Simon, additional, Lecky, Fiona, additional, Otesile, Olubukola, additional, Johnson, Faye, additional, Dark, Paul, additional, Jankowski, Stefan, additional, Lightfoot, Roger, additional, Wilson, Lindsay, additional, Horton, Lindsay, additional, Stevens, Robert, additional, Rosand, Jonathan, additional, Manley, Geoffrey, additional, Jarrett, Mike, additional, Brinck, Vibeke, additional, Wang, Kevin K.W., additional, Yang, Zhihui, additional, Vespa, Paul M., additional, Gruen, Russell L., additional, Cameron, Peter, additional, Donoghue, Emma, additional, Gantner, Dashiell, additional, Gruen, Russel, additional, Murray, Lynette, additional, Rosenfeld, Jeffrey V., additional, Varma, Dinesh, additional, Trapani, Tony, additional, Vallance, Shirley, additional, MacIsaac, Cristopher, additional, and Jordan, Andrea, additional
Published: 2021
Full Text: View/download PDF

128. Use of the Ventrain Ventilation Device and an Airway Exchange Catheter to Manage Hypoxemia During Thoracic Surgery and One-Lung Ventilation

Author: W Templeton, A Caccioppola, Federico Piccioni, Franco Valenza, and G L Rosboch
Subjects: medicine.medical_specialty, Catheters, business.industry, Thoracic Surgery, Respiration, Artificial, One lung ventilation, One-Lung Ventilation, law.invention, Hypoxemia, Anesthesiology and Pain Medicine, law, Cardiothoracic surgery, Anesthesia, Ventilation (architecture), medicine, Humans, Airway exchange catheter, medicine.symptom, Hypoxia, Cardiology and Cardiovascular Medicine, business
Published: 2021

129. Comparability of (Post-Concussion) Symptoms across Time in Individuals after Traumatic Brain Injury: Results from the CENTER-TBI Study

Author: Rivera, Diego, Greving, Sven, Arango-Lasprilla, Juan Carlos, von Steinbuechel, Nicole, Zeldovich, Marina, Åkerlund, Cecilia, Vik, Anne, Andelic, Nada, Andreassen, Lasse, Anke, Audny Gabriele Wagner, Skandsen, Toril, Røe, Cecilie, Røise, Olav, Frisvold, Shirin, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Veronique, Degos, Vincent, Della Corte, Francesco, den Boogert, Hugo, Depreitere, Bart, Đilvesi, Đula, Dixit, Abhilasha, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L, Foks, Kelly, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubovic, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L, Universidad Pública de Navarra. Departamento de Ciencias de la Salud, and Nafarroako Unibertsitate Publikoa. Osasun Zientziak Saila
Subjects: Traumatic brain injury, Post-concussion symptoms, post-concussion symptoms, Rivermead Post-Concussion Symptoms Questionnaire, measurement invariance, longitudinal assessments, traumatic brain injury, General Medicine, Longitudinal assessments, Measurement invariance
Abstract: settingsOrder Article Reprints Open AccessArticle Comparability of (Post-Concussion) Symptoms across Time in Individuals after Traumatic Brain Injury: Results from the CENTER-TBI Study by Diego Rivera 1,2ORCID,Sven Greving 3,Juan Carlos Arango-Lasprilla 4ORCID,Nicole von Steinbuechel 3,Marina Zeldovich 3,*ORCID andCENTER-TBI Participants and Investigators † 1 Department of Health Sciences, Public University of Navarre, Arrosadia Campus, 31006 Pamplona, Spain 2 Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea Street 3, 31008 Pamplona, Spain 3 Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany 4 Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284-2018, USA * Author to whom correspondence should be addressed. † The full list of the CENTER-TBI participants and investigators can be found in the Supplementary Materials. J. Clin. Med. 2022, 11(14), 4090; https://doi.org/10.3390/jcm11144090 Received: 20 May 2022 / Revised: 10 July 2022 / Accepted: 13 July 2022 / Published: 14 July 2022 (This article belongs to the Special Issue Traumatic Brain Injury: Diagnosis, Management, and Outcomes) Download Browse Figures Versions Notes Abstract Post-concussion symptoms often occur after TBI, persist and cause disabilities. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is widely used in this population, but little is known about the comparability of the symptoms over time, i.e., longitudinal measurement invariance (MI). The objectives of this study were to analyze the longitudinal MI of RPQ symptoms from three to twelve months after TBI and to find factors related to RPQ symptoms. The study involved 1023 individuals after TBI who took part in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study and completed the RPQ at three, six and twelve months post-injury. Longitudinal confirmatory factor analysis showed that the three-factor structure (somatic, emotional and cognitive) remains stable within one year after TBI. Linear mixed models revealed that sex, injury cause and prior psychiatric problems were related to the RPQ three-factor structure as well as to the RPQ total score. The study strengthens evidence for the RPQ’s factorial structure stability within one year after TBI and identifies sex, injury cause and prior psychiatric problems as important factors that may help clinicians to prevent future complications of symptomatology after TBI.
Published: 2022

130. Latent class analysis to predict intensive care outcomes in Acute Respiratory Distress Syndrome: a proposal of two pulmonary phenotypes

Author: Davide Chiumello, Tommaso Pozzi, Silvia Coppola, Pedro David Wendel Garcia, Alessio Caccioppola, Stefano Cenci, Arianna Ciabattoni, University of Zurich, and Chiumello, Davide
Subjects: medicine.medical_specialty, ARDS, Critical Care, medicine.medical_treatment, Respiratory mechanics, 610 Medicine & health, Respiratory physiology, Critical Care and Intensive Care Medicine, 03 medical and health sciences, 0302 clinical medicine, Mechanical ventilation, Internal medicine, Intensive care, medicine, Humans, Lung volumes, Respiratory system, Prospective cohort study, Lung, Respiratory Distress Syndrome, business.industry, RC86-88.9, Research, Hazard ratio, 030208 emergency & critical care medicine, Medical emergencies. Critical care. Intensive care. First aid, medicine.disease, Phenotypes, Radiological data, Phenotype, 030228 respiratory system, Enrichment, Latent Class Analysis, Cardiology, Recruitment, 10023 Institute of Intensive Care Medicine, business, 2706 Critical Care and Intensive Care Medicine
Abstract: Background Acute respiratory distress syndrome remains a heterogeneous syndrome for clinicians and researchers difficulting successful tailoring of interventions and trials. To this moment, phenotyping of this syndrome has been approached by means of inflammatory laboratory panels. Nevertheless, the systemic and inflammatory expression of acute respiratory distress syndrome might not reflect its respiratory mechanics and gas exchange. Methods Retrospective analysis of a prospective cohort of two hundred thirty-eight patients consecutively admitted patients under mechanical ventilation presenting with acute respiratory distress syndrome. All patients received standardized monitoring of clinical variables, respiratory mechanics and computed tomography scans at predefined PEEP levels. Employing latent class analysis, an unsupervised structural equation modelling method, on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes at a PEEP level of 5cmH2O, distinct pulmonary phenotypes of acute respiratory distress syndrome were identified. Results Latent class analysis was applied to 54 respiratory mechanics, gas-exchange and CT-derived gas- and tissue-volume variables, and a two-class model identified as best fitting. Phenotype 1 (non-recruitable) presented lower respiratory system elastance, alveolar dead space and amount of potentially recruitable lung volume than phenotype 2 (recruitable). Phenotype 2 (recruitable) responded with an increase in ventilated lung tissue, compliance and PaO2/FiO2 ratio (p p recruitable) presented a higher intensive care mortality (hazard ratio 2.9, 95% confidence interval 1.7–2.7, p = 0.001). Conclusions The present study identifies two ARDS phenotypes based on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes. These phenotypes are characterized by distinctly diverse responses to a standardized recruitment manoeuvre and by a diverging mortality. Given multicentre validation, the simple and rapid identification of these pulmonary phenotypes could facilitate enrichment of future prospective clinical trials addressing mechanical ventilation strategies in ARDS.
Published: 2021

131. Sodium Bicarbonate in Different Critically Ill Conditions: From Physiology to Clinical Practice

Author: Davide Chiumello, Sara Froio, Alessio Caccioppola, and Silvia Coppola
Subjects: medicine.medical_specialty, Critical Care, Critical Illness, MEDLINE, Buffers, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Sodium bicarbonate, business.industry, Critically ill, 030208 emergency & critical care medicine, Metabolic acidosis, Acute Kidney Injury, medicine.disease, Clinical Practice, Anesthesiology and Pain Medicine, Sodium Bicarbonate, chemistry, Critical illness, business, Acidosis
Abstract: Intravenous sodium bicarbonate is commonly used in several critically ill conditions for the management of acute acidemia independently of the etiology, and for the prevention of acute kidney injury, although this is still controversial from a physiologic point of view.
Published: 2021

132. Understanding the relationship between cognitive performance and function in daily life after traumatic brain injury

Author: Wilson, Lindsay, Horton, Lindsay, Kunzmann, Kevin, Sahakian, Barbara J., Newcombe, Virginia, Stamatakis, E, Steinbuechel, Nicole, Cunitz, Kathrin, Covic, Amra, Maas, Andrew, van Praag, Dominigue, Menon, David, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Frisvold, Shirin, Helseth, Eirik, Røe, Cecilie, Røise, Olav, Skandsen, Toril, Vik, Anne, Åkerlund, Cecilia, Amrein, Krisztina, Antoni, Anna, Audibert, Gerard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzo, Pal, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Centre of Excellence in Complex Disease Genetics, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Genomics of Neurological and Neuropsychiatric Disorders, HUS Neurocenter, Neurokirurgian yksikkö, Statistical and population genetics, Biostatistics Helsinki, Samuli Olli Ripatti / Principal Investigator, Complex Disease Genetics, Helsinki University Hospital Area, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, BMJ Publishing Group, Ročka, Saulius, Tamošuitis, Tomas, Wilson, L, Horton, L, Kunzmann, K, Sahakian, B, Newcombe, V, Stamatakis, E, Von Steinbuechel, N, Cunitz, K, Covic, A, Maas, A, Van Praag, D, Menon, D, Citerio, G, Neurology, Public Health, Neurosurgery, Intensive Care, Pediatric Surgery, Wilson, Lindsay [0000-0003-4113-2328], Newcombe, Virginia Fj [0000-0001-6044-9035], Apollo - University of Cambridge Repository, CENTER-TBI participants and investigators, Wilson, L., Horton, L., Kunzmann, K., Sahakian, B. J., Newcombe, V. F. J., Stamatakis, E. A., Von Steinbuechel, N., Cunitz, K., Covic, A., Maas, A., Van Praag, D., Menon D., (CENTER-TBI participants and investigators), Beretta, Luigi, and Molecular Neuroscience and Ageing Research (MOLAR)
Subjects: cognition, demography, age distribution, Rey auditory verbal learning test, physical capacity, 3124 Neurology and psychiatry, memory, 0302 clinical medicine, Medicine, processing speed, 030212 general & internal medicine, Cognitive impairment, learning, adult, traumatic brain injury, Cambridge Neuropsychological Test Automated Battery, Cognition, prospective observational study, Cognitive test, Psychiatry and Mental health, Short Form 12, female, injury severity, mental health, Clinical psychology, Traumatic brain injury, sex difference, Article, functional outcome, 03 medical and health sciences, SDG 3 - Good Health and Well-being, male, controlled study, Effects of sleep deprivation on cognitive performance, human, outcome assessment, CENTER-TBI participants and investigators, trail making test, business.industry, cognition assessment, medicine.disease, daily life activity, Mental health, Glasgow outcome scale, major clinical study, Surgery, Observational study, Neurology (clinical), Human medicine, functional assessment, business, 030217 neurology & neurosurgery
Abstract: ObjectiveCognitive impairment is a key cause of disability after traumatic brain injury (TBI) but relationships with overall functioning in daily life are often modest. The aim is to examine cognition at different levels of function and identify domains associated with disability.Methods1554 patients with mild-to-severe TBI were assessed at 6 months post injury on the Glasgow Outcome Scale—Extended (GOSE), the Short Form-12v2 and a battery of cognitive tests. Outcomes across GOSE categories were compared using analysis of covariance adjusting for age, sex and education.ResultsOverall effect sizes were small to medium, and greatest for tests involving processing speed (ηp2 0.057–0.067) and learning and memory (ηp2 0.048–0.052). Deficits in cognitive performance were particularly evident in patients who were dependent (GOSE 3 or 4) or who were unable to participate in one or more major life activities (GOSE 5). At higher levels of function (GOSE 6–8), cognitive performance was surprisingly similar across categories. There were decreases in performance even in patients reporting complete recovery without significant symptoms. Medium to large effect sizes were present for summary measures of cognition (ηp2 0.111), mental health (ηp2 0.131) and physical health (ηp2 0.252).ConclusionsThis large-scale study provides novel insights into cognitive performance at different levels of disability and highlights the importance of processing speed in function in daily life. At upper levels of outcome, any influence of cognition on overall function is markedly attenuated and differences in mental health are salient.
Published: 2021

133. Use and impact of high intensity treatments in patients with traumatic brain injury across Europe: a CENTER-TBI analysis

Author: Huijben, Jilske A., Dixit, Abhishek, Stocchetti, Nino, Maas, Andrew I. R., Lingsma, Hester F., Van Der Jagt, Mathieu, Nelson, David, Citerio, Giuseppe, Wilson, Lindsay, Menon, David K., Ercole, Ari, 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, León, Ana M. Castaño, 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, Dreier, Jens, Dulière, Guy-Loup, Ezer, Erzsébet, Fabricius, Martin, Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Galanaud, Damien, Gomez, Pedro A., Grossi, Francesca, Gupta, Deepak, Haitsma, Iain, 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, 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, Newcombe, Virginia, Nyirádi, József, Ortolano, Fabrizio, Payen, Jean François, Perlbarg, Vincent, Persona, Paolo, 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, 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 Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Vik, Anne, Vilcinis, Rimantas, Volovici, Victor, Vulekovic, Petar, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Younsi, Alexander, Zeiler, Frederick A., Clusmann, Agate Ziverte Hans, Voormolen, Daphne, Van Dijck, Jeroen T. J. M., Van Essen, Thomas A., Huijben, Jilske A. [0000-0002-2892-5406], and Apollo - University of Cambridge Repository
Subjects: Traumatic brain injury, Research, Barbiturates, Hyperventilation, Hypothermia, Therapy intensity level, Decompressive craniectomy
Abstract: Purpose: To study variation in, and clinical impact of high Therapy Intensity Level (TIL) treatments for elevated intracranial pressure (ICP) in patients with traumatic brain injury (TBI) across European Intensive Care Units (ICUs). Methods: We studied high TIL treatments (metabolic suppression, hypothermia (< 35 °C), intensive hyperventilation (PaCO2 < 4 kPa), and secondary decompressive craniectomy) in patients receiving ICP monitoring in the ICU stratum of the CENTER-TBI study. A random effect logistic regression model was used to determine between-centre variation in their use. A propensity score-matched model was used to study the impact on outcome (6-months Glasgow Outcome Score-extended (GOSE)), whilst adjusting for case-mix severity, signs of brain herniation on imaging, and ICP. Results: 313 of 758 patients from 52 European centres (41%) received at least one high TIL treatment with significant variation between centres (median odds ratio = 2.26). Patients often transiently received high TIL therapies without escalation from lower tier treatments. 38% of patients with high TIL treatment had favourable outcomes (GOSE ≥ 5). The use of high TIL treatment was not significantly associated with worse outcome (285 matched pairs, OR 1.4, 95% CI [1.0–2.0]). However, a sensitivity analysis excluding high TIL treatments at day 1 or use of metabolic suppression at any day did reveal a statistically significant association with worse outcome. Conclusion: Substantial between-centre variation in use of high TIL treatments for TBI was found and treatment escalation to higher TIL treatments were often not preceded by more conventional lower TIL treatments. The significant association between high TIL treatments after day 1 and worse outcomes may reflect aggressive use or unmeasured confounders or inappropriate escalation strategies. Take home message: Substantial variation was found in the use of highly intensive ICP-lowering treatments across European ICUs and a stepwise escalation strategy from lower to higher intensity level therapy is often lacking. Further research is necessary to study the impact of high therapy intensity treatments. Trial registration: The core study was registered with ClinicalTrials.gov, number NCT02210221, registered 08/06/2014, https://clinicaltrials.gov/ct2/show/NCT02210221?id=NCT02210221&draw=1&rank=1 and with Resource Identification Portal (RRID: SCR_015582).
Published: 2021

134. Persistent postconcussive symptoms in children and adolescents with mild traumatic brain injury receiving initial head computed tomography

Author: Riemann, Lennart, primary, Voormolen, Daphne C., additional, Rauen, Katrin, additional, Zweckberger, Klaus, additional, Unterberg, Andreas, additional, Younsi, Alexander, additional, _, _, additional, Åkerlund, Cecilia, additional, Amrein, Krisztina, additional, Andelic, Nada, additional, Andreassen, Lasse, additional, Anke, Audny, additional, Antoni, Anna, additional, Audibert, Gérard, additional, Azouvi, Philippe, additional, Azzolini, Maria Luisa, additional, Bartels, Ronald, additional, Barzó, Pál, additional, Beauvais, Romuald, additional, Beer, Ronny, additional, Bellander, Bo-Michael, additional, Belli, Antonio, additional, Benali, Habib, additional, Berardino, Maurizio, additional, Beretta, Luigi, additional, Blaabjerg, Morten, additional, Bragge, Peter, additional, Brazinova, Alexandra, additional, Brinck, Vibeke, additional, Brooker, Joanne, additional, Brorsson, Camilla, additional, Buki, Andras, additional, Bullinger, Monika, additional, Cabeleira, Manuel, additional, Caccioppola, Alessio, additional, Calappi, Emiliana, additional, Calvi, Maria Rosa, additional, Cameron, Peter, additional, Lozano, Guillermo Carbayo, additional, Carbonara, Marco, additional, Cavallo, Simona, additional, Chevallard, Giorgio, additional, Chieregato, Arturo, additional, Citerio, Giuseppe, additional, Ceyisakar, Iris, additional, Clusmann, Hans, additional, Coburn, Mark, additional, Coles, Jonathan, additional, Cooper, Jamie D., additional, Correia, Marta, additional, Čović, Amra, additional, Curry, Nicola, additional, Czeiter, Endre, additional, Czosnyka, Marek, additional, Dahyot-Fizelier, Claire, additional, Dark, Paul, additional, Dawes, Helen, additional, Keyser, Véronique De, additional, Degos, Vincent, additional, Corte, Francesco Della, additional, Boogert, Hugo den, additional, Depreitere, Bart, additional, Ðilvesi, Ðula, additional, Dixit, Abhishek, additional, Donoghue, Emma, additional, Dreier, Jens, additional, Dulière, Guy-Loup, additional, Ercole, Ari, additional, Esser, Patrick, additional, Ezer, Erzsébet, additional, Fabricius, Martin, additional, Feigin, Valery L., additional, Foks, Kelly, additional, Frisvold, Shirin, additional, Furmanov, Alex, additional, Gagliardo, Pablo, additional, Galanaud, Damien, additional, Gantner, Dashiell, additional, Gao, Guoyi, additional, George, Pradeep, additional, Ghuysen, Alexandre, additional, Giga, Lelde, additional, Glocker, Ben, additional, Golubovic, Jagoš, additional, Gomez, Pedro A., additional, Gratz, Johannes, additional, Gravesteijn, Benjamin, additional, Grossi, Francesca, additional, Gruen, Russell L., additional, Gupta, Deepak, additional, Haagsma, Juanita A., additional, Haitsma, Iain, additional, Helbok, Raimund, additional, Helseth, Eirik, additional, Horton, Lindsay, additional, Huijben, Jilske, additional, Hutchinson, Peter J., additional, Jacobs, Bram, additional, Jankowski, Stefan, additional, Jarrett, Mike, additional, Jiang, Ji-yao, additional, Johnson, Faye, additional, Jones, Kelly, additional, Karan, Mladen, additional, Kolias, Angelos G., additional, Kompanje, Erwin, additional, Kondziella, Daniel, additional, Koraropoulos, Evgenios, additional, Koskinen, Lars-Owe, additional, Kovács, Noémi, additional, Kowark, Ana, additional, Lagares, Alfonso, additional, Lanyon, Linda, additional, Laureys, Steven, additional, Lecky, Fiona, additional, Ledoux, Didier, additional, Lefering, Rolf, additional, Legrand, Valerie, additional, Lejeune, Aurelie, additional, Levi, Leon, additional, Lightfoot, Roger, additional, Lingsma, Hester, additional, Maas, Andrew I. R., additional, Castaño-León, Ana M., additional, Maegele, Marc, additional, Majdan, Marek, additional, Manara, Alex, additional, Manley, Geoffrey, additional, Martino, Costanza, additional, Maréchal, Hugues, additional, Mattern, Julia, additional, McMahon, Catherine, additional, Melegh, Béla, additional, Menon, David, additional, Menovsky, Tomas, additional, Mikolic, Ana, additional, Misset, Benoit, additional, Muraleedharan, Visakh, additional, Murray, Lynnette, additional, Negru, Ancuta, additional, Nelson, David, additional, Newcombe, Virginia, additional, Nieboer, Daan, additional, Nyirádi, József, additional, Olubukola, Otesile, additional, Oresic, Matej, additional, Ortolano, Fabrizio, additional, Palotie, Aarno, additional, Parizel, Paul M., additional, Payen, Jean-François, additional, Perera, Natascha, additional, Perlbarg, Vincent, additional, Persona, Paolo, additional, Peul, Wilco, additional, Piippo-Karjalainen, Anna, additional, Pirinen, Matti, additional, Ples, Horia, additional, Polinder, Suzanne, additional, Pomposo, Inigo, additional, Posti, Jussi P., additional, Puybasset, Louis, additional, Radoi, Andreea, additional, Ragauskas, Arminas, additional, Raj, Rahul, additional, Rambadagalla, Malinka, additional, Rhodes, Jonathan, additional, Richardson, Sylvia, additional, Richter, Sophie, additional, Ripatti, Samuli, additional, Rocka, Saulius, additional, Roe, Cecilie, additional, Roise, Olav, additional, Rosand, Jonathan, additional, Rosenfeld, Jeffrey V., additional, Rosenlund, Christina, additional, Rosenthal, Guy, additional, Rossaint, Rolf, additional, Rossi, Sandra, additional, Rueckert, Daniel, additional, Rusnák, Martin, additional, Sahuquillo, Juan, additional, Sakowitz, Oliver, additional, Sanchez-Porras, Renan, additional, Sandor, Janos, additional, Schäfer, Nadine, additional, Schmidt, Silke, additional, Schoechl, Herbert, additional, Schoonman, Guus, additional, Schou, Rico Frederik, additional, Schwendenwein, Elisabeth, additional, Sewalt, Charlie, additional, Skandsen, Toril, additional, Smielewski, Peter, additional, Sorinola, Abayomi, additional, Stamatakis, Emmanuel, additional, Stanworth, Simon, additional, Stevens, Robert, additional, Stewart, William, additional, Steyerberg, Ewout W., additional, Stocchetti, Nino, additional, Sundström, Nina, additional, Synnot, Anneliese, additional, Takala, Riikka, additional, Tamás, Viktória, additional, Tamosuitis, Tomas, additional, Taylor, Mark Steven, additional, Ao, Braden Te, additional, Tenovuo, Olli, additional, Theadom, Alice, additional, Thomas, Matt, additional, Tibboel, Dick, additional, Timmers, Marjolein, additional, Tolias, Christos, additional, Trapani, Tony, additional, Tudora, Cristina Maria, additional, Vajkoczy, Peter, additional, Vallance, Shirley, additional, Valeinis, Egils, additional, Vámos, Zoltán, additional, Jagt, Mathieu van der, additional, Steen, Gregory Van der, additional, Naalt, Joukje van der, additional, Dijck, Jeroen T. J. M. van, additional, Essen, Thomas A. van, additional, Hecke, Wim Van, additional, Heugten, Caroline van, additional, Praag, Dominique Van, additional, Vyvere, Thijs Vande, additional, Wijk, Roel P. J. van, additional, Vargiolu, Alessia, additional, Vega, Emmanuel, additional, Velt, Kimberley, additional, Verheyden, Jan, additional, Vespa, Paul M., additional, Vik, Anne, additional, Vilcinis, Rimantas, additional, Volovici, Victor, additional, Steinbüchel, Nicole von, additional, Voormolen, Daphne, additional, Vulekovic, Petar, additional, Wang, Kevin K. W., additional, Wiegers, Eveline, additional, Williams, Guy, additional, Wilson, Lindsay, additional, Winzeck, Stefan, additional, Wolf, Stefan, additional, Yang, Zhihui, additional, Ylén, Peter, additional, Zeiler, Frederick A., additional, Zelinkova, Veronika, additional, Ziverte, Agate, additional, and Zoerle, Tommaso, additional
Published: 2021
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135. Global Citizenship Education in the classroom : An exploratory study on teachers’ views

Author: Caccioppola, Federica
Subjects: global citizenship education, teachers, open classroom climate, students, lessons, schools
Abstract: The study “Global Citizenship Education in the classroom. An exploratory study on teachers’ views” aims at describing teachers’ views on possible goals and practices on GCE in two different contexts: Central Italy (2017-2018) and Queensland (2019), Australia. To this end, the research analyses teaching strategies devoted to promoting dialogue among students and between teachers and students. The research specifically focuses on how secondary schools’ teachers promote the development of knowledge and skills related to GCE, in their verbal and nonverbal interactions. The study follows a qualitative methodology, adopting classroom observations in secondary schools and interviews to teachers focused on GCE aims and learning activities. In addition, in Italy a set of video-analysis was carried out in order to retrieve data for the documentation and representation of verbal and non-verbal interactions between teachers and students. Finding could indicate opportunities and challenges teachers face in dealing with topics related to global citizenship. The data referring to Italian context were collected in 2018. In Australia data were collected throughout 2019. On the short term, this explorative study intends to provide insights on GCE teaching practices and relative constructs possible operativization; and to support teachers’ professional development through critical reflection. On the medium-long term, the study could have an impact in: building or reinforcing networks between schools and Higher Education institutions, both at a national and at an international level; promoting in Italy educational change and disseminate innovative teaching knowledge and practices; outlining possible pathways to improve GCE teaching practices both in Australia and in Italy.
Published: 2021
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136. Additional file 1 of Latent class analysis to predict intensive care outcomes in Acute Respiratory Distress Syndrome: a proposal of two pulmonary phenotypes

Author: Garcia, Pedro D. Wendel, Caccioppola, Alessio, Coppola, Silvia, Pozzi, Tommaso, Ciabattoni, Arianna, Cenci, Stefano, and Chiumello, Davide
Abstract: Additional file 1: Appendix 1. Additional Information. Table S1. Variable Missingness. Figure S1. Multiple Imputation—Convergence plots. Figure S2. Multiple Imputation—Distribution plots. Table S2. Internal validity analysis of LCA class assignment. Figure S3. Internal validity analysis of LCA class assignment—Kaplan–Meier. Table S3. Imputation model-dependent latent class transitions and outcome data. Figure S4. Imputation model-dependent Kaplan–Meier curves. Appendix 2. Complete case sensitivity analysis. Table S4. Respiratory mechanics—gas exchange and computed tomography data at 5 cmH2O of PEEP. Table S5. Respiratory mechanics and gas exchange at 15 cmH2O of PEEP. Table S6. Computed tomography data at 45 cmH2O of PEEP. Table S7. Latent class analysis identified, phenotype defining variables at PEEP 5. Figure S5. Profile plot all variables at PEEP 5. Table S8. All variables at PEEP 5 cmH2O employed for the LCA. Figure S6. Response to recruitment manoeuvre for LCA-derived phenotypes (with trendlines). Table S9. Full specification of mixed-effect models. Figure S7. Dependency of the amount of potentially recruitable lung on the PaO2/ FiO2 ratio depending on the pulmonary phenotype. Figure S8. Distribution of PaO2/ FiO2 Ratios in pulmonary phenotypes stratified by underlying PEEP. Figure S9. Survival analysis for patients with moderate ARDS. Figure S10. Receiver operating characteristics curves of phenotype prediction model. Table S10. Area under the receiver operating curves (AUROCs) for the LASSO and nested GLM inferred models and classic severity scores. Table S11. LASSO + Nested Generalized Logistic Regression for “ElastanceRespiratory System, Dead SpacePhysiological and P/F ratio” at PEEP 5. Table S12. LASSO + Nested Generalized Logistic Regression for “ElastanceRespiratory System, Dead SpaceAlveolar and P/F ratio” at PEEP 5. Table S13. LASSO + Nested Generalized Logistic Regression for “ElastanceRespiratory System, Dead SpacePhysiological and P/F ratio” at PEEP 5ss. Table S14. LASSO + Nested Generalized Logistic Regression for “ElastanceRespiratory System, Dead SpaceAlveolar and P/F ratio” at PEEP 5.
Published: 2021
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137. Persistent postconcussive symptoms in children and adolescents with mild traumatic brain injury receiving initial head computed tomography

Author: Lennart Riemann, Daphne C. Voormolen, Katrin Rauen, Klaus Zweckberger, Andreas Unterberg, Alexander Younsi, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Iris Ceyisakar, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Ðula Ðilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Koraropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I. R. Maas, Ana M. Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T. J. M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Roel P. J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K. W. Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Riemann, L, Voormolen, D, Rauen, K, Zweckberger, K, Unterberg, A, Younsi, A, Citerio, G, Public Health, Riemann, L., Voormolen, D. C., Rauen, K., Zweckberger, K., Unterberg, A., Younsi A., (CENTER-TBI Investigators and Participants), Beretta, Luigi, University of Zurich, Younsi, Alexander, and Molecular Neuroscience and Ageing Research (MOLAR)
Subjects: Male, Pediatrics, Neurologi, Health-related quality of life, Computed tomography, law.invention, 0302 clinical medicine, Quality of life, law, Prevalence, Child, Pediatric, medicine.diagnostic_test, Post-Concussion Syndrome, 11359 Institute for Regenerative Medicine (IREM), General Medicine, Rivermead post-concussion symptoms questionnaire, Intensive care unit, 2746 Surgery, health-related quality of life, HRQOL, 2728 Neurology (clinical), trauma, Post concussion, Neurology, Postconcussive symptom, Child, Preschool, 030220 oncology & carcinogenesis, CT imaging, Postconcussive symptoms, Female, medicine.medical_specialty, Adolescent, Traumatic brain injury, 610 Medicine & health, Neuroimaging, Trauma, RPQ, Young Adult, 03 medical and health sciences, mild traumatic brain injury, medicine, Humans, In patient, 2735 Pediatrics, Perinatology and Child Health, Mild traumatic brain injury, Brain Concussion, business.industry, postconcussive symptoms, Glasgow Coma Scale, medicine.disease, pediatric, Quality of Life, Rivermead Post Concussion Symptoms Questionnaire, Tomography, X-Ray Computed, business, 030217 neurology & neurosurgery
Abstract: OBJECTIVE: The aim of this paper was to evaluate the prevalence of postconcussive symptoms and their relation to health-related quality of life (HRQOL) in pediatric and adolescent patients with mild traumatic brain injury (mTBI) who received head CT imaging during initial assessment. METHODS: Patients aged between 5 and 21 years with mTBI (Glasgow Coma Scale scores 13-15) and available Rivermead Post Concussion Questionnaire (RPQ) at 6 months of follow-up in the multicenter, prospectively collected CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) study were included. The prevalence of postconcussive symptoms was assessed, and the occurrence of postconcussive syndrome (PSC) based on the ICD-10 criteria, was analyzed. HRQOL was compared in patients with and without PCS using the Quality of Life after Brain Injury (QOLIBRI) questionnaire. RESULTS: A total of 196 adolescent or pediatric mTBI patients requiring head CT imaging were included. High-energy trauma was prevalent in more than half of cases (54%), abnormalities on head CT scans were detected in 41%, and admission to the regular ward or intensive care unit was necessary in 78%. Six months postinjury, 36% of included patients had experienced at least one moderate or severe symptom on the RPQ. PCS was present in 13% of adolescents and children when considering symptoms of at least moderate severity, and those patients had significantly lower QOLIBRI total scores, indicating lower HRQOL, compared with young patients without PCS (57 vs 83 points, p < 0.001). CONCLUSIONS: Adolescent and pediatric mTBI patients requiring head CT imaging show signs of increased trauma severity. Postconcussive symptoms are present in up to one-third of those patients, and PCS can be diagnosed in 13% 6 months after injury. Moreover, PCS is significantly associated with decreased HRQOL., Funding Agencies: OneMind (USA) Hannelore Kohl Stiftung (Germany)
Published: 2021

138. Primary versus early secondary referral to a specialized neurotrauma center in patients with moderate/severe traumatic brain injury: a CENTER TBI study

Author: Sewalt, CA, Gravesteijn, BY, Menon, D, Lingsma, HF, Maas, AIR, Stocchetti, N, Venema, E, Lecky, FE, Åkerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, ML, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, BM, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, MR, Cameron, P, Lozano, GC, Carbonara, M, Chevallard, G, Chieregato, A, Citerio, G, Cnossen, M, Coburn, M, Coles, J, Cooper, DJ, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dawes, H, De Keyser, V, Degos, V, Corte, FD, Boogert, HD, Depreitere, B, Ðilvesi, Ð, Dixit, A, Donoghue, E, Dreier, J, Dulière, GL, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, VL, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, PA, Gratz, J, Grossi, F, Gruen, RL, Gupta, D, Haagsma, JA, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, PJ, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, JY, Jones, K, and Synnot, Anneliese
Subjects: Uncategorized
Abstract: Full list of CENTER TBI Participants and Investigators can be found in publication (p.8-11): https://sjtrem.biomedcentral.com/articles/10.1186/s13049-021-00930-1#Abs1Background: Prehospital care for patients with traumatic brain injury (TBI) varies with some emergency medical systems recommending direct transport of patients with moderate to severe TBI to hospitals with specialist neurotrauma care (SNCs). The aim of this study is to assess variation in levels of early secondary referral within European SNCs and to compare the outcomes of directly admitted and secondarily transferred patients. Methods: Patients with moderate and severe TBI (Glasgow Coma Scale < 13) from the prospective European CENTER-TBI study were included in this study. All participating hospitals were specialist neuroscience centers. First, adjusted between-country differences were analysed using random effects logistic regression where early secondary referral was the dependent variable, and a random intercept for country was included. Second, the adjusted effect of early secondary referral on survival to hospital discharge and functional outcome [6 months Glasgow Outcome Scale Extended (GOSE)] was estimated using logistic and ordinal mixed effects models, respectively. Results: A total of 1347 moderate/severe TBI patients from 53 SNCs in 18 European countries were included. Of these 1347 patients, 195 (14.5%) were admitted after early secondary referral. Secondarily referred moderate/severe TBI patients presented more often with a CT abnormality: mass lesion (52% vs. 34%), midline shift (54% vs. 36%) and acute subdural hematoma (77% vs. 65%). After adjusting for case-mix, there was a large European variation in early secondary referral, with a median OR of 1.69 between countries. Early secondary referral was not associated with functional outcome (adjusted OR 1.07, 95% CI 0.78–1.69), nor with survival at discharge (1.05, 0.58–1.90). Conclusions: Across Europe, substantial practice variation exists in the proportion of secondarily referred TBI patients at SNCs that is not explained by case mix. Within SNCs early secondary referral does not seem to impact functional outcome and survival after stabilisation in a non-specialised hospital. Future research should identify which patients with TBI truly benefit from direct transportation.
Published: 2021
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139. Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI):A CENTER-TBI Analysis

Author: Böhm, Julia K., Güting, Helge, Thorn, Sophie, Schäfer, Nadine, Rambach, Victoria, Schöchl, Herbert, Grottke, Oliver, Rossaint, Rolf, Stanworth, Simon, Curry, Nicola, Lefering, Rolf, Maegele, Marc, Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Fabricius, Martin, Kondziella, Daniel, Nelson, David, Böhm, Julia K., Güting, Helge, Thorn, Sophie, Schäfer, Nadine, Rambach, Victoria, Schöchl, Herbert, Grottke, Oliver, Rossaint, Rolf, Stanworth, Simon, Curry, Nicola, Lefering, Rolf, Maegele, Marc, Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Fabricius, Martin, Kondziella, Daniel, and Nelson, David
Abstract: Background: Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood. Methods: This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI. Emphasis was placed on the acute phase following TBI, primary on subgroups of patients with abnormal coagulation profile within 4 h of admission, and the impact of pre-injury anticoagulant and/or antiplatelet therapy. In order to minimise confounding factors, patients with isolated TBI (iTBI) (n = 598) were selected for this analysis. Results: Haemostatic disorders were observed in approximately 20% of iTBI patients. In a subgroup analysis, patients with pre-injury anticoagulant and/or antiplatelet therapy had a twice exacerbated coagulation profile as likely as those without premedication. This was in turn associated with increased rates of mortality and unfavourable outcome post-injury. A multivariate analysis of iTBI patients without pre-injury anticoagulant therapy identified several independent risk factors for coagulopathy which were present at hospital admission. Glasgow Coma Scale (GCS) less than or equal to 8, base excess (BE) less than or equal to − 6, hypothermia and hypotension increased risk significantly. Conclusion: Consideration of these factors enables early prediction and risk stratification of acute coagulopathy after TBI, thus guiding clinical management.
Published: 2021

140. Latent class analysis to predict intensive care outcomes in Acute Respiratory Distress Syndrome: a proposal of two pulmonary phenotypes

Author: Wendel Garcia, Pedro D, Caccioppola, Alessio, Coppola, Silvia, Pozzi, Tommaso, Ciabattoni, Arianna, Cenci, Stefano, Chiumello, Davide; https://orcid.org/0000-0001-9260-3930, Wendel Garcia, Pedro D, Caccioppola, Alessio, Coppola, Silvia, Pozzi, Tommaso, Ciabattoni, Arianna, Cenci, Stefano, and Chiumello, Davide; https://orcid.org/0000-0001-9260-3930
Abstract: Background: Acute respiratory distress syndrome remains a heterogeneous syndrome for clinicians and researchers difficulting successful tailoring of interventions and trials. To this moment, phenotyping of this syndrome has been approached by means of inflammatory laboratory panels. Nevertheless, the systemic and inflammatory expression of acute respiratory distress syndrome might not reflect its respiratory mechanics and gas exchange. Methods: Retrospective analysis of a prospective cohort of two hundred thirty-eight patients consecutively admitted patients under mechanical ventilation presenting with acute respiratory distress syndrome. All patients received standardized monitoring of clinical variables, respiratory mechanics and computed tomography scans at predefined PEEP levels. Employing latent class analysis, an unsupervised structural equation modelling method, on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes at a PEEP level of 5cmH2O, distinct pulmonary phenotypes of acute respiratory distress syndrome were identified. Results: Latent class analysis was applied to 54 respiratory mechanics, gas-exchange and CT-derived gas- and tissue-volume variables, and a two-class model identified as best fitting. Phenotype 1 (non-recruitable) presented lower respiratory system elastance, alveolar dead space and amount of potentially recruitable lung volume than phenotype 2 (recruitable). Phenotype 2 (recruitable) responded with an increase in ventilated lung tissue, compliance and PaO2/FiO2 ratio (p < 0.001), in addition to a decrease in alveolar dead space (p < 0.001), to a standardized recruitment manoeuvre. Patients belonging to phenotype 2 (recruitable) presented a higher intensive care mortality (hazard ratio 2.9, 95% confidence interval 1.7-2.7, p = 0.001). Conclusions: The present study identifies two ARDS phenotypes based on respiratory mechanics, gas-exchange and computed tomography-derived gas- and tissue-volumes. T
Published: 2021

141. Interdependence between elevated intra-abdominal, pleural, and airway opening pressure in severe acute respiratory distress syndrome with extracorporeal membrane oxygenation

Author: Mauri, Tommaso, Spinelli, Elena, Caccioppola, Alessio, Marongiu, Ines, Colombo, Sebastiano M., Abbruzzese, Chiara, Lissoni, Alfredo, Tagliabue, Paola, Grasselli, Giacomo, and Pesenti, Antonio
Published: 2020
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142. Variation in the practice of tracheal intubation in Europe after traumatic brain injury : a prospective cohort study

Author: Gravesteijn B. Y., Sewalt C. A., Ercole A., Lecky F., Menon D., Steyerberg E. W., Maas A. I. R., Lingsma H. F., Klimek M., Akerlund C., Adams H., Amrein K., Andelic N., Andreassen L., Anke A., Audibert G., Azouvi P., Azzolini M., Bartels R., Beer R., Bellander B., Benali H., Berardino M., Beretta L., Blaabjerg M., Borgen L., Brorsson C., Buki A., Cabeleira M., Caccioppola A., Calappi E., Calvi M., Cameron P., Carbayo L., Carbonara M., Leon A., Chevallard G., Chieregato A., Citerio G., Coburn M., Coles J., Cooper J., Correia M., Cnossen M., Czeiter E., Czosnyka M., Fizelier C., DeKeyser V., Degos V., DellaCorte F., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G., Ezer E., Fabricius M., Foks K., Frisvold S., Furmanov A., Galanaud D., Gantner D., Ghuysen A., Giga L., Golubovic J., Gomez P., Grossi F., Gupta D., Haitsma I., Helbok R., Helseth E., Hutchinson P., Jankowski S., Karan M., Kolias A., Kondziella D., Koskinen L., Kovacs N., Lagares A., Laureys S., Lightfoot R., Lingsma H., Maas A., Manara A., Martino C., Marechal H., Mattern J., McFadyen C., McMahon C., Menovsky T., Mulazzi D., Muraleedharan V., Murray L., Nair N., Negru A., Nelson D., Newcombe V., Noirhomme Q., Nyiradi J., Ortolano F., Payen J., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Ples H., Pomposo I., Posti J., Puybasset L., Radoi A., Ragauskas A., Raj R., Rhodes J., Richter S., Rocka S., Roe C., Roise O., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Sahuquillo J., Sandro O., Sakowitz O., Porras R., Schirmer-Mikalsen K., SchouRico F., Smielewski P., Sorinola A., Stamatakis E., Kowalk A., Steyerberg E., Stocchetti N., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Tenovuo O., Thomas M., Tibboel D., Tolias C., Trapani T., Tudora C., Vajkoczy P., Vallance S., Valeinis E., Vamos Z., Van der Steen G., vanDijck J., van Essen T., Vanhaudenhuyse A., van Wijk R., Vargiolu A., Vega E., Vik A., Vilcinis R., Volovici V., Voormolen D., Vulekovic P., Williams G., Wolf S., Younsi A., Zeiler F., Ziverte A., Zoerle T., CENTER-TBI Collaborators, Ercole, Ari [0000-0001-8350-8093], Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, „Wiley' grupė, Gravesteijn, By, Sewalt, Ca, Ercole, A, Lecky, F, Menon, D, Steyerberg, Ew, Maas, A I R, Lingsma, H F, Klimek, M (CENTER-TBI collaborators), Beretta, L, Gravesteijn, B, Sewalt, C, Steyerberg, E, Maas, A, Lingsma, H, Klimek, M, Akerlund, C, Adams, H, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Beer, R, Bellander, B, Benali, H, Berardino, M, Blaabjerg, M, Borgen, L, Brorsson, C, Buki, A, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo, L, Carbonara, M, Leon, A, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Cnossen, M, Czeiter, E, Czosnyka, M, Fizelier, C, Dekeyser, V, Degos, V, Dellacorte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ezer, E, Fabricius, M, Foks, K, Frisvold, S, Furmanov, A, Galanaud, D, Gantner, D, Ghuysen, A, Giga, L, Golubovic, J, Gomez, P, Grossi, F, Gupta, D, Haitsma, I, Helbok, R, Helseth, E, Hutchinson, P, Jankowski, S, Karan, M, Kolias, A, Kondziella, D, Koskinen, L, Kovacs, N, Lagares, A, Laureys, S, Lightfoot, R, Manara, A, Martino, C, Marechal, H, Mattern, J, Mcfadyen, C, Mcmahon, C, Menovsky, T, Mulazzi, D, Muraleedharan, V, Murray, L, Nair, N, Negru, A, Nelson, D, Newcombe, V, Noirhomme, Q, Nyiradi, J, Ortolano, F, Payen, J, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Ples, H, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rhodes, J, Richter, S, Rocka, S, Roe, C, Roise, O, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Sahuquillo, J, Sandro, O, Sakowitz, O, Porras, R, Schirmer-Mikalsen, K, Schourico, F, Smielewski, P, Sorinola, A, Stamatakis, E, Kowalk, A, Stocchetti, N, Sundstrom, N, Takala, R, Tamas, V, Tamosuitis, T, Tenovuo, O, Thomas, M, Tibboel, D, Tolias, C, Trapani, T, Tudora, C, Vajkoczy, P, Vallance, S, Valeinis, E, Vamos, Z, Van der Steen, G, Vandijck, J, van Essen, T, Vanhaudenhuyse, A, van Wijk, R, Vargiolu, A, Vega, E, Vik, A, Vilcinis, R, Volovici, V, Voormolen, D, Vulekovic, P, Williams, G, Wolf, S, Younsi, A, Zeiler, F, Ziverte, A, Zoerle, T, Ročka, Saulius, Tamošuitis, Tomas, Anesthesiology, and Public Health
Subjects: Adult, Male, medicine.medical_specialty, Anestesi och intensivvård, Neurology, Neurologi, Traumatic brain injury, medicine.medical_treatment, Severity of Illness Index, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, Brain Injuries, Traumatic, Severity of illness, Intubation, Intratracheal, medicine, Humans, Intubation, tracheal intubation, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aged, Anesthesiology and Intensive Care, business.industry, traumatic brain injury, Tracheal intubation, Age Factors, VDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710, Middle Aged, medicine.disease, VDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710, 3. Good health, Europe, Anesthesiology and Pain Medicine, guideline, practice variation, Emergency medicine, Europe, guideline, practice variation, tracheal intubation, traumatic brain injury, Female, Neurosurgery, Human medicine, business, Cohort study
Abstract: Traumatic brain injury patients frequently undergo tracheal intubation. We aimed to assess current intubation practice in Europe and identify variation in practice. We analysed data from patients with traumatic brain injury included in the prospective cohort study collaborative European neurotrauma effectiveness research in traumatic brain injury (CENTER‐TBI) in 45 centres in 16 European countries. We included patients who were transported to hospital by emergency medical services. We used mixed‐effects multinomial regression to quantify the effects on pre‐hospital or in‐hospital tracheal intubation of the following: patient characteristics; injury characteristics; centre; and trauma system characteristics. A total of 3843 patients were included. Of these, 1322 (34%) had their tracheas intubated; 839 (22%) pre‐hospital and 483 (13%) in‐hospital. The fit of the model with only patient characteristics predicting intubation was good (Nagelkerke R2 64%). The probability of tracheal intubation increased with the following: younger age; lower pre‐hospital or emergency department GCS; higher abbreviated injury scale scores (head and neck, thorax and chest, face or abdomen abbreviated injury score); and one or more unreactive pupils. The adjusted median odds ratio for intubation between two randomly chosen centres was 3.1 (95%CI 2.1–4.3) for pre‐hospital intubation, and 2.7 (95%CI 1.9–3.5) for in‐hospital intubation. Furthermore, the presence of an anaesthetist was independently associated with more pre‐hospital intubation (OR 2.9, 95%CI 1.3–6.6), in contrast to the presence of ambulance personnel who are allowed to intubate (OR 0.5, 95%CI 0.3–0.8). In conclusion, patient and injury characteristics are key drivers of tracheal intubation. Between‐centre differences were also substantial. Further studies are needed to improve the evidence base supporting recommendations for tracheal intubation. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Published: 2019

143. Complications associated with paediatric airway management during the COVID‐19 pandemic: an international, multicentre, observational study.

Author: Peterson, M. B., Gurnaney, H. G., Disma, N., Matava, C., Jagannathan, N., Stein, M. L., Liu, H., Kovatsis, P. G., von Ungern‐Sternberg, B. S., Fiadjoe, J. E., Arnold, P., Schindler, E., Garcia‐Marcinkiewicz, A., Peyton, J., Park, R., Sommerfield, A., Sommerfield, D., Griffis, H., Hu, P., and Caccioppola, A.
Abstract: Summary: Respiratory adverse events in adults with COVID‐19 undergoing general anaesthesia can be life‐threatening. However, there remains a knowledge gap about respiratory adverse events in children with COVID‐19. We created an international observational registry to collect airway management outcomes in children with COVID‐19 who were having a general anaesthetic. We hypothesised that children with confirmed or suspected COVID‐19 would experience more hypoxaemia and complications than those without. Between 3 April 2020 and 1 November 2020, 78 international centres participated. In phase 1, centres collected outcomes on all children (age ≤ 18 y) having a general anaesthetic for 2 consecutive weeks. In phase 2, centres recorded outcomes for children with test‐confirmed or suspected COVID‐19 (based on symptoms) having a general anaesthetic. We did not study children whose tracheas were already intubated. The primary outcome was the incidence of hypoxaemia during airway management. Secondary outcomes included: incidence of other complications; and first‐pass success rate for tracheal intubation. In total, 7896 children were analysed (7567 COVID‐19 negative and 329 confirmed or presumed COVID‐19 positive). The incidence of hypoxaemia during airway management was greater in children who were COVID‐19 positive (24 out of 329 (7%) vs. 214 out of 7567 (3%); OR 2.70 (95%CI 1.70–4.10)). Children who had symptoms of COVID‐19 had a higher incidence of hypoxaemia compared with those who were asymptomatic (9 out of 51 (19%) vs. 14 out of 258 (5%), respectively; OR 3.7 (95%CI 1.5–9.1)). Children with confirmed or presumed COVID‐19 have an increased risk of hypoxaemia during airway management in conjunction with general anaesthesia. [ABSTRACT FROM AUTHOR]
Published: 2022
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144. Prediction of global functional outcome and post-concussive symptoms after mild Traumatic Brain Injury: external validation of prognostic models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study

Author: Mikolic, Ana, Polinder, Suzanne, Steyerberg, Ewout W, Retel Helmrich, Isabel, Giacino, Joseph T., Maas, Andrew I.R., van der Naalt, Joukje, Voormolen, Daphne, von Steinbüchel, Nicole, Wilson, Lindsay, Lingsma, Hester F, van Klaveren, David, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Frisvold, Shirin, Helseth, Eirik, Røe, Cecilie, Røise, Olav, Skandsen, Toril, Vik, Anne, Åkerlund, Cecilia, Amrein, Krisztina, Antoni, Anna, Audibert, Gerard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzo, Pal, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, CENTER-TBI Study Participants, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, Mary Ann Liebert, Centre of Excellence in Complex Disease Genetics, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Genomics of Neurological and Neuropsychiatric Disorders, HUS Neurocenter, Neurokirurgian yksikkö, Helsinki Institute for Information Technology, Statistical and population genetics, Department of Mathematics and Statistics, Biostatistics Helsinki, Clinicum, Helsinki University Hospital Area, Department of Public Health, Doctoral Programme in Clinical Research, Samuli Olli Ripatti / Principal Investigator, Complex Disease Genetics, University Management, Ročka, Saulius, Tamošuitis, Tomas, Mikolic, A, Polinder, S, Steyerberg, E, Retel Helmrich, I, Giacino, J, Maas, A, Van Der Naalt, J, Voormolen, D, Von Steinbuchel, N, Wilson, L, Lingsma, H, Van Klaveren, D, Citerio, G, Public Health, Mikolić, Ana, Polinder, Suzanne, Steyerberg, Ewout W, Retel Helmrich, Isabel R A, Giacino, Joseph T, Maas, Andrew I R, van der Naalt, Joukje, Voormolen, Daphne C, von Steinbüchel, Nicole, Wilson, Lindsay, Lingsma, Hester F, van Klaveren, David (Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study Participants and Investigators), Beretta, Luigi, Molecular Neuroscience and Ageing Research (MOLAR), Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, and RS: FPN NPPP I
Subjects: Male, DISORDER, 030506 rehabilitation, Neurologi, Glasgow Outcome Scale, GUIDELINES, 3124 Neurology and psychiatry, 0302 clinical medicine, Epidemiology, Medicine, EPIDEMIOLOGY, prognostic model, Longitudinal Studies, Prospective Studies, Aged, 80 and over, education.field_of_study, Post-Concussion Syndrome, Head injury, Glasgow outcome scale extended, external validation, mild traumatic brain injury, post-concussive symptoms, Rivermead post-concussion symptoms questionnaire, Middle Aged, RECOVERY, Prognosis, 3. Good health, PREVALENCE, Neurology, Female, 0305 other medical science, Glasgow Outcome Scale Extended, Adult, medicine.medical_specialty, Adolescent, Traumatic brain injury, Population, BIOMARKERS, QUESTIONNAIRE, 03 medical and health sciences, Young Adult, Humans, Glasgow Coma Scale, education, Prognostic models, Brain Concussion, Aged, business.industry, 3112 Neurosciences, HEAD-INJURY, post-concussive symptom, Models, Theoretical, CARE, medicine.disease, PREVENTION, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Physical therapy, Quality of Life, RISK-FACTORS, Neurology (clinical), Human medicine, business, 030217 neurology & neurosurgery
Abstract: The majority of traumatic brain injuries (TBIs) are categorized as mild, according to a baseline Glasgow Coma Scale (GCS) score of 13-15. Prognostic models that were developed to predict functional outcome and persistent post-concussive symptoms (PPCS) after mild TBI have rarely been externally validated. We aimed to externally validate models predicting 3-12-month Glasgow Outcome Scale Extended (GOSE) or PPCS in adults with mild TBI. We analyzed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) project, which included 2862 adults with mild TBI, with 6-month GOSE available for 2374 and Rivermead Post-Concussion Symptoms Questionnaire (RPQ) results available for 1605 participants. Model performance was evaluated based on calibration (graphically and characterized by slope and intercept) and discrimination (C-index). We validated five published models for 6-month GOSE and three for 6-month PPCS scores. The models used different cutoffs for outcome and some included symptoms measured 2 weeks post-injury. Discriminative ability varied substantially (C-index between 0.58 and 0.79). The models developed in the Corticosteroid Randomisation After Significant Head Injury (CRASH) trial for prediction of GOSE, Funding Agencies:Hannelore Kohl Stiftung (Germany) OneMind (USA) Integra LifeSciences Corporation (USA) Neurotrauma Sciences (USA)
Published: 2020

145. Interdependence between elevated intra-abdominal, pleural, and airway opening pressure in severe acute respiratory distress syndrome with extracorporeal membrane oxygenation

Author: Ines Marongiu, Tommaso Mauri, S. Colombo, Elena Spinelli, Alfredo Lissoni, Chiara Abbruzzese, Paola Tagliabue, Giacomo Grasselli, Antonio Pesenti, and Alessio Caccioppola
Subjects: 2019-20 coronavirus outbreak, ARDS, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.medical_treatment, Acute respiratory distress, medicine.disease, Anesthesiology and Pain Medicine, Anesthesia, Extracorporeal membrane oxygenation, medicine, Airway, business
Published: 2020
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146. The Authors Reply: Correlation Between Ultrasonographic Optic Nerve Sheath Diameter and Intracranial Pressure in Patients with Aneurysmal Subarachnoid Hemorrhage

Author: Alessio, Caccioppola, Tommaso, Zoerle, and Nino, Stocchetti
Subjects: Central Nervous System, Intracranial Pressure, Humans, Optic Nerve, Intracranial Hypertension, Subarachnoid Hemorrhage
Published: 2020

147. Care transitions in the first 6months following traumatic brain injury: Lessons from the CENTER-TBI study

Author: Borgen, Ida Maria Henriksen, Røe, Cecilie, Brunborg, Cathrine, Tenovuo, Olli, Azouvi, Philippe, Dawes, Helen, Majdan, Marek, Ranta, Jukka, Rusnak, Martin, Wiegers, E, Tverdal, Cathrine Buaas, Jacob, Louis, Cogne, Melanie, von Steinbuechel, Nicole, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Frisvold, Shirin, Helseth, Eirik, Røise, Olav, Skandsen, Toril, Vik, Anne, Åkerlund, Cecilia, Amrein, Krisztina, Antoni, Anna, Audibert, Gerard, Azzolini, Maria Luisa, Bartels, Ronald, Barzo, Pal, 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, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Public Health, Centre de recherche en épidémiologie et santé des populations (CESP), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Université de Versailles Saint-Quentin-en-Yvelines - UFR Sciences de la santé Simone Veil (UVSQ Santé), Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), CHU Pontchaillou [Rennes], Seventh Framework Programme, FP7, European Commission, EC: 247 602150, ZNS - Hannelore Kohl Stiftung, Data used in preparation of this manuscript were obtained in the context of CENTER-TBI, a large collaborative project with the support of the European Union 7th Framework program (EC grant no. 247 602150). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), OneMind (USA) and Integra LifeSciences Corp. (USA)., Data used in preparation of this manuscript were obtained in the context of CENTER-TBI, a large collaborative project with the support of the European Union 7th Framework program (EC grant no. 247 602150 ). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany) , OneMind (USA) and Integra LifeSciences Corp. (USA) ., University of Oslo (UiO), University of Turku, Oxford Brookes University, and University Medical Center Göttingen (UMG)
Subjects: Patient Transfer, Pediatrics, medicine.medical_specialty, Traumatic brain injury, [SDV]Life Sciences [q-bio], Poison control, Glasgow Outcome Scale, Logistic regression, Cohort Studies, Interquartile range, Injury prevention, Brain Injuries, Traumatic, medicine, Humans, Orthopedics and Sports Medicine, business.industry, Rehabilitation, Infant, Odds ratio, medicine.disease, Confidence interval, 3. Good health, Hospitalization, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, Cohort study
Abstract: Annals of physical and rehabilitation medicine 64(6), 101458 (2021). doi:10.1016/j.rehab.2020.10.009, Published by Elsevier Masson, Amsterdam [u.a.]
Published: 2020

148. Interdependence between elevated intrabdominal, pleural and airway opening pressure in severe ARDS with ECMO

Author: Mauri, Tommaso, Spinelli, Elena, Caccioppola, Alessio, Marongiu, Ines, Colombo, Sebastiano M., Abbruzzese, Chiara, Lissoni, Alfredo, Tagliabue, Paola, Grasselli, Giacomo, and Pesenti, Antonio
Subjects: SARS-Cov-2, C-ARDS, COVID-19, airway opening pressure, ECMO, Article
Published: 2020

149. Body Mass Index and ARDS severity in patients with and without SARS-CoV-2 infection

Author: Antonio E. Pontiroli, Tommaso Pozzi, Davide Chiumello, Alessio Caccioppola, Enrico Storti, and Silvia Coppola
Subjects: Male, medicine.medical_specialty, obesity, Critical Care, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, body mass index, Overweight, Article, Internal medicine, Pandemic, C-ARDS, Medicine, Humans, In patient, Simplified Acute Physiology Score, Pandemics, Aged, Retrospective Studies, Respiratory Distress Syndrome, business.industry, SARS-CoV-2, COVID-19, Retrospective cohort study, Middle Aged, medicine.disease, Obesity, Respiratory Function Tests, Anesthesiology and Pain Medicine, Female, ARDS, medicine.symptom, business, Coronavirus Infections, Body mass index
Published: 2020

150. The assessment of esophageal pressure using different devices: a validation study

Author: Erica Ferrari, Andrea C Lusardi, Davide Chiumello, Valentina Galanti, Tommaso Pozzi, Alessio Caccioppola, Valentina De Giorgis, and Silvia Coppola
Subjects: Validation study, ARDS, Respiratory Distress Syndrome, Lung, business.industry, 030208 emergency & critical care medicine, Acute respiratory distress, respiratory system, Baseline level, medicine.disease, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Anesthesiology and Pain Medicine, medicine.anatomical_structure, 030202 anesthesiology, Anesthesia, Hemodynamic monitor, medicine, Esophageal pressure, Humans, business, Transpulmonary pressure
Abstract: Background Although esophageal pressure measurement could help clinicians to improve the ventilatory management of acute respiratory distress syndrome (ARDS) patients, it has been mainly used in clinical research. Aim of this study was to compare the measurements of end-expiratory esophageal pressure, end-expiratory transpulmonary pressure and lung stress by three systems: a dedicated manual device, taken as gold standard, a new automatic system (Optivent) and a bedside equipment, consisting of a mechanical ventilator and a hemodynamic monitor. Methods In sedated and paralyzed mechanically ventilated ARDS patients the esophageal pressure was measured at three PEEP levels in random fashion (baseline level, 50% higher and 50% lower). Results Forty patients were enrolled (BMI 25 [23-28] kg/m2, PaO 2 /FiO 2 187 [137-223] and PEEP 9±3 cmH 2 O). The mean esophageal pressure measured during an expiratory pause by the dedicated system, the bedside system and Optivent were 10.0±4.2, 10±4 and 9.9±4.0 cmH 2 O, respectively. The respective bias and limits of agreement between the dedicated system and Optivent and between the dedicated system and the bedside system were as follows: end-expiratory esophageal pressure, 0.2 cmH 2 O, (-0.4 to 0.9) and -0.1 cmH 2 O (-1.9 to 1.7); end-expiratory transpulmonary pressure, -0.6 cmH 2 O (-1.7 to 0.4) and -0.4 cmH 2 O, (-2.2 to 1.5); lung stress -0.9 cmH 2 O (-3.0 to 1.1) and -1.5 cmH 2 O (-4.4 to 1.4). Conclusions Both Optivent and the bedside system showed clinically acceptability if compared to the gold standard device. The possibility to apply one of these systems could allow a wider use of esophageal pressure in clinical practice.
Published: 2020

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