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1. Double data and dubious conclusions, ‘Houston do we have a problem?’

Author: Epker, J.L. (Jelle), Valkenburg, A.J. (Abraham), Kompanje, E.J.O. (Erwin), Epker, J.L. (Jelle), Valkenburg, A.J. (Abraham), and Kompanje, E.J.O. (Erwin)
Published: 2021
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2. Frequency of fatigue and its changes in the first 6 months after traumatic brain injury: results from the CENTER-TBI study

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

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

Author: van der Zee, E.N. (Esther N.), Epker, J.L. (Jelle), Bakker, J. (Jan), Benoit, D.D. (Dominique), Kompanje, E.J.O. (Erwin), van der Zee, E.N. (Esther N.), Epker, J.L. (Jelle), Bakker, J. (Jan), Benoit, D.D. (Dominique), and Kompanje, E.J.O. (Erwin)
Abstract: Background: Treatment limitation decisions (TLDs) on the ICU can be challenging, especially in patients with a malignancy. Up-to-date literature regarding TLDs in critically ill patients with a malignancy admitted to the ICU is scarce. The aim was to compare the incidence of written TLDs between patients with an active malignancy, patients with a malignancy in their medical history (complete remission, CR) and patients without a malignancy admitted unplanned to the ICU. Methods: We conducted a retrospective cohort study in a large university hospital in the Netherlands. We identified all unplanned admissions to the ICU in 2017 and categorized the patients in 3 groups: patients with an active malignancy (study population), with CR and without a malignancy. A TLD was defined as a written instruction not to perform life-saving treatments, such as CPR in case of cardiac arrest. A multivariate binary logistic regression analysis was used to identify whether having a malignancy was associated with TLDs. Results: Of the 1046 unplanned admissions, 125 patients (12%) had an active malignancy and 76 (7.3%) patients had CR. The incidence of written TLDs in these subgroups were 37 (29.6%) and 20 (26.3%). Age (OR 1.03; 95% CI 1.01 -1.04), SOFA score at ICU admission (OR 1.11; 95% CI 1.05 -1.18) and having an active malignancy (OR 1.75; 95% CI 1.04-2.96) compared to no malignancy were independently associated with written TLDs. SOFA scores on the day of the TLD were not significantly different in patients with and without a malignancy. Conclusions: This study shows that the presence of an underlying malignancy is independently associated with written TLDs during ICU stay. Patients with CR were not at risk of more written TLDs. Whether this higher incidence of TLDs in patients with a malignancy is justified, is at least questionable and should be evaluated in future research.
Published: 2020
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5. Tracheal intubation in traumatic brain injury

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

Author: Voormolen, D.C. (Daphne), Polinder, S. (Suzanne), Von Steinbuechel, N. (Nicole), Feng, Y. (Yan), Wilson, L. (Lindsay), Oppe, M. (Mark), Haagsma, J.A. (Juanita), Åkerlund, C. (Cecilia), Adams, H. (Hadie), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzó, P. (Pál), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Castaño-León, A.M. (Ana M.), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Cnossen, M.C. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Boogert, H. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), L.Gruen, R. (Russell), Gupta, D. (Deepak), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Jones, K.M. (Kelly M.), Karan–, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McFadyen, C. (Charles), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Nair, N. (Nandesh), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Real, R. (Ruben), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevanovic, A. (Ana), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T. J. M.), van Essen, T. (Thomas), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vanhaudenhuyse, A. (Audrey), van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederik A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), Zoerle, T. (Tommaso), Voormolen, D.C. (Daphne), Polinder, S. (Suzanne), Von Steinbuechel, N. (Nicole), Feng, Y. (Yan), Wilson, L. (Lindsay), Oppe, M. (Mark), Haagsma, J.A. (Juanita), Åkerlund, C. (Cecilia), Adams, H. (Hadie), Amrein, K. (Krisztina), Andelic, N. (Nada), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Audibert, G. (Gérard), Azouvi, P. (Philippe), Azzolini, M.L. (Maria Luisa), Bartels, R.H.M.A. (Ronald), Barzó, P. (Pál), Beauvais, R. (Romuald), Beer, R. (Ronny), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Benali, H. (Habib), Berardino, M. (Maurizio), Beretta, L. (Luigi), Blaabjerg, M. (Morten), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brinck, V. (Vibeke), Brooker, J. (Joanne), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Cabeleira, M. (Manuel), Caccioppola, A. (Alessio), Calappi, E. (Emiliana), Calvi, M.R. (Maria Rosa), Cameron, P. (Peter), Lozano, G.C. (Guillermo Carbayo), Carbonara, M. (Marco), Castaño-León, A.M. (Ana M.), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Cnossen, M.C. (Maryse), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Dawes, H. (Helen), De Keyser, V. (Véronique), Degos, V. (Vincent), Corte, F.D. (Francesco Della), Boogert, H. (Hugo den), Depreitere, B. (Bart), Đilvesi, Đ. (Đula), Dixit, A. (Abhishek), Donoghue, E. (Emma), Dreier, J.P. (Jens), Dulière, G.-L. (Guy-Loup), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (Valery L.), Foks, K. (Kelly), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gantner, D. (Dashiell), Gao, G. (Guoyi), George, P. (Pradeep), Ghuysen, A. (Alexandre), Giga, L. (Lelde), Glocker, B. (Ben), Golubovic, J. (Jagoš), Gomez, P.A. (Pedro A.), Gratz, J. (Johannes), Gravesteijn, B. (Benjamin), Grossi, F. (Francesca), L.Gruen, R. (Russell), Gupta, D. (Deepak), Haitsma, I. (Iain), Helbok, R. (Raimund), Helseth, E. (Eirik), Horton, L. (Lindsay), Huijben, J. (Jilske), Hutchinson, P.J. (Peter J.), Jacobs, B.C. (Bart), Jankowski, S. (Stefan), Jarrett, M. (Mike), Jiang, J.-Y. (Ji-Yao), Jones, K.M. (Kelly M.), Karan–, M. (Mladen), Kolias, A.G. (Angelos G.), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lecky, F.E. (Fiona), Lefering, R., Legrand, V. (Valerie), Lejeune, A. (Aurelie), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Maegele, M. (Marc), Majdan, M. (Marek), Manara, A. (Alex), Manley, G. (Geoffrey), Martino, C. (Costanza), Maréchal, H. (Hugues), Mattern, J. (Julia), McFadyen, C. (Charles), McMahon, C. (Catherine), Melegh, B. (Béla), Menon, D.K. (David ), Menovsky, T. (Tomas), Mulazzi, D. (Davide), Muraleedharan, V. (Visakh), Murray, L. (Lynnette), Nair, N. (Nandesh), Negru, A. (Ancuta), Nelson, D. (David), Newcombe, V.F. (Virginia F.), Nieboer, D. (Daan), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Olubukola, O. (Otesile), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Piippo-Karjalainen, A. (Anna), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Posti, J.P. (Jussi P.), Puybasset, L. (Louis), Radoi, A. (Andreea), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Real, R. (Ruben), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Richter, S. (Sophie), Ripatti, S. (Samuli), Rocka, S. (Saulius), Roe, C. (Cecilie), Roise, O. (Olav), Rosand, J. (Jonathan), Rosenfeld, J.V. (Jeffrey V.), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rueckert, D. (Daniel), Rusnák, M. (Martin), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Schäfer, N. (Nadine), Schmidt, S. (Silke), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Sewalt, C. (Charlie), Skandsen, T. (Toril), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E. (Emmanuel), Stanworth, S. (Simon), Stevanovic, A. (Ana), Stevens, R. (Robert), Stewart, W. (William), Steyerberg, E.W. (Ewout), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Takala, R. (Riikka), Tamás, V. (Viktória), Tamosuitis, T. (Tomas), Taylor, M.S. (Mark Steven), Ao, B.T. (Braden Te), Tenovuo, O. (Olli), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Timmers, M. (Marjolein), Tolias, C.M. (Christos M.), Trapani, T. (Tony), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Vallance, S. (Shirley), Valeinis, E. (Egils), Vámos, Z. (Zoltán), Van der Steen, G. (Gregory), Naalt, J. (Joukje) van der, van Dijck, J.T.J.M. (Jeroen T. J. M.), van Essen, T. (Thomas), Hecke, W. (Wim) van, van Heugten, C.M. (Caroline M.), Van Praag, D. (Dominique), Vyvere, T.V. (Thijs Vande), Vanhaudenhuyse, A. (Audrey), van Wijk, R.P.J. (Roel P. J.), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Velt, K. (Kimberley), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Volovici, V. (Victor), Von Steinbüchel, N. (Nicole), Voormolen, D. (Daphne), Vulekovic, P. (Peter), Wang, K.K.W. (Kevin), Wiegers, E. (Eveline), Williams, G. (Guy), Wolf, S. (Stefan), Yang, Z. (Zhihui), Ylén, P. (Peter), Younsi, A. (Alexander), Zeiler, F.A. (Frederik A.), Zelinkova, V. (Veronika), Ziverte, A. (Agate), and Zoerle, T. (Tommaso)
Abstract: Purpose: The Quality of Life after Brain Injury overall scale (QOLIBRI-OS) measures health-related quality of life (HRQoL) after traumatic brain injury (TBI). The aim of this study was to derive value sets for the QOLIBRI-OS in three European countries, which will allow calculation of utility scores for TBI health states. Methods: A QOLIBRI-OS value set was derived by using discrete choice experiments (DCEs) and visual analogue scales (VAS) in general population samples from the Netherlands, United Kingdom and Italy. A three-stage procedure was used: (1) A selection of health states, covering the entire spectrum of severity, was defined; (2) General population samples performed the health state valuation task using a web-based survey with three VAS questions and an at random selection of sixteen DCEs; (3) DCEs were analysed using a conditional logistic regression and were then anchored on the VAS data. Utility scores for QOLIBRI-OS health states were generated resulting in estimates for all potential health states. Results: The questionnaire was completed by 13,623 respondents. The biggest weight increase for all attributes is seen from “slightly” to “not at all satisfied”, resulting in the largest impact on HRQoL. “Not at all satisfied with how brain is working” should receive the greatest weight in utility calculations in all three countries. Conclusion: By transforming the QOLIBRI-OS into utility scores, we enabled the application in economic evaluations and in summary measures of population health, which may be used to inform decision-makers on the best interventions and strategies for TBI patients.
Published: 2020
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7. How do 66 European institutional review boards approve one protocol for an international prospective observational study on traumatic brain injury? Experiences from the CENTER-TBI study

Author: Timmers, M. (Marjolein), van Dijck, J.T.J.M. (Jeroen T J M), van Wijk, R.P.J. (Roel P J), Legrand, V. (Valerie), van Veen, E. (Ernest), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Citerio, G. (Giuseppe), Stocchetti, N. (Nino), Kompanje, E.J.O. (Erwin), Timmers, M. (Marjolein), van Dijck, J.T.J.M. (Jeroen T J M), van Wijk, R.P.J. (Roel P J), Legrand, V. (Valerie), van Veen, E. (Ernest), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Citerio, G. (Giuseppe), Stocchetti, N. (Nino), and Kompanje, E.J.O. (Erwin)
Abstract: BACKGROUND: The European Union (EU) aims to optimize patient protection and efficiency of health-care research by harmonizing procedures across Member States. Nonetheless, further improvements are required to increase multicenter research efficiency. We investigated IRB procedures in a large prospective European multicenter study on traumatic brain injury (TBI), aiming to inform and stimulate initiatives to improve efficiency. METHODS: We reviewed relevant documents regarding IRB submission and IRB approval from European neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI). Documents included detailed information on IRB procedures and the duration from IRB submission until approval(s). They were translated and analyzed to determine the level of harmonization of IRB procedures within Europe. RESULTS: From 18 countries, 66 centers provided the requested documents. The primary IRB review was conducted centrally (N = 11, 61%) or locally (N = 7, 39%) and primary IRB approval was obtained after one (N = 8, 44%), two (N = 6, 33%) or three (N = 4, 23%) review rounds with a median duration of respectively 50 and 98 days until primary IRB approval. Additional IRB approval was required in 55% of countries and could increase duration to 535 days. Total duration from submission until required IRB approval was obtained was 114 days (IQR 75-224) and appeared to be shorter after submission to local IR
Published: 2020
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8. Functional outcome, in-hospital healthcare consumption and in-hospital costs for hospitalised traumatic brain injury patients: a Dutch prospective multicentre study

Author: van Dijck, J.T.J.M. (Jeroen T. J. M.), Mostert, C.Q.B. (Cassidy Q. B.), Greeven, A.P.A. (Alexander), Kompanje, E.J.O. (Erwin), Peul, W.C. (Wilco), De Ruiter, G.C.W. (Godard C.W.), Polinder, S. (Suzanne), van Dijck, J.T.J.M. (Jeroen T. J. M.), Mostert, C.Q.B. (Cassidy Q. B.), Greeven, A.P.A. (Alexander), Kompanje, E.J.O. (Erwin), Peul, W.C. (Wilco), De Ruiter, G.C.W. (Godard C.W.), and Polinder, S. (Suzanne)
Abstract: Background: The high occurrence and acute and chronic sequelae of traumatic brain injury (TBI) cause major healthcare and socioeconomic challenges. This study aimed to describe outcome, in-hospital healthcare consumption and in-hospital costs of patients with TBI. Methods: We used data from hospitalised TBI patients that were included in the prospective observational CENTER-TBI study in three Dutch Level I Trauma Centres from 2015 to 2017. Clinical data was completed with data on in-hospital healthcare consumption and costs. TBI severity was classified using the Glasgow Coma Score (GCS). Patient outcome was measured by in-hospital mortality and Glasgow Outcome Score–Extended (GOSE) at 6 months. In-hospital costs were calculated following the Dutch guidelines for cost calculation. Results: A total of 486 TBI patients were included. Mean age was 56.1 ± 22.4 years and mean GCS was 12.7 ± 3.8. Six-month mortality (4.2%–66.7%), unfavourable outcome (GOSE ≤ 4) (14.6%–80.4%) and full recovery (GOSE = 8) (32.5%–5.9%) rates varied from patients with mild TBI (GCS13–15) to very severe TBI (GCS3–5). Length of stay (8 ± 13 days) and in-hospital costs (€11,920) were substantial and increased with higher TBI severity, presence of intracranial abnormalities, extracranial injury and surgical intervention. Costs were primarily driven by admission (66%) and surgery (13%). Conclusion: In-hospital mortality and unfavourable outcome rates were rather high, but many patients also achieved full recovery. Hospitalised TBI patients show substantial in-hospital healthcare consumption and costs, even in patients with mild TBI. Because these costs are likely to be an underestimation of the actual total costs, more research is required to investigate the actual costs-effectiveness of TBI care.
Published: 2020
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9. Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury

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

Author: van Veen, E. (Ernest), Jagt, M. (Mathieu) van der, Citerio, G. (Giuseppe), Stocchetti, N. (Nino), Epker, J.L. (Jelle), Gommers, D.A.M.P.J. (Diederik), Burdorf, L. (Lex), Menon, D.K. (David ), Maas, A.I.R. (Andrew), Lingsma, H.F. (Hester), Kompanje, E.J.O. (Erwin), van Veen, E. (Ernest), Jagt, M. (Mathieu) van der, Citerio, G. (Giuseppe), Stocchetti, N. (Nino), Epker, J.L. (Jelle), Gommers, D.A.M.P.J. (Diederik), Burdorf, L. (Lex), Menon, D.K. (David ), Maas, A.I.R. (Andrew), Lingsma, H.F. (Hester), and Kompanje, E.J.O. (Erwin)
Abstract: Purpose: We aimed to study variation regarding specific 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 management 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/withdraw 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 variability 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.
Published: 2020
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11. Medisch-wetenschappelijk onderzoek in spoedeisende situaties: Mag dat zonder voorafgaande toestemming van de patiënt?

Author: Timmers, Marjolein, van Duijn, D. (Ditty), Kompanje, E.J.O. (Erwin), Law & Health Care (LHC), and Intensive Care
Abstract: Casus Een 19-jarige man werd om 2:00 uur in de nacht op de Intensive Care opgenomen vanwege traumatisch schedelhersenletsel. Hij was met zijn auto van de weg geraakt en uit de auto geslingerd. Bij opname was hij diep comateus. Bij screening bleek de man geschikt voor inclusie in een wetenschappelijke studie naar het effect van een neuroprotectief medicament. De eerste gift van de studiemedicatie diende binnen 3 uur na het letsel te worden toegediend. Om deze reden had de medisch-ethische toetsingscommissie (METC) inclusie met uitgestelde toestemming goedgekeurd. Ruim 2 uur na het ongeval werd de eerste dosis toegediend. 3 uur na het ongeval arriveerden de ouders van de man. Zij werden op de hoogte gebracht van de ernst van het levensbedreigende hersenletsel. De ouders waren zeer ontdaan en wilden na het gesprek zo snel mogelijk hun zoon zien, wat nog meer verdriet genereerde. Kort daarna verslechterde de toestand en moest een CT-scan worden gemaakt. De ouders werden op de hoogte gebracht van de uitslag. In de uren hierna stabiliseerde de toestand van de man en werd tijdens een derde gesprek, ruim 9 uur na het ongeval, de inclusie in het onderzoek besproken. Nu gaven de, inmiddels wat tot rust gekomen, ouders hun toestemming voor vervolg van het onderzoek.
Published: 2019

12. Ethical climate and intention to leave among critical care clinicians: an observational study in 68 intensive care units across Europe and the United States

Author: Van den Bulcke, B. (Bo), Metaxa, V. (Victoria), Reyners, A.K.L. (Anna), Rusinova, K. (Katerina), Jensen, H.I. (Hanne I.), Malmgren, J. (J.), Darmon, M. (Michael), Talmor, D. (Daniel), Meert, A.-P. (Anne-Pascale), Cancelliere, L. (Laura), Zubek, L. (László), Maia, P. (Paulo), Michalsen, A. (Andrej), Kompanje, E.J.O. (Erwin), Vlerick, P. (Peter), Roels, J. (Jolien), Vansteelandt, S. (Stijn), Decruyenaere, J. (Johan), Azoulay, E. (Elie), Vanheule, S. (Stijn), Piers, R.D. (Ruth), Benoit, D.D. (Dominique), Van den Bulcke, B. (Bo), Metaxa, V. (Victoria), Reyners, A.K.L. (Anna), Rusinova, K. (Katerina), Jensen, H.I. (Hanne I.), Malmgren, J. (J.), Darmon, M. (Michael), Talmor, D. (Daniel), Meert, A.-P. (Anne-Pascale), Cancelliere, L. (Laura), Zubek, L. (László), Maia, P. (Paulo), Michalsen, A. (Andrej), Kompanje, E.J.O. (Erwin), Vlerick, P. (Peter), Roels, J. (Jolien), Vansteelandt, S. (Stijn), Decruyenaere, J. (Johan), Azoulay, E. (Elie), Vanheule, S. (Stijn), Piers, R.D. (Ruth), and Benoit, D.D. (Dominique)
Abstract: Purpose: Apart from organizational issues, quality of inter-professional collaboration during ethical decision-making may affect the intention to leave one’s job. To determine whether ethical climate is associated with the intention to leave after adjustment for country, ICU and clinicians characteristics. Methods: Perceptions of the ethical climate among clinicians working in 68 adult ICUs in 12 European countries and the US were measured using a self-assessment questionnaire, together with job characteristics and intent to leave as a sub-analysis of the Dispropricus study. The validated ethical decision-making climate questionnaire included seven factors: not avoiding decision-making at end-of-life (EOL), mutual respect within the interdisciplinary team, open interdisciplinary reflection, ethical awareness, self-reflective physician leadership, active decision-making at end-of-life by physicians, and involvement of nurses in EOL. Hierarchical mixed effect models were used to assess associations between these factors, and the intent to leave in clinicians within IC
Published: 2019
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13. A jackass and a fish: A case of life-threatening intentional ingestion of a live pet catfish (Corydoras aeneus)

Author: Benoist, L.B.L. (Linda), Hoven, B. (Ben) van der, Vries, A.C. (Annemarie) de, Pullens, B. (Bas), Kompanje, E.J.O. (Erwin), Moeliker, C.W. (Cornelis), Benoist, L.B.L. (Linda), Hoven, B. (Ben) van der, Vries, A.C. (Annemarie) de, Pullens, B. (Bas), Kompanje, E.J.O. (Erwin), and Moeliker, C.W. (Cornelis)
Abstract: Inspired by Jackass (a tv-show about self-injuring stunts), some friends topped off a drinking party with live fishes from their aquarium. After the goldfishes had gone down smoothly, a bronze catfish was ingested. Unaware of the morphology and anti-predator behaviour of this species, a healthy but intoxicated 28-year-old man got a surprise. The catfish erected and locked the spines of its pectoral fins and got lodged in the hypopharynx. After several hours, he presented himself at the emergency department with dysphonia and dysphagia. The fish had to be removed endoscopically. Intubation and admittance to the intensive care unit was necessary due to laryngeal oedema. Two weeks postoperatively, the patient made a full recovery and donated the fish to the Natural History Museum Rotterdam. The publicity generated by public exhibition of the ‘do-not-swallow-fish’ emphasised the official Jackass warning: ‘.. do not attempt any of the stunts you’re about to see’.
Published: 2019
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14. Medisch-wetenschappelijk onderzoek in spoedeisende situaties:Mag dat zonder voorafgaande toestemming van de patiënt?

Author: Timmers, Marjolein, van Duijn, D. (Ditty), Kompanje, E.J.O. (Erwin), Timmers, Marjolein, van Duijn, D. (Ditty), and Kompanje, E.J.O. (Erwin)
Abstract: Casus Een 19-jarige man werd om 2:00 uur in de nacht op de Intensive Care opgenomen vanwege traumatisch schedelhersenletsel. Hij was met zijn auto van de weg geraakt en uit de auto geslingerd. Bij opname was hij diep comateus. Bij screening bleek de man geschikt voor inclusie in een wetenschappelijke studie naar het effect van een neuroprotectief medicament. De eerste gift van de studiemedicatie diende binnen 3 uur na het letsel te worden toegediend. Om deze reden had de medisch-ethische toetsingscommissie (METC) inclusie met uitgestelde toestemming goedgekeurd. Ruim 2 uur na het ongeval werd de eerste dosis toegediend. 3 uur na het ongeval arriveerden de ouders van de man. Zij werden op de hoogte gebracht van de ernst van het levensbedreigende hersenletsel. De ouders waren zeer ontdaan en wilden na het gesprek zo snel mogelijk hun zoon zien, wat nog meer verdriet genereerde. Kort daarna verslechterde de toestand en moest een CT-scan worden gemaakt. De ouders werden op de hoogte gebracht van de uitslag. In de uren hierna stabiliseerde de toestand van de man en werd tijdens een derde gesprek, ruim 9 uur na het ongeval, de inclusie in het onderzoek besproken. Nu gaven de, inmiddels wat tot rust gekomen, ouders hun toestemming voor vervolg van het onderzoek.
Published: 2019

15. Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study

Author: van Veen, E. (Ernest), Jagt, M. (Mathieu) van der, Cnossen, M.C. (Maryse), Maas, A.I.R. (Andrew), Beaufort, I.D. (Inez) de, Menon, D.K. (David ), Citerio, G. (Giuseppe), Stocchetti, N. (Nino), Rietdijk, W.J.R. (Wim), van Dijck, J.T.J.M. (Jeroen T J M), Kompanje, E.J.O. (Erwin), van Veen, E. (Ernest), Jagt, M. (Mathieu) van der, Cnossen, M.C. (Maryse), Maas, A.I.R. (Andrew), Beaufort, I.D. (Inez) de, Menon, D.K. (David ), Citerio, G. (Giuseppe), Stocchetti, N. (Nino), Rietdijk, W.J.R. (Wim), van Dijck, J.T.J.M. (Jeroen T J M), and Kompanje, E.J.O. (Erwin)
Abstract: BACKGROUND: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation. METHODS: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%). RESULTS: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time. CONCLUSIONS: This study showed both agreement and some regional
Published: 2018
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16. Outcome in patients perceived as receiving excessive care across different ethical climates: a prospective study in 68 intensive care units in Europe and the USA

Author: Benoit, D.D. (Dominique), Jensen, H.I. (H. I.), Malmgren, J. (J.), Metaxa, V. (V.), Reyners, A.K.L. (Anna), Darmon, M. (M.), Rusinova, K. (K.), Talmor, D. (Daniel), Meert, A.P. (A. P.), Cancelliere, L. (L.), Zubek, L. (L.), Maia, P. (P.), Michalsen, A. (A.), Vanheule, S. (S.), Kompanje, E.J.O. (E. J.O.), Decruyenaere, J. (J.), Vandenberghe, S. (S.), Vansteelandt, S. (Stijn), Gadeyne, B. (B.), van Den Bulcke, B. (B.), Azoulay, E. (Elie), Piers, R.D. (Ruth), Spapen, H., van Malderen, M.-C. (Marie-Claire), Opdenacker, G. (Godelieve), Meyfroidt, G. (Geert), Mesotten, D., Wauters, J. (Joost), van Laer, M. (Marie), Wilmer, A. (Alexander), Ceunen, H. (H.), De Laet, I. (Inneke), Jans, A. (Anita), Benoit, D. (Dominique), Oeyen, S. (Sandra), Herck, I. (Ingrid), Bracke, S. (Stephanie), Clauwaert, C. (Charlotte), Meert, A.-P. (Anne-Pascale), Leclercq, N. (Nathalie), Jacques, D. (Devriendt), Philippe, D. (Dechamps), Zykova, I. (Ivana), Malaska, J. (Jan), Schmidt, M. (Matous), Satinsky, I. (Igor), Kieslichova, E. (Eva), Krizova, J. (Jarmila), Janda, R. (Robert), Fortova, M. (Magdalena), Matyas, J. (Jiri), Rusinova, K. (Katerina), Kopecky, O. (Ondrej), Pedersen, C.A.K. (Christian Alves Køhler), Hebsgaard, S. (Stine), Johnsen, R.F.A. (Rikke Frank Aagaard), Hansen, T.C.B. (Tina Charlotte Bitsch), Darmon, M. (Michael), Reuter, D. (Danielle), Mokart, D. (Djamel), Vincent, F. (François), Hartog, C.S. (Christiane), Gretenkort, P. (Peter), Michalsen, A. (Andrej), Kounougeri, A. (Aikaterini), Nanas, S. (Serafim), Papachristou, D. (Despina), Soultati, I. (Ioanna), Lathyris, D. (Dimitrios), Pasakiotou, M. (Marili), Oikonomou, M. (Marina), Elö, G. (Gabor), Szücs, O. (Orsolya), Fogas, J. (János), Bobek, I. (Ilona), Corte, F.D. (Francesco Della), Olivieri, C. (Carlo), Vaschetto, R. (Rosanna), Cancelliere, L. (Laura), Marinangeli, F. (Franco), Pozone, T. (Tullio), Ciccozzi, A. (Alessandra), Schouten, A. (A.), Bruns, M. (Monique), Gerritsen, R.T. (Rik T.), Koopmans, M. (Matty), Kompanje, E.J.O. (Erwin), van Duijn, M.A.J. (Marijtje A. J.), Zijlstra, J.G. (Jan G.), Reyners, A.K. (Anne KL.), Lutisan, J.G. (Johan), Monte, R. (Raquel), Pinho, J.A. (José António), Pimenta, P. (Pedro), Fernandes, P. (Paula), Paixão, A.I. (Ana Isabel), Faria, R. (Rui), Malmgren, J.A. (Johan A.), Andersson, B. (Bertil), Akerman, E. (Eva), Hvarfner, A. (Andreas), Svensson, R. (Robert), Metaxa, V. (Victoria), Mueller, A. (Ariel), Banner-Goodspeed, V. (Valerie), Rickett, D. (Dee), Wilson, M.E. (Michael E.), Hinds, R. (Richard), Benoit, D.D. (Dominique), Jensen, H.I. (H. I.), Malmgren, J. (J.), Metaxa, V. (V.), Reyners, A.K.L. (Anna), Darmon, M. (M.), Rusinova, K. (K.), Talmor, D. (Daniel), Meert, A.P. (A. P.), Cancelliere, L. (L.), Zubek, L. (L.), Maia, P. (P.), Michalsen, A. (A.), Vanheule, S. (S.), Kompanje, E.J.O. (E. J.O.), Decruyenaere, J. (J.), Vandenberghe, S. (S.), Vansteelandt, S. (Stijn), Gadeyne, B. (B.), van Den Bulcke, B. (B.), Azoulay, E. (Elie), Piers, R.D. (Ruth), Spapen, H., van Malderen, M.-C. (Marie-Claire), Opdenacker, G. (Godelieve), Meyfroidt, G. (Geert), Mesotten, D., Wauters, J. (Joost), van Laer, M. (Marie), Wilmer, A. (Alexander), Ceunen, H. (H.), De Laet, I. (Inneke), Jans, A. (Anita), Benoit, D. (Dominique), Oeyen, S. (Sandra), Herck, I. (Ingrid), Bracke, S. (Stephanie), Clauwaert, C. (Charlotte), Meert, A.-P. (Anne-Pascale), Leclercq, N. (Nathalie), Jacques, D. (Devriendt), Philippe, D. (Dechamps), Zykova, I. (Ivana), Malaska, J. (Jan), Schmidt, M. (Matous), Satinsky, I. (Igor), Kieslichova, E. (Eva), Krizova, J. (Jarmila), Janda, R. (Robert), Fortova, M. (Magdalena), Matyas, J. (Jiri), Rusinova, K. (Katerina), Kopecky, O. (Ondrej), Pedersen, C.A.K. (Christian Alves Køhler), Hebsgaard, S. (Stine), Johnsen, R.F.A. (Rikke Frank Aagaard), Hansen, T.C.B. (Tina Charlotte Bitsch), Darmon, M. (Michael), Reuter, D. (Danielle), Mokart, D. (Djamel), Vincent, F. (François), Hartog, C.S. (Christiane), Gretenkort, P. (Peter), Michalsen, A. (Andrej), Kounougeri, A. (Aikaterini), Nanas, S. (Serafim), Papachristou, D. (Despina), Soultati, I. (Ioanna), Lathyris, D. (Dimitrios), Pasakiotou, M. (Marili), Oikonomou, M. (Marina), Elö, G. (Gabor), Szücs, O. (Orsolya), Fogas, J. (János), Bobek, I. (Ilona), Corte, F.D. (Francesco Della), Olivieri, C. (Carlo), Vaschetto, R. (Rosanna), Cancelliere, L. (Laura), Marinangeli, F. (Franco), Pozone, T. (Tullio), Ciccozzi, A. (Alessandra), Schouten, A. (A.), Bruns, M. (Monique), Gerritsen, R.T. (Rik T.), Koopmans, M. (Matty), Kompanje, E.J.O. (Erwin), van Duijn, M.A.J. (Marijtje A. J.), Zijlstra, J.G. (Jan G.), Reyners, A.K. (Anne KL.), Lutisan, J.G. (Johan), Monte, R. (Raquel), Pinho, J.A. (José António), Pimenta, P. (Pedro), Fernandes, P. (Paula), Paixão, A.I. (Ana Isabel), Faria, R. (Rui), Malmgren, J.A. (Johan A.), Andersson, B. (Bertil), Akerman, E. (Eva), Hvarfner, A. (Andreas), Svensson, R. (Robert), Metaxa, V. (Victoria), Mueller, A. (Ariel), Banner-Goodspeed, V. (Valerie), Rickett, D. (Dee), Wilson, M.E. (Michael E.), and Hinds, R. (Richard)
Abstract: Purpose: Whether the quality of the ethical climate in the intensive care unit (ICU) improves the identification of patients receiving excessive care and affects patient outcomes is unknown. Methods: In this prospective observational study, perceptions of excessive care (PECs) by clinicians working in 68 ICUs in Europe and the USA were collected daily during a 28-day period. The quality of the ethical climate in the ICUs was assessed via a validated questionnaire. We compared the combined endpoint (death, not at home or poor quality of life at 1 year) of patients with PECs and the time from PECs until written treatment-limitation decisions (TLDs) and death across the four climates defined via cluster analysis. Results: Of the 4747 eligible clinicians, 2992 (63%) evaluated the ethical climate in their ICU. Of the 321 and 623 patients not admitted for monitoring only in ICUs with a good (n = 12, 18%) and poor (n = 24, 35%) climate, 36 (11%) and 74 (12%), respectively were identified with PECs by at least two clinicians. Of the 35 and 71 identified patients with an available combined endpoint, 100% (95% CI 90.0–1.00) and 85.9% (75.4–92.0) (P = 0.02) attained that endpoint. The risk of death (HR 1.88, 95% CI 1.20–2.92) or receiving a written TLD (HR 2.32, CI 1.11–4.85) in patients with PECs by at least two clinicians was higher in ICUs with a good climate than in those with a poor one. The differences between ICUs with an average climate, with (n = 12, 18%) or without (n = 20, 29%) nursing involvement at the end of life, and ICUs with a poor climate were less obvious but still in favour of the former. Conclusion: Enhancing the quality of the ethical climate in the ICU may improve both the identification of patients receiving excessive care and the decision-making process at the end of life.
Published: 2018
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17. Will we become more compassionate or empathic intensive care professionals by watching films and documentaries about suffering?

Author: Kompanje, E.J.O. (Erwin), Mol, M.M.C. (Margo) van, Weigel, J. (Joachim), Kompanje, E.J.O. (Erwin), Mol, M.M.C. (Margo) van, and Weigel, J. (Joachim)
Abstract: The daily work of physicians and nurses in intensive care medicine is depicted in many fictional series, movies and in real-life documentaries. _Extremis_ is such
Published: 2017
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18. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: A survey in 66 neurotrauma centers participating in the CENTER-TBI study

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

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

Author: Kompanje, E.J.O. (Erwin), Groot, Y.J. (Yorick) de, Kompanje, E.J.O. (Erwin), and Groot, Y.J. (Yorick) de
Published: 2015
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21. Compassion fatigue and burnout among healthcare professionals in the ICU

Author: Mol, M.M.C. (Margo) van, Kompanje, E.J.O. (Erwin), Bakker, J. (Jan), Nijkamp, M.D. (Marjan), Mol, M.M.C. (Margo) van, Kompanje, E.J.O. (Erwin), Bakker, J. (Jan), and Nijkamp, M.D. (Marjan)
Published: 2014
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22. Donor conversion rates depend on the assessment tools used in the evaluation of potential organ donors

Author: Groot, Y.J. (Yorick) de, Wijdicks, E.F.M. (Eelco), Jagt, M. (Mathieu) van der, Bakker, J. (Jan), Roozenbeek, B. (Bob), IJzermans, J.N.M. (Jan), Kompanje, E.J.O. (Erwin), Groot, Y.J. (Yorick) de, Wijdicks, E.F.M. (Eelco), Jagt, M. (Mathieu) van der, Bakker, J. (Jan), Roozenbeek, B. (Bob), IJzermans, J.N.M. (Jan), and Kompanje, E.J.O. (Erwin)
Abstract: Purpose: It is desirable to identify a potential organ donor (POD) as early as possible to achieve a donor conversion rate (DCR) as high as possible which is defined as the actual number of organ donors divided by the number of patients who are regarded as a potential organ donor. The DCR is calculated with different assessment tools to identify a POD. Obviously, with different assessment tools, one may calculate different DCRs, which make comparison difficult. Our aim was to determine which assessment tool can be used for a realistic estimation of a POD pool and how they compare to each other with regard to DCR. Methods: Retrospective chart review of patients diagnosed with a subarachnoid haemorrhage, traumatic brain injury or intracerebral haemorrhage. We applied three different assessment tools on this cohort of patients. Results: We identified a cohort of 564 patients diagnosed with a subarachnoid haemorrhage, traumatic brain injury or intracerebral haemorrhage of whom 179/564 (31.7%) died. After applying the three different assessment tools the number of patients, before exclusion of medical reasons or age, was 76 for the IBD-FOUR definition, 104 patients for the IBD-GCS definition and 107 patients based on the OPTN definition of imminent neurological death. We noted the highest DCR (36.5%) in the IBD-FOUR definition. Conclusion: The definition of imminent brain death based on the FOUR-score is the most practical tool to identify patients with a realistic chance to become brain dead and therefore to identify the patients most likely to become POD.
Published: 2011
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23. Imminent brain death and brain death are not the same: Reply to Verheijde and Rady

Author: Groot, Y.J. (Yorick) de, Bakker, J. (Jan), Wijdicks, E.F.M. (Eelco), Kompanje, E.J.O. (Erwin), Groot, Y.J. (Yorick) de, Bakker, J. (Jan), Wijdicks, E.F.M. (Eelco), and Kompanje, E.J.O. (Erwin)
Published: 2011
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24. Remarkable changes in the choice of timing to discuss organ donation with the relatives of a patient: A study in 228 organ donations in 20 years

Author: Groot, Y.J. (Yorick) de, Roozenbeek, B. (Bob), Jagt, M. (Mathieu) van der, Bakker, J. (Jan), IJzermans, J.N.M. (Jan), Kompanje, E.J.O. (Erwin), Groot, Y.J. (Yorick) de, Roozenbeek, B. (Bob), Jagt, M. (Mathieu) van der, Bakker, J. (Jan), IJzermans, J.N.M. (Jan), and Kompanje, E.J.O. (Erwin)
Abstract: Introduction: We studied whether the choice of timing of discussing organ donation for the first time with the relatives of a patient with catastrophic brain injury in The Netherlands has changed over time and explored its possible consequences. Second, we investigated how thorough the process of brain death determination was over time by studying the number of medical specialists involved. And we studied the possible influence of the Donor Register on the consent rate.Methods: We performed a retrospective chart review of all effectuated brain dead organ donors between 1987 and 2009 in one Dutch university hospital with a large neurosurgical serving area.Results: A total of 271 medical charts were collected, of which 228 brain dead patients were included. In the first period, organ donation was discussed for the first time after brain death determination (87%). In 13% of the cases, the issue of organ donation was raised before the first EEG. After 1998, we observed a shift in this practice. Discussing organ donation for the first time after brain death determination occurred in only 18% of the cases. In 58% of the cases, the issue of organ donation was discussed before the first EEG but after confirming the absence of all brain stem reflexes, and in 24% of the cases, the issue of organ donation was discussed after the prognosis was deemed catastrophic but before a neurologist or neurosurgeon assessed and determined the absence of all brain stem reflexes as required by the Dutch brain death determination protocol.Conclusions: The phases in the process of brain death determination and the time at which organ donation is first discussed with relatives have changed over time. Possible causes of this change
Published: 2011
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25. Quality of life after adjuvant intra-arterial chemotherapy and radiotherapy versus surgery alone in resectable pancreatic and periampullary cancer: A prospective randomized controlled study

Author: Morak, M.J.M. (Marjolein), Pek, C.J. (Chulja), Kompanje, E.J.O. (Erwin), Hop, W.C.J. (Wim), Kazemier, G. (Geert), Eijck, C.H.J. (Casper) van, Morak, M.J.M. (Marjolein), Pek, C.J. (Chulja), Kompanje, E.J.O. (Erwin), Hop, W.C.J. (Wim), Kazemier, G. (Geert), and Eijck, C.H.J. (Casper) van
Abstract: BACKGROUND: Adjuvant therapies for pancreatic and periampullary cancer reportedly achieve only a marginal survival benefit. In this randomized controlled trial, 120 patients with resected pancreatic or periampullary cancer received either adjuvant celiac axis infusion chemotherapy combined with radiotherapy (CAI/RT) or no adjuvant treatment. The objective of the study was to compare the quality of life (QoL) in patients who received CAI/RT after pancreatoduodenectomy with the QoL in patients who did not receive adjuvant treatment. METHODS: During and after CAI/RT, QoL was assessed using the European Organization for Research and Treatment of Cancer QoL Questionnaire C30 every 3 months during the first 24 months after randomization. RESULTS: Eighty-six percent of patients (n=103) completed 1 or more questionnaires. In total, 355 questionnaires were completed. The results indicated that CAI/RT did not impair physical, emotional, or social functioning. During and after CAI/RT, patients had significantly less pain (P=.02) and less nausea and vomiting (P=.01). Overall QoL (global functioning) tended to be better (P=.08) after CAI/RT. CONCLUSIONS: Over a period of 24 months, CAI/RT improved QoL compared with observation alone in patients with resected pancreatic and periampullary cancer. This beneficial effect of CAI/RT was most prominent in the latter half of the follow-up.
Published: 2010
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26. Imminent brain death: Point of departure for potential heart-beating organ donor recognition

Author: Groot, Y.J. (Yorick) de, Jansen, N.E. (Nichon), Bakker, J. (Jan), Kuiper, M.A. (Michael), Aerdts, S. (Stan), Maas, A.I.R. (Andrew), Wijdicks, E.F.M. (Eelco), Leiden, H.A. (Hendrik) van, Hoitsma, A.J. (Andries), Kremer, H.P.H. (Berry), Kompanje, E.J.O. (Erwin), Groot, Y.J. (Yorick) de, Jansen, N.E. (Nichon), Bakker, J. (Jan), Kuiper, M.A. (Michael), Aerdts, S. (Stan), Maas, A.I.R. (Andrew), Wijdicks, E.F.M. (Eelco), Leiden, H.A. (Hendrik) van, Hoitsma, A.J. (Andries), Kremer, H.P.H. (Berry), and Kompanje, E.J.O. (Erwin)
Abstract: Purpose: There is, in European countries that conduct medical chart review of intensive care unit (ICU) deaths, no consensus on uniform criteria for defining a potential organ donor. Although the term is increasingly being used in recent literature, it is seldom defined in detail. We searched for criteria for determination of imminent brain death, which can be seen as a precursor for organ donation. Methods: We organized meetings with representatives from the field of clinical neurology, neurotraumatology, intensive care medicine, transplantation medicine, clinical intensive care ethics, and organ procurement management. During these meetings, all possible criteria were discussed to identify a patient with a reasonable probability to become brain dead (imminen
Published: 2010
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27. Editorial: The worst is yet to come. Many elderly patients with chronic terminal illnesses will eventually die in the emergency department

Author: Kompanje, E.J.O. (Erwin) and Kompanje, E.J.O. (Erwin)
Published: 2010
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28. Inability to obtain deferred consent due to early death in emergency research: Effect on validity of clinical trial results

Author: Jansen, T.C. (Tim), Bakker, J. (Jan), Kompanje, E.J.O. (Erwin), Jansen, T.C. (Tim), Bakker, J. (Jan), and Kompanje, E.J.O. (Erwin)
Abstract: Purpose: To illustrate the impact on the validity of trial results due to excluding patients from a randomized controlled trial for whom no deferred consent could be obtained after randomization because study procedures had already been finished. Methods: The unadjusted and adjusted primary outcome measures of a recent randomized controlled multicentre study in the field of intensive care medicine were compared, including (n = 348) or excluding (n = 289) patients with missing deferred consent. Results: Thirty-nine patients (11%) died early, before the patient or his/her proxy could be approached and consent be obtained. In another 20 patients (6%), it was not possible to inform proxies and ask consent within the period of study procedures. A significant treatment effect (p = 0.006) in the adjusted analysis became non-significant (p = 0.35) when the patients with missing deferred consent were excluded. Conclusions: Exclusion of patients without obtained deferred consent can reduce statistical power, introduce selection bias, make randomization asymmetrical, decrease external validity and thereby jeopardize study results. This may have implications for emergency research in various disciplines.
Published: 2010
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29. What to do when a competent ICU patient does not want to live anymore but is dependent on life-sustaining treatment? Experience from the Netherlands

Author: Hoven, B. (Ben) van der, Groot, Y.J. (Yorick) de, Thijsse, W.J. (Wilhelmina), Kompanje, E.J.O. (Erwin), Hoven, B. (Ben) van der, Groot, Y.J. (Yorick) de, Thijsse, W.J. (Wilhelmina), and Kompanje, E.J.O. (Erwin)
Abstract: If patients on the intensive care unit (ICU) are awake and life-sustaining treatment is suspended because of the patients' request, because of recovering from the disease, or because independence from organ function supportive or replacement therapy outside the ICU can no longer be achieved, these patients can suffer before they inevitably die. In The Netherlands, two scenarios are possible for these patients: (1) deep palliative (terminal) sedation through ongoing administration of barbiturates or benzodiazepines before withdrawal of treatment, or (2) deliberate termination of life (euthanasia) before termination of treatment. In this article we describe two awake patients who asked for withdrawal of life-sustaining measures, but who were dependent on mechanical ventilation. We discuss the doctrine of double effect in relation to palliative sedation on the ICU. Administration of sedatives and analgesics before withdrawal of treatment is seen as normal palliative care. We conclude that the doctrine of the double effect is not applicable in this situation, and mentioning it criminalised the practice unnecessarily and wrongfully.
Published: 2010
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30. 'The devil lay upon her and held her down' Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664

Author: Kompanje, E.J.O. (Erwin) and Kompanje, E.J.O. (Erwin)
Abstract: Hypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with
Published: 2008
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31. Anticipation of distress after discontinuation of mechanical ventilation in the ICU at the end of life

Author: Kompanje, E.J.O. (Erwin), Hoven, B. (Ben) van der, Bakker, J. (Jan), Kompanje, E.J.O. (Erwin), Hoven, B. (Ben) van der, and Bakker, J. (Jan)
Abstract: Background: A considerable number of patients admitted to the intensive care unit (ICU) die following withdrawal of mechanical ventilation. After discontinuation of ventilation without proper preparation, excessive respiratory secretion is common, resulting in a 'death rattle'. Post-extubation stridor can give rise to the relatives' perception that the patient is choking and suffering. Existing protocols lack adequate anticipatory preparation to respond to all distressing symptoms. Methods: We analyzed existing treatment strategies in distressing symptoms after discontinuation of mechanical ventilation. Conclusion: The actual period of discontinuation of mechanical ventilation can be very short, but thoughtful anticipation of distressing symptoms takes time. There is an ethical responsibility to anticipate and treat (iatrogenic) symptoms such as pain, dyspnea-associated respiratory distress, anxiety, delirium, post-extubation stridor, and excessive broncho-pulmonary secretions. This makes withdrawal of mechanical ventilation in ICU patients a thoughtful process, taking palliative actions instead of fast terminal actions. We developed a flowchart covering all possible distressin
Published: 2008
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32. 'No time to be lost!' Ethical considerations on consent for inclusion in emergency pharmacological research in severe traumatic brain injury in the European Union

Author: Kompanje, E.J.O. (Erwin) and Kompanje, E.J.O. (Erwin)
Abstract: Severe Traumatic Brain Injury (TBI) remains a major cause of death and disability afflicting mostly young adult males and elderly people, resulting in high economic costs to society. Therapeutic approaches focus on reducing the risk on secondary brain injury. Specific ethical issues pertaining in clinical testing of pharmacological neuroprotective agents in TBI include the emergency nature of the research, the incapacity of the patients to informed consent before inclusion, short therapeutic time windows, and a risk-benefit ratio based on concep
Published: 2007
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33. Deferred consent in emergency intensive care research: What if the patient dies early? Use the data or not?

Author: Jansen, T.C. (Tim), Kompanje, E.J.O. (Erwin), Druml, C. (Christiane), Menon, D.K. (David ), Wiedermann, C.J. (Christian), Bakker, J. (Jan), Jansen, T.C. (Tim), Kompanje, E.J.O. (Erwin), Druml, C. (Christiane), Menon, D.K. (David ), Wiedermann, C.J. (Christian), and Bakker, J. (Jan)
Published: 2007
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34. Short notes and reviews Spondyloarthropathy and osteoarthrosis in three Indomalayan bears: Ursus ursinus Cuvier, 1823, Ursus thibetanus Raffles, 1821, and Ursus malayanus Shaw & Nodder, 1791 (Mammalia: Carnivora: Ursidae)

Author: Kompanje, E.J.O. (Erwin), Klaver, (Peter S.J.), Vries, (Gilbert Th.) de, Kompanje, E.J.O. (Erwin), Klaver, (Peter S.J.), and Vries, (Gilbert Th.) de
Abstract: In the skeletons of three species of Indomalayan bears, pathological changes are described that could be diagnosed as spondyloarthropathy and as discarthrosis/osteoarthrosis.
Published: 2000

35. Geven en Nemen: De praktijk van postmortale orgaandonatie; een kritische beschouwing

Author: Kompanje, E.J.O. (Erwin) and Kompanje, E.J.O. (Erwin)
Published: 1999

36. Considerations on the comparative pathology of the vertebrae in Mysticeti and Odontoceti; evidence for the occurrence of discarthrosis, zygarthrosis, infectious spondylitis and spondyloarthritis

Author: Kompanje, E.J.O. (Erwin) and Kompanje, E.J.O. (Erwin)
Abstract: Cleaned skeletons of 658 specimen of 47 species of Odontoceti and 44 skeletons of 10 species of Mysticeti were examined for evidence of pathological changes, especially of the vertebrae. Beside the examination of the cleaned skeletons, 132 spinal columns of seven species of Odontoceti were studied during autopsy. Four different pathological conditions were considered to occur: 1. Discarthrosis (spondylosis deformans); 2. Infectious spondylitis; 3. Diffuse idiopathic skeletal hyperostosis; and 4. Spondyloarthritis. Three cases of spondyloarthritis in cetaceans are described in detail. Spondyloarthritis had never before been recognized in any cetacean species.
Published: 1999

37. On the occurrence of spondylosis deformans in white-beaked dolphins Lagenorhynchus albirostris (Gray, 1846) stranded on the Dutch coast

Author: Kompanje, E.J.O. (Erwin) and Kompanje, E.J.O. (Erwin)
Abstract: Fourty-three skeletons of Lagenorhynchus albirostris were examined for the occurrence of pathological changes in the vertebral column. In comparison, 83 skeletons of Phocoena phocoena and 18 of Tursiops truncatus were studied. The pathogenesis of spondylosis deformans is discussed.
Published: 1995

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