Search

Your search keyword '"Okonkwo, D"' showing total 115 results
Start Over Author "Okonkwo, D"
115 results on '"Okonkwo, D"'

1. DEVELOPMENT OF SOFTWARE FOR SCHEDULED MAINTENACE OF DIESEL GENERATOR SETS

Author

Nwogu C N, Eze C C, Okonkwo D U, and Agu J

Subjects
scheduled maintenance, diesel generator, software, netbeans ide, Technology, Science
Abstract

A software for scheduled maintenance of diesel generators was designed and developed. This software uses vibration level (0-0.4mm), diesel level (25-100%), water level (50-100L), temperature (20-500C), air inlet pressure (20-30bar), battery voltage (24volts) and oil level (2.8-7.1cm) to evaluate the operating condition of diesel generators. The software uses these data to recommend the required maintenance scheme to be carried out on this generator with respect to the runtime in hours. The method of collection of these data is carried out manually since it is designed to be a cost effective software in order to make it available to everyone who runs a diesel generator. The software is written in Java programming language using NetBeans IDE platform, which is cross-platform and runs on Microsoft Windows, Mac OS X, Linux, Solaris and other platforms supporting a compatible JVM. This software is designed to bring maintenance to any level of technical knowhow and reduce the rate of diesel engine failures. Hence, reducing the losses associated with unexpected breakdown of diesel generators.

Published
2022

2. Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS)

Author

Picetti, E, Demetriades, A, Catena, F, Aarabi, B, Abu-Zidan, F, Alves, O, Ansaloni, L, Armonda, R, Badenes, R, Bala, M, Balogh, Z, Barbanera, A, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Castano-Leon, A, Cerasti, D, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Costa, F, De Iure, F, Depreitere, B, Fainardi, E, Fehlings, M, Gabrovsky, N, Godoy, D, Gruen, P, Gupta, D, Hawryluk, G, Helbok, R, Hossain, I, Hutchinson, P, Iaccarino, C, Inaba, K, Ivanov, M, Kaprovoy, S, Kirkpatrick, A, Klein, S, Kolias, A, Konovalov, N, Lagares, A, Lippa, L, Loza-Gomez, A, Luoto, T, Maas, A, Maciejczak, A, Maier, R, Marklund, N, Martin, M, Melloni, I, Mendoza-Lattes, S, Meyfroidt, G, Munari, M, Napolitano, L, Okonkwo, D, Otomo, Y, Papadopoulos, M, Petr, O, Peul, W, Pudkrong, A, Qasim, Z, Rasulo, F, Reizinho, C, Ringel, F, Rizoli, S, Rostami, E, Rubiano, A, Russo, E, Sarwal, A, Schwab, J, Servadei, F, Sharma, D, Sharif, S, Shiban, E, Shutter, L, Stahel, P, Taccone, F, Terpolilli, N, Thomé, C, Toth, P, Tsitsopoulos, P, Udy, A, Vaccaro, A, Varon, A, Vavilala, M, Younsi, A, Zackova, M, Zoerle, T, Robba, C, Picetti, Edoardo, Demetriades, Andreas K., Catena, Fausto, Aarabi, Bizhan, Abu-Zidan, Fikri M., Alves, Oscar L., Ansaloni, Luca, Armonda, Rocco A., Badenes, Rafael, Bala, Miklosh, Balogh, Zsolt J., Barbanera, Andrea, Bertuccio, Alessandro, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Castano-Leon, Ana Maria, Cerasti, Davide, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Costa, Francesco, De Iure, Federico, Depreitere, Bart, Fainardi, Enrico, Fehlings, Michael J., Gabrovsky, Nikolay, Godoy, Daniel Agustin, Gruen, Peter, Gupta, Deepak, Hawryluk, Gregory W. J., Helbok, Raimund, Hossain, Iftakher, Hutchinson, Peter J., Iaccarino, Corrado, Inaba, Kenji, Ivanov, Marcel, Kaprovoy, Stanislav, Kirkpatrick, Andrew W., Klein, Sam, Kolias, Angelos, Konovalov, Nikolay A., Lagares, Alfonso, Lippa, Laura, Loza-Gomez, Angelica, Luoto, Teemu M., Maas, Andrew I. R., Maciejczak, Andrzej, Maier, Ronald V., Marklund, Niklas, Martin, Matthew J., Melloni, Ilaria, Mendoza-Lattes, Sergio, Meyfroidt, Geert, Munari, Marina, Napolitano, Lena M., Okonkwo, David O., Otomo, Yasuhiro, Papadopoulos, Marios C., Petr, Ondra, Peul, Wilco C., Pudkrong, Aichholz K., Qasim, Zaffer, Rasulo, Frank, Reizinho, Carla, Ringel, Florian, Rizoli, Sandro, Rostami, Elham, Rubiano, Andres M., Russo, Emanuele, Sarwal, Aarti, Schwab, Jan M., Servadei, Franco, Sharma, Deepak, Sharif, Salman, Shiban, Ehab, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Terpolilli, Nicole A., Thomé, Claudius, Toth, Peter, Tsitsopoulos, Parmenion P., Udy, Andrew, Vaccaro, Alexander R., Varon, Albert J., Vavilala, Monica S., Younsi, Alexander, Zackova, Monika, Zoerle, Tommaso, Robba, Chiara, Picetti, E, Demetriades, A, Catena, F, Aarabi, B, Abu-Zidan, F, Alves, O, Ansaloni, L, Armonda, R, Badenes, R, Bala, M, Balogh, Z, Barbanera, A, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Castano-Leon, A, Cerasti, D, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Costa, F, De Iure, F, Depreitere, B, Fainardi, E, Fehlings, M, Gabrovsky, N, Godoy, D, Gruen, P, Gupta, D, Hawryluk, G, Helbok, R, Hossain, I, Hutchinson, P, Iaccarino, C, Inaba, K, Ivanov, M, Kaprovoy, S, Kirkpatrick, A, Klein, S, Kolias, A, Konovalov, N, Lagares, A, Lippa, L, Loza-Gomez, A, Luoto, T, Maas, A, Maciejczak, A, Maier, R, Marklund, N, Martin, M, Melloni, I, Mendoza-Lattes, S, Meyfroidt, G, Munari, M, Napolitano, L, Okonkwo, D, Otomo, Y, Papadopoulos, M, Petr, O, Peul, W, Pudkrong, A, Qasim, Z, Rasulo, F, Reizinho, C, Ringel, F, Rizoli, S, Rostami, E, Rubiano, A, Russo, E, Sarwal, A, Schwab, J, Servadei, F, Sharma, D, Sharif, S, Shiban, E, Shutter, L, Stahel, P, Taccone, F, Terpolilli, N, Thomé, C, Toth, P, Tsitsopoulos, P, Udy, A, Vaccaro, A, Varon, A, Vavilala, M, Younsi, A, Zackova, M, Zoerle, T, Robba, C, Picetti, Edoardo, Demetriades, Andreas K., Catena, Fausto, Aarabi, Bizhan, Abu-Zidan, Fikri M., Alves, Oscar L., Ansaloni, Luca, Armonda, Rocco A., Badenes, Rafael, Bala, Miklosh, Balogh, Zsolt J., Barbanera, Andrea, Bertuccio, Alessandro, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Castano-Leon, Ana Maria, Cerasti, Davide, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Costa, Francesco, De Iure, Federico, Depreitere, Bart, Fainardi, Enrico, Fehlings, Michael J., Gabrovsky, Nikolay, Godoy, Daniel Agustin, Gruen, Peter, Gupta, Deepak, Hawryluk, Gregory W. J., Helbok, Raimund, Hossain, Iftakher, Hutchinson, Peter J., Iaccarino, Corrado, Inaba, Kenji, Ivanov, Marcel, Kaprovoy, Stanislav, Kirkpatrick, Andrew W., Klein, Sam, Kolias, Angelos, Konovalov, Nikolay A., Lagares, Alfonso, Lippa, Laura, Loza-Gomez, Angelica, Luoto, Teemu M., Maas, Andrew I. R., Maciejczak, Andrzej, Maier, Ronald V., Marklund, Niklas, Martin, Matthew J., Melloni, Ilaria, Mendoza-Lattes, Sergio, Meyfroidt, Geert, Munari, Marina, Napolitano, Lena M., Okonkwo, David O., Otomo, Yasuhiro, Papadopoulos, Marios C., Petr, Ondra, Peul, Wilco C., Pudkrong, Aichholz K., Qasim, Zaffer, Rasulo, Frank, Reizinho, Carla, Ringel, Florian, Rizoli, Sandro, Rostami, Elham, Rubiano, Andres M., Russo, Emanuele, Sarwal, Aarti, Schwab, Jan M., Servadei, Franco, Sharma, Deepak, Sharif, Salman, Shiban, Ehab, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Terpolilli, Nicole A., Thomé, Claudius, Toth, Peter, Tsitsopoulos, Parmenion P., Udy, Andrew, Vaccaro, Alexander R., Varon, Albert J., Vavilala, Monica S., Younsi, Alexander, Zackova, Monika, Zoerle, Tommaso, and Robba, Chiara

Abstract

Background: The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies. Methods: A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established. The World Society of Emergency Surgery (WSES) and the European Association of Neurosurgical Societies (EANS) endorsed the consensus, and a modified Delphi approach was adopted. Results: A total of 17 statements were proposed and discussed. A consensus was reached generating 17 recommendations (16 strong and 1 weak). Conclusions: This consensus provides practical recommendations to support a clinician’s decision making in the management of tSCI polytrauma patients.

Published
2024

6. Effect of frailty on 6-month outcome after traumatic brain injury: a multicentre cohort study with external validation

Author

Galimberti, S, Graziano, F, Maas, A, Isernia, G, Lecky, F, Jain, S, Sun, X, Gardner, R, Taylor, S, Markowitz, A, Manley, G, Valsecchi, M, Bellelli, G, Citerio, G, Ackerlund, C, Adams, H, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castano-Leon, A, Cavallo, S, Chevallard, G, Chieregato, A, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, Maegele, M, Majdan, M, Manara, A, Marechal, H, Martino, C, Mattern, J, Mcfadyen, C, Mcmahon, C, Melegh, B, Menon, D, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyiradi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Singh, R, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Steyerberg, E, Stocchetti, N, Sundstrom, N, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Valeinis, E, Vallance, S, Vamos, Z, van der Jagt, M, van der Naalt, J, Van der Steen, G, van Dijck, J, van Erp, I, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, van Wijk, R, Vande Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Wolf, S, Yang, Z, Ylen, P, Younsi, A, Zeiler, F, Ziverte, A, Zoerle, T, Adeoye, O, Badjatia, N, Barber, J, Bergin, M, Boase, K, Bodien, Y, Chesnut, R, Corrigan, J, Crawford, K, Diaz-Arrastia, R, Dikmen, S, Duhaime, A, Ellenbogen, R, Feeser, V, Ferguson, A, Foreman, B, Gaudette, E, Giacino, J, Gonzalez, L, Gopinath, S, Grandhi, R, Gullapalli, R, Hemphill, C, Hotz, G, Huie, R, Jha, R, Keene, C, Kitagawa, R, Korley, F, Kramer, J, Kreitzer, N, Levin, H, Lindsell, C, Machamer, J, Madden, C, Martin, A, Mcallister, T, Mccrea, M, Merchant, R, Mukherjee, P, Nelson, L, Ngwenya, L, Noel, F, Nolan, A, Okonkwo, D, Palacios, E, Perl, D, Puccio, A, Rabinowitz, M, Robertson, C, Rodgers, R, Rosand, J, Rosenthal, E, Sander, A, Sandsmark, D, Sugar, G, Schneider, A, Schnyer, D, Seabury, S, Sherer, M, Stein, M, Temkin, N, Toga, A, Torres-Espin, A, Valadka, A, Vassar, M, Wang, V, Yue, J, Yuh, E, Zafonte, R, Galimberti S., Graziano F., Maas A. I. R., Isernia G., Lecky F., Jain S., Sun X., Gardner R. C., Taylor S. R., Markowitz A. J., Manley G. T., Valsecchi M. G., Bellelli G., Citerio G., Ackerlund C., Adams H., Amrein K., Andelic N., Andreassen L., Anke A., Antoni A., Audibert G., Azouvi P., Azzolini M. L., Bartels R., Barzo P., Beauvais R., Beer R., Bellander B. -M., Belli A., Benali H., Berardino M., Beretta L., Blaabjerg M., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Cabeleira M., Caccioppola A., Calappi E., Calvi M. R., Cameron P., Carbayo Lozano G., Carbonara M., Castano-Leon A. M., Cavallo S., Chevallard G., Chieregato A., Clusmann H., Coburn M. S., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Dark P., Dawes H., De Keyser V., Degos V., Della Corte F., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Foks K., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., George P., Ghuysen A., Giga L., Glocker B., Golubovic J., Gomez P. A., Gratz J., Gravesteijn B., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Helbok R., Helseth E., Horton L., Huijben J., Hutchinson P. J., Jacobs B., Jankowski S., Jarrett M., Jiang J. -Y., Johnson F., Jones K., Karan M., Kolias A. G., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kowark A., Lagares A., Lanyon L., Laureys S., Ledoux D., Lefering R., Legrand V., Lejeune A., Levi L., Lightfoot R., Lingsma H., Maegele M., Majdan M., Manara A., Marechal H., Martino C., Mattern J., McFadyen C., McMahon C., Melegh B., Menon D., Menovsky T., Mikolic A., Misset B., Muraleedharan V., Murray L., Negru A., Nelson D., Newcombe V., Nieboer D., Nyiradi J., Oresic M., Ortolano F., Otesile O., Palotie A., Parizel P. M., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Pirinen M., Pisica D., Ples H., Polinder S., Pomposo I., Posti J. P., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Retel Helmrich I., Rhodes J., Richardson S., Richter S., Ripatti S., Rocka S., Roe C., Roise O., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sahuquillo J., Sakowitz O., Sanchez-Porras R., Sandor J., Schafer N., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Sewalt C., Singh R. D., Skandsen T., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stevens R., Stewart W., Steyerberg E. W., Stocchetti N., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Taylor M. S., Te Ao B., Tenovuo O., Theadom A., Thomas M., Tibboel D., Timmers M., Tolias C., Trapani T., Tudora C. M., Unterberg A., Vajkoczy P., Valeinis E., Vallance S., Vamos Z., van der Jagt M., van der Naalt J., Van der Steen G., van Dijck J. T. J. M., van Erp I. A., van Essen T. A., Van Hecke W., van Heugten C., Van Praag D., van Veen E., van Wijk R., Vande Vyvere T., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Volovici V., von Steinbuchel N., Voormolen D., Vulekovic P., Wang K. K. W., Wiegers E., Williams G., Wilson L., Wolf S., Yang Z., Ylen P., Younsi A., Zeiler F. A., Ziverte A., Zoerle T., Adeoye O., Badjatia N., Barber J., Bergin M., Boase K., Bodien Y., Chesnut R., Corrigan J., Crawford K., Diaz-Arrastia R., Dikmen S., Duhaime A. -C., Ellenbogen R., Feeser V., Ferguson A. R., Foreman B., Gaudette E., Giacino J., Gonzalez L., Gopinath S., Grandhi R., Gullapalli R., Hemphill C., Hotz G., Huie R., Jha R., Keene C. D., Kitagawa R., Korley F., Kramer J., Kreitzer N., Levin H., Lindsell C., Machamer J., Madden C., Martin A., McAllister T., McCrea M., Merchant R., Mukherjee P., Nelson L., Ngwenya L. B., Noel F., Nolan A., Okonkwo D., Palacios E., Perl D., Puccio A., Rabinowitz M., Robertson C., Rodgers R. B., Rosand J., Rosenthal E., Sander A., Sandsmark D., Sugar G., Schneider A., Schnyer D., Seabury S., Sherer M., Stein M., Temkin N., Toga A., Torres-Espin A., Valadka A., Vassar M., Wang K., Wang V., Yue J. K., Yuh E., Zafonte R., Galimberti, S, Graziano, F, Maas, A, Isernia, G, Lecky, F, Jain, S, Sun, X, Gardner, R, Taylor, S, Markowitz, A, Manley, G, Valsecchi, M, Bellelli, G, Citerio, G, Ackerlund, C, Adams, H, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzo, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Castano-Leon, A, Cavallo, S, Chevallard, G, Chieregato, A, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, Maegele, M, Majdan, M, Manara, A, Marechal, H, Martino, C, Mattern, J, Mcfadyen, C, Mcmahon, C, Melegh, B, Menon, D, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyiradi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Retel Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Singh, R, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Steyerberg, E, Stocchetti, N, Sundstrom, N, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Te Ao, B, Tenovuo, O, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Unterberg, A, Vajkoczy, P, Valeinis, E, Vallance, S, Vamos, Z, van der Jagt, M, van der Naalt, J, Van der Steen, G, van Dijck, J, van Erp, I, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, van Veen, E, van Wijk, R, Vande Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Wolf, S, Yang, Z, Ylen, P, Younsi, A, Zeiler, F, Ziverte, A, Zoerle, T, Adeoye, O, Badjatia, N, Barber, J, Bergin, M, Boase, K, Bodien, Y, Chesnut, R, Corrigan, J, Crawford, K, Diaz-Arrastia, R, Dikmen, S, Duhaime, A, Ellenbogen, R, Feeser, V, Ferguson, A, Foreman, B, Gaudette, E, Giacino, J, Gonzalez, L, Gopinath, S, Grandhi, R, Gullapalli, R, Hemphill, C, Hotz, G, Huie, R, Jha, R, Keene, C, Kitagawa, R, Korley, F, Kramer, J, Kreitzer, N, Levin, H, Lindsell, C, Machamer, J, Madden, C, Martin, A, Mcallister, T, Mccrea, M, Merchant, R, Mukherjee, P, Nelson, L, Ngwenya, L, Noel, F, Nolan, A, Okonkwo, D, Palacios, E, Perl, D, Puccio, A, Rabinowitz, M, Robertson, C, Rodgers, R, Rosand, J, Rosenthal, E, Sander, A, Sandsmark, D, Sugar, G, Schneider, A, Schnyer, D, Seabury, S, Sherer, M, Stein, M, Temkin, N, Toga, A, Torres-Espin, A, Valadka, A, Vassar, M, Wang, V, Yue, J, Yuh, E, Zafonte, R, Galimberti S., Graziano F., Maas A. I. R., Isernia G., Lecky F., Jain S., Sun X., Gardner R. C., Taylor S. R., Markowitz A. J., Manley G. T., Valsecchi M. G., Bellelli G., Citerio G., Ackerlund C., Adams H., Amrein K., Andelic N., Andreassen L., Anke A., Antoni A., Audibert G., Azouvi P., Azzolini M. L., Bartels R., Barzo P., Beauvais R., Beer R., Bellander B. -M., Belli A., Benali H., Berardino M., Beretta L., Blaabjerg M., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Cabeleira M., Caccioppola A., Calappi E., Calvi M. R., Cameron P., Carbayo Lozano G., Carbonara M., Castano-Leon A. M., Cavallo S., Chevallard G., Chieregato A., Clusmann H., Coburn M. S., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Dark P., Dawes H., De Keyser V., Degos V., Della Corte F., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Foks K., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., George P., Ghuysen A., Giga L., Glocker B., Golubovic J., Gomez P. A., Gratz J., Gravesteijn B., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Helbok R., Helseth E., Horton L., Huijben J., Hutchinson P. J., Jacobs B., Jankowski S., Jarrett M., Jiang J. -Y., Johnson F., Jones K., Karan M., Kolias A. G., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kowark A., Lagares A., Lanyon L., Laureys S., Ledoux D., Lefering R., Legrand V., Lejeune A., Levi L., Lightfoot R., Lingsma H., Maegele M., Majdan M., Manara A., Marechal H., Martino C., Mattern J., McFadyen C., McMahon C., Melegh B., Menon D., Menovsky T., Mikolic A., Misset B., Muraleedharan V., Murray L., Negru A., Nelson D., Newcombe V., Nieboer D., Nyiradi J., Oresic M., Ortolano F., Otesile O., Palotie A., Parizel P. M., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Pirinen M., Pisica D., Ples H., Polinder S., Pomposo I., Posti J. P., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Retel Helmrich I., Rhodes J., Richardson S., Richter S., Ripatti S., Rocka S., Roe C., Roise O., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sahuquillo J., Sakowitz O., Sanchez-Porras R., Sandor J., Schafer N., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Sewalt C., Singh R. D., Skandsen T., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stevens R., Stewart W., Steyerberg E. W., Stocchetti N., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Taylor M. S., Te Ao B., Tenovuo O., Theadom A., Thomas M., Tibboel D., Timmers M., Tolias C., Trapani T., Tudora C. M., Unterberg A., Vajkoczy P., Valeinis E., Vallance S., Vamos Z., van der Jagt M., van der Naalt J., Van der Steen G., van Dijck J. T. J. M., van Erp I. A., van Essen T. A., Van Hecke W., van Heugten C., Van Praag D., van Veen E., van Wijk R., Vande Vyvere T., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Volovici V., von Steinbuchel N., Voormolen D., Vulekovic P., Wang K. K. W., Wiegers E., Williams G., Wilson L., Wolf S., Yang Z., Ylen P., Younsi A., Zeiler F. A., Ziverte A., Zoerle T., Adeoye O., Badjatia N., Barber J., Bergin M., Boase K., Bodien Y., Chesnut R., Corrigan J., Crawford K., Diaz-Arrastia R., Dikmen S., Duhaime A. -C., Ellenbogen R., Feeser V., Ferguson A. R., Foreman B., Gaudette E., Giacino J., Gonzalez L., Gopinath S., Grandhi R., Gullapalli R., Hemphill C., Hotz G., Huie R., Jha R., Keene C. D., Kitagawa R., Korley F., Kramer J., Kreitzer N., Levin H., Lindsell C., Machamer J., Madden C., Martin A., McAllister T., McCrea M., Merchant R., Mukherjee P., Nelson L., Ngwenya L. B., Noel F., Nolan A., Okonkwo D., Palacios E., Perl D., Puccio A., Rabinowitz M., Robertson C., Rodgers R. B., Rosand J., Rosenthal E., Sander A., Sandsmark D., Sugar G., Schneider A., Schnyer D., Seabury S., Sherer M., Stein M., Temkin N., Toga A., Torres-Espin A., Valadka A., Vassar M., Wang K., Wang V., Yue J. K., Yuh E., and Zafonte R.

Abstract

Background: Frailty is known to be associated with poorer outcomes in individuals admitted to hospital for medical conditions requiring intensive care. However, little evidence is available for the effect of frailty on patients’ outcomes after traumatic brain injury. Many frailty indices have been validated for clinical practice and show good performance to predict clinical outcomes. However, each is specific to a particular clinical context. We aimed to develop a frailty index to predict 6-month outcomes in patients after a traumatic brain injury. Methods: A cumulative deficit approach was used to create a novel frailty index based on 30 items dealing with disease states, current medications, and laboratory values derived from data available from CENTER-TBI, a prospective, longitudinal observational study of patients with traumatic brain injury presenting within 24 h of injury and admitted to a ward or an intensive care unit at 65 centres in Europe between Dec 19, 2014, and Dec 17, 2017. From the individual cumulative CENTER-TBI frailty index (range 0–30), we obtained a standardised value (range 0–1), with high scores indicating higher levels of frailty. The effect of frailty on 6-month outcome evaluated with the extended Glasgow Outcome Scale (GOSE) was assessed through a proportional odds logistic model adjusted for known outcome predictors. An unfavourable outcome was defined as death or severe disability (GOSE score ≤4). External validation was performed on data from TRACK-TBI, a prospective observational study co-designed with CENTER-TBI, which enrolled patients with traumatic brain injury at 18 level I trauma centres in the USA from Feb 26, 2014, to July 27, 2018. CENTER-TBI is registered with ClinicalTrials.gov, NCT02210221; TRACK-TBI is registered at ClinicalTrials.gov, NCT02119182. Findings: 2993 participants (median age was 51 years [IQR 30–67], 2058 [69%] were men) were included in this analysis. The overall median CENTER-TBI frailty index score was 0·07

Published
2022

7. Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations

Author

Chesnut, R, Aguilera, S, Buki, A, Bulger, E, Citerio, G, Cooper, D, Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hawryluk, G, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Videtta, W, Wright, D, Zammit, C, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Bulger, Eileen M, Citerio, Giuseppe, Cooper, D Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romergryko G, Ghajar, Jamshid, Harris, Odette, Hawryluk, Gregory W J, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K, Meyfroidt, Geert, Michael, Daniel B, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juain, Servadei, Franco, Shutter, Lori, Stein, Deborah M, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly D, Tsai, Eve C, Ullman, Jamie S, Videtta, Walter, Wright, David W, Zammit, Christopher, Chesnut, R, Aguilera, S, Buki, A, Bulger, E, Citerio, G, Cooper, D, Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hawryluk, G, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Videtta, W, Wright, D, Zammit, C, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Bulger, Eileen M, Citerio, Giuseppe, Cooper, D Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romergryko G, Ghajar, Jamshid, Harris, Odette, Hawryluk, Gregory W J, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K, Meyfroidt, Geert, Michael, Daniel B, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juain, Servadei, Franco, Shutter, Lori, Stein, Deborah M, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly D, Tsai, Eve C, Ullman, Jamie S, Videtta, Walter, Wright, David W, and Zammit, Christopher

Abstract

BACKGROUND: Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed. OBJECTIVE: To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion. METHODS: We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression. RESULTS: Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations. CONCLUSION: Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions.

Published
2023

8. Prognostication and Withdrawal of Care Decisions in Severe Traumatic Brain Injury: A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC) Working Group

Author

Sarigul, B, Bell, R, Chesnut, R, Aguilera, S, Buki, A, Citerio, G, Cooper, D, Diaz-Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Hawryluk, G, Sarigul, Buse, Bell, Randy S, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Citerio, Giuseppe, Cooper, D James, Diaz-Arrastia, Ramon R, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette A, Hoffer, Alan, Hutchinson, Peter John, Joseph, Matthew, Kitagawa, Ryan Seiji, Manley, Geoffrey T, Mayer, Stephan, Menon, David, Meyfroidt, Geert, Michael, Daniel, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia S, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul M, Videtta, Walter, Wright, David, Zammit, Christopher, Hawryluk, Gregory, Sarigul, B, Bell, R, Chesnut, R, Aguilera, S, Buki, A, Citerio, G, Cooper, D, Diaz-Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Hawryluk, G, Sarigul, Buse, Bell, Randy S, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Citerio, Giuseppe, Cooper, D James, Diaz-Arrastia, Ramon R, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette A, Hoffer, Alan, Hutchinson, Peter John, Joseph, Matthew, Kitagawa, Ryan Seiji, Manley, Geoffrey T, Mayer, Stephan, Menon, David, Meyfroidt, Geert, Michael, Daniel, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia S, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul M, Videtta, Walter, Wright, David, Zammit, Christopher, and Hawryluk, Gregory

Abstract

Best practice guidelines have advanced severe traumatic brain injury (TBI) care; however, there is little that currently informs goals of care decisions and processes despite their importance and frequency. Panelists from the Seattle International severe traumatic Brain Injury Consensus Conference (SIBICC) participated in a survey consisting of 24 questions. Questions queried use of prognostic calculators, variability in and responsibility for goals of care decisions, and acceptability of neurological outcomes, as well as putative means of improving decisions that might limit care. A total of 97.6% of the 42 SIBICC panelists completed the survey. Responses to most questions were highly variable. Overall, panelists reported infrequent use of prognostic calculators, and observed variability in patient prognostication and goals of care decisions. They felt that it would be beneficial for physicians to improve consensus on what constitutes an acceptable neurological outcome as well as what chance of achieving that outcome is acceptable. Panelists felt that the public should help to define what constitutes a good outcome and expressed some support for a “nihilism guard.” More than 50% of panelists felt that if it was certain to be permanent, a vegetative state or lower severe disability would justify a withdrawal of care decision, whereas 15% felt that upper severe disability justified such a decision. Whether conceptualizing an ideal or existing prognostic calculator to predict death or an unacceptable outcome, on average a 64-69% chance of a poor outcome was felt to justify treatment withdrawal. These results demonstrate important variability in goals of care decision making and a desire to reduce this variability. Our panel of recognized TBI experts opined on the neurological outcomes and chances of those outcomes that might prompt consideration of care withdrawal; however, imprecision of prognostication and existing prognostication tools is a significant impediment t

Published
2023

9. Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Author

Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawrylux, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A., Bala, Miklosh, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M., Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawrylux, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E., Sartelli, Massimo, Weber, Dieter, Robba, Chiara, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawrylux, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A., Bala, Miklosh, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M., Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawrylux, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E., Sartelli, Massimo, Weber, Dieter, and Robba, Chiara

Abstract

Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.

Published
2023

10. Correction: Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Author

Picetti, Edoardo, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawryluk, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A, Bala, Miklosh, Balogh, Zsolt J, Bertuccio, Alessandro, Biffl, Walt L, Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M, Hawryluk, Gregory W J, Helbok, Raimund, Hutchinson, Peter J A, Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W, Martin, Matthew J, Meyfroidt, Geert, Okonkwo, David O, Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G, Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F, Taccone, Fabio S, Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E, Sartelli, Massimo, Weber, Dieter, Robba, Chiara, Picetti, Edoardo, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawryluk, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A, Bala, Miklosh, Balogh, Zsolt J, Bertuccio, Alessandro, Biffl, Walt L, Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M, Hawryluk, Gregory W J, Helbok, Raimund, Hutchinson, Peter J A, Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W, Martin, Matthew J, Meyfroidt, Geert, Okonkwo, David O, Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G, Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F, Taccone, Fabio S, Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E, Sartelli, Massimo, Weber, Dieter, and Robba, Chiara

Published
2023

11. Outcomes of circumferential minimally-invasive technique vs open technique in adult spinal deformity surgery patients over 80 years of age: A propensity-matched analysis

Author

Tretiakov, P., primary, Passias, P., additional, Uribe, J., additional, Alan, N., additional, Le, V., additional, Dave, P., additional, Mir, J., additional, Lafage, R., additional, Wang, M., additional, Okonkwo, D., additional, Anand, N., additional, Fessler, R., additional, Fu, K.M., additional, Nunley, P., additional, Park, P., additional, Turner, J., additional, Kanter, A., additional, Mundis, G., additional, Chou, D., additional, Ames, C., additional, Hart, R., additional, Smith, J., additional, Shaffrey, C., additional, Schwab, F., additional, Bess, S., additional, Eastlack, R., additional, Mummaneni, P., additional, Burton, D., additional, and Group, I.S. Study, additional

Published
2023
Full Text
View/download PDF

12. Traumatic brain injury: progress and challenges in prevention, clinical care, and research

Author

Maas, A.I.R., Menon, D.K., Manley, G.T., Abrams, M., Akerlund, C., Andelic, N., Aries, M., Bashford, T., Bell, M.J., Bodien, Y.G., Brett, B.L., Buki, A., Chesnut, R.M., Citerio, G., Clark, D., Clasby, B., Cooper, D.J., Czeiter, E., Czosnyka, M., Dams-O'Connor, K., Keyser, V. de, Diaz-Arrastia, R., Ercole, A., Essen, T.A. van, Falvey, E., Ferguson, A.R., Figaji, A., Fitzgerald, M., Foreman, B., Gantner, D., Gao, G.Y., Giacino, J., Gravesteijn, B., Guiza, F., Gupta, D., Gurnell, M., Haagsma, J.A., Hammond, F.M., Hawryluk, G., Hutchinson, P., Jagt, M. van der, Jain, S., Jiang, J.Y., Kent, H., Kolias, A., Kompanje, E.J.O., Lecky, F., Lingsma, H.F., Maegele, M., Majdan, M., Markowitz, A., McCrea, M., Meyfroidt, G., Mikoli, A., Mondello, S., Mukherjee, P., Nelson, D., Nelson, L.D., Newcombe, V., Okonkwo, D., Oresic, M., Peul, W., Pisica, D., Polinder, S., Ponsford, J., Puybasset, L., Raj, R., Robba, C., Roe, C., Rosand, J., Schueler, P., Sharp, D.J., Smielewski, P., Stein, M.B., Steinbuchel, N. von, Stewart, W., Steyerberg, E.W., Stocchetti, N., Temkin, N., Tenovuo, O., Theadom, A., Thomas, I., Espin, A.T., Turgeon, A.F., Unterberg, A., Praag, D. van, Veen, E. van, Verheyden, J., Vande Vyvere, T., Wang, K.K.W., Wiegers, E.J.A., Williams, W.H., Wilson, L., Wisniewski, S.R., Younsi, A., Yue, J.K., Yuh, E.L., Zeiler, F.A., Zeldovich, M., Zemek, R., and TBIR Participants Investigators

Published
2022

13. Pathological Computed Tomography Features Associated with Adverse Outcomes after Mild Traumatic Brain Injury: A TRACK-TBI Study with External Validation in CENTER-TBI

Author

Yuh, E, Jain, S, Sun, X, Pisica, D, Harris, M, Taylor, S, Markowitz, A, Mukherjee, P, Verheyden, J, Giacino, J, Levin, H, Mccrea, M, Stein, M, Temkin, N, Diaz-Arrastia, R, Robertson, C, Lingsma, H, Okonkwo, D, Maas, A, Manley, G, Adeoye, O, Badjatia, N, Boase, K, Bodien, Y, Corrigan, J, Crawford, K, Dikmen, S, Duhaime, A, Ellenbogen, R, Feeser, V, Ferguson, A, Foreman, B, Gardner, R, Gaudette, E, Gonzalez, L, Gopinath, S, Gullapalli, R, Hemphill, J, Hotz, G, Keene, C, Kramer, J, Kreitzer, N, Lindsell, C, Machamer, J, Madden, C, Martin, A, Mcallister, T, Merchant, R, Nelson, L, Ngwenya, L, Noel, F, Nolan, A, Palacios, E, Perl, D, Rabinowitz, M, Rosand, J, Sander, A, Satris, G, Schnyer, D, Seabury, S, Toga, A, Valadka, A, Vassar, M, Zafonte, R, Citerio, G, Yuh E. L., Jain S., Sun X., Pisica D., Harris M. H., Taylor S. R., Markowitz A. J., Mukherjee P., Verheyden J., Giacino J. T., Levin H. S., McCrea M., Stein M. B., Temkin N. R., Diaz-Arrastia R., Robertson C. S., Lingsma H. F., Okonkwo D. O., Maas A. I. R., Manley G. T., Adeoye O., Badjatia N., Boase K., Bodien Y., Corrigan J. D., Crawford K., Dikmen S., Duhaime A. -C., Ellenbogen R., Feeser V. R., Ferguson A. R., Foreman B., Gardner R., Gaudette E., Gonzalez L., Gopinath S., Gullapalli R., Hemphill J. C., Hotz G., Keene C. D., Kramer J., Kreitzer N., Lindsell C., MacHamer J., Madden C., Martin A., McAllister T., Merchant R., Nelson L., Ngwenya L. B., Noel F., Nolan A., Palacios E., Perl D., Rabinowitz M., Rosand J., Sander A., Satris G., Schnyer D., Seabury S., Toga A., Valadka A., Vassar M., Zafonte R., Citerio G., Yuh, E, Jain, S, Sun, X, Pisica, D, Harris, M, Taylor, S, Markowitz, A, Mukherjee, P, Verheyden, J, Giacino, J, Levin, H, Mccrea, M, Stein, M, Temkin, N, Diaz-Arrastia, R, Robertson, C, Lingsma, H, Okonkwo, D, Maas, A, Manley, G, Adeoye, O, Badjatia, N, Boase, K, Bodien, Y, Corrigan, J, Crawford, K, Dikmen, S, Duhaime, A, Ellenbogen, R, Feeser, V, Ferguson, A, Foreman, B, Gardner, R, Gaudette, E, Gonzalez, L, Gopinath, S, Gullapalli, R, Hemphill, J, Hotz, G, Keene, C, Kramer, J, Kreitzer, N, Lindsell, C, Machamer, J, Madden, C, Martin, A, Mcallister, T, Merchant, R, Nelson, L, Ngwenya, L, Noel, F, Nolan, A, Palacios, E, Perl, D, Rabinowitz, M, Rosand, J, Sander, A, Satris, G, Schnyer, D, Seabury, S, Toga, A, Valadka, A, Vassar, M, Zafonte, R, Citerio, G, Yuh E. L., Jain S., Sun X., Pisica D., Harris M. H., Taylor S. R., Markowitz A. J., Mukherjee P., Verheyden J., Giacino J. T., Levin H. S., McCrea M., Stein M. B., Temkin N. R., Diaz-Arrastia R., Robertson C. S., Lingsma H. F., Okonkwo D. O., Maas A. I. R., Manley G. T., Adeoye O., Badjatia N., Boase K., Bodien Y., Corrigan J. D., Crawford K., Dikmen S., Duhaime A. -C., Ellenbogen R., Feeser V. R., Ferguson A. R., Foreman B., Gardner R., Gaudette E., Gonzalez L., Gopinath S., Gullapalli R., Hemphill J. C., Hotz G., Keene C. D., Kramer J., Kreitzer N., Lindsell C., MacHamer J., Madden C., Martin A., McAllister T., Merchant R., Nelson L., Ngwenya L. B., Noel F., Nolan A., Palacios E., Perl D., Rabinowitz M., Rosand J., Sander A., Satris G., Schnyer D., Seabury S., Toga A., Valadka A., Vassar M., Zafonte R., and Citerio G.

Abstract

Importance: A head computed tomography (CT) with positive results for acute intracranial hemorrhage is the gold-standard diagnostic biomarker for acute traumatic brain injury (TBI). In moderate to severe TBI (Glasgow Coma Scale [GCS] scores 3-12), some CT features have been shown to be associated with outcomes. In mild TBI (mTBI; GCS scores 13-15), distribution and co-occurrence of pathological CT features and their prognostic importance are not well understood. Objective: To identify pathological CT features associated with adverse outcomes after mTBI. Design, Setting, and Participants: The longitudinal, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study enrolled patients with TBI, including those 17 years and older with GCS scores of 13 to 15 who presented to emergency departments at 18 US level 1 trauma centers between February 26, 2014, and August 8, 2018, and underwent head CT imaging within 24 hours of TBI. Evaluations of CT imaging used TBI Common Data Elements. Glasgow Outcome Scale-Extended (GOSE) scores were assessed at 2 weeks and 3, 6, and 12 months postinjury. External validation of results was performed via the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Data analyses were completed from February 2020 to February 2021. Exposures: Acute nonpenetrating head trauma. Main Outcomes and Measures: Frequency, co-occurrence, and clustering of CT features; incomplete recovery (GOSE scores <8 vs 8); and an unfavorable outcome (GOSE scores <5 vs ≥5) at 2 weeks and 3, 6, and 12 months. Results: In 1935 patients with mTBI (mean [SD] age, 41.5 [17.6] years; 1286 men [66.5%]) in the TRACK-TBI cohort and 2594 patients with mTBI (mean [SD] age, 51.8 [20.3] years; 1658 men [63.9%]) in an external validation cohort, hierarchical cluster analysis identified 3 major clusters of CT features: contusion, subarachnoid hemorrhage, and/or subdural hematoma; intrav

Published
2021

14. A genome-wide association study of outcome from traumatic brain injury

Author

Kals, M., Kunzmann, K., Parodi, L., Radmanesh, F., Wilson, L., Izzy, S., Anderson, C. D., Puccio, A. M., Okonkwo, D. O., Temkin, N., Steyerberg, E. W., Stein, M. B., Manley, G. T., Maas, A. I. R., Richardson, S., Diaz-Arrastia, R., Palotie, A., Ripatti, S., Rosand, J., Menon, D. K., Kals, M., Kunzmann, K., Parodi, L., Radmanesh, F., Wilson, L., Izzy, S., Anderson, C. D., Puccio, A. M., Okonkwo, D. O., Temkin, N., Steyerberg, E. W., Stein, M. B., Manley, G. T., Maas, A. I. R., Richardson, S., Diaz-Arrastia, R., Palotie, A., Ripatti, S., Rosand, J., and Menon, D. K.

Abstract

Background: Factors such as age, pre-injury health, and injury severity, account for less than 35% of outcome variability in traumatic brain injury (TBI). While some residual outcome variability may be attributable to genetic factors, published candidate gene association studies have often been underpowered and subject to publication bias. Methods: We performed the first genome- and transcriptome-wide association studies (GWAS, TWAS) of genetic effects on outcome in TBI. The study population consisted of 5268 patients from prospective European and US studies, who attended hospital within 24 h of TBI, and satisfied local protocols for computed tomography. Findings: The estimated heritability of TBI outcome was 0·26. GWAS revealed no genetic variants with genome-wide significance (p < 5 × 10 −8), but identified 83 variants in 13 independent loci which met a lower pre-specified sub-genomic statistical threshold (p < 10 −5). Similarly, none of the genes tested in TWAS met tissue-wide significance. An exploratory analysis of 75 published candidate variants associated with 28 genes revealed one replicable variant (rs1800450 in the MBL2 gene) which retained significance after correction for multiple comparison (p = 5·24 × 10 −4). Interpretation: While multiple novel loci reached less stringent thresholds, none achieved genome-wide significance. The overall heritability estimate, however, is consistent with the hypothesis that common genetic variation substantially contributes to inter-individual variability in TBI outcome. The meta-analytic approach to the GWAS and the availability of summary data allows for a continuous extension with additional cohorts as data becomes available. Funding: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.

Published
2022

15. Traumatic brain injury: progress and challenges in prevention, clinical care, and research

Author

Maas, A, Menon, D, Manley, G, Abrams, M, Åkerlund, C, Andelic, N, Aries, M, Bashford, T, Bell, M, Bodien, Y, Brett, B, Büki, A, Chesnut, R, Citerio, G, Clark, D, Clasby, B, Cooper, D, Czeiter, E, Czosnyka, M, Dams-O'Connor, K, De Keyser, V, Diaz-Arrastia, R, Ercole, A, van Essen, T, Falvey, É, Ferguson, A, Figaji, A, Fitzgerald, M, Foreman, B, Gantner, D, Gao, G, Giacino, J, Gravesteijn, B, Guiza, F, Gupta, D, Gurnell, M, Haagsma, J, Hammond, F, Hawryluk, G, Hutchinson, P, van der Jagt, M, Jain, S, Jiang, J, Kent, H, Kolias, A, Kompanje, E, Lecky, F, Lingsma, H, Maegele, M, Majdan, M, Markowitz, A, Mccrea, M, Meyfroidt, G, Mikolić, A, Mondello, S, Mukherjee, P, Nelson, D, Nelson, L, Newcombe, V, Okonkwo, D, Orešič, M, Peul, W, Pisică, D, Polinder, S, Ponsford, J, Puybasset, L, Raj, R, Robba, C, Røe, C, Rosand, J, Schueler, P, Sharp, D, Smielewski, P, Stein, M, von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Temkin, N, Tenovuo, O, Theadom, A, Thomas, I, Espin, A, Turgeon, A, Unterberg, A, Van Praag, D, van Veen, E, Verheyden, J, Vyvere, T, Wang, K, Wiegers, E, Williams, W, Wilson, L, Wisniewski, S, Younsi, A, Yue, J, Yuh, E, Zeiler, F, Zeldovich, M, Zemek, R, Maas, Andrew I R, Menon, David K, Manley, Geoffrey T, Abrams, Mathew, Åkerlund, Cecilia, Andelic, Nada, Aries, Marcel, Bashford, Tom, Bell, Michael J, Bodien, Yelena G, Brett, Benjamin L, Büki, András, Chesnut, Randall M, Citerio, Giuseppe, Clark, David, Clasby, Betony, Cooper, D Jamie, Czeiter, Endre, Czosnyka, Marek, Dams-O'Connor, Kristen, De Keyser, Véronique, Diaz-Arrastia, Ramon, Ercole, Ari, van Essen, Thomas A, Falvey, Éanna, Ferguson, Adam R, Figaji, Anthony, Fitzgerald, Melinda, Foreman, Brandon, Gantner, Dashiell, Gao, Guoyi, Giacino, Joseph, Gravesteijn, Benjamin, Guiza, Fabian, Gupta, Deepak, Gurnell, Mark, Haagsma, Juanita A, Hammond, Flora M, Hawryluk, Gregory, Hutchinson, Peter, van der Jagt, Mathieu, Jain, Sonia, Jain, Swati, Jiang, Ji-yao, Kent, Hope, Kolias, Angelos, Kompanje, Erwin J O, Lecky, Fiona, Lingsma, Hester F, Maegele, Marc, Majdan, Marek, Markowitz, Amy, McCrea, Michael, Meyfroidt, Geert, Mikolić, Ana, Mondello, Stefania, Mukherjee, Pratik, Nelson, David, Nelson, Lindsay D, Newcombe, Virginia, Okonkwo, David, Orešič, Matej, Peul, Wilco, Pisică, Dana, Polinder, Suzanne, Ponsford, Jennie, Puybasset, Louis, Raj, Rahul, Robba, Chiara, Røe, Cecilie, Rosand, Jonathan, Schueler, Peter, Sharp, David J, Smielewski, Peter, Stein, Murray B, von Steinbüchel, Nicole, Stewart, William, Steyerberg, Ewout W, Stocchetti, Nino, Temkin, Nancy, Tenovuo, Olli, Theadom, Alice, Thomas, Ilias, Espin, Abel Torres, Turgeon, Alexis F, Unterberg, Andreas, Van Praag, Dominique, van Veen, Ernest, Verheyden, Jan, Vyvere, Thijs Vande, Wang, Kevin K W, Wiegers, Eveline J A, Williams, W Huw, Wilson, Lindsay, Wisniewski, Stephen R, Younsi, Alexander, Yue, John, Yuh, Esther L, Zeiler, Frederick A, Zeldovich, Marina, Zemek, Roger, Maas, A, Menon, D, Manley, G, Abrams, M, Åkerlund, C, Andelic, N, Aries, M, Bashford, T, Bell, M, Bodien, Y, Brett, B, Büki, A, Chesnut, R, Citerio, G, Clark, D, Clasby, B, Cooper, D, Czeiter, E, Czosnyka, M, Dams-O'Connor, K, De Keyser, V, Diaz-Arrastia, R, Ercole, A, van Essen, T, Falvey, É, Ferguson, A, Figaji, A, Fitzgerald, M, Foreman, B, Gantner, D, Gao, G, Giacino, J, Gravesteijn, B, Guiza, F, Gupta, D, Gurnell, M, Haagsma, J, Hammond, F, Hawryluk, G, Hutchinson, P, van der Jagt, M, Jain, S, Jiang, J, Kent, H, Kolias, A, Kompanje, E, Lecky, F, Lingsma, H, Maegele, M, Majdan, M, Markowitz, A, Mccrea, M, Meyfroidt, G, Mikolić, A, Mondello, S, Mukherjee, P, Nelson, D, Nelson, L, Newcombe, V, Okonkwo, D, Orešič, M, Peul, W, Pisică, D, Polinder, S, Ponsford, J, Puybasset, L, Raj, R, Robba, C, Røe, C, Rosand, J, Schueler, P, Sharp, D, Smielewski, P, Stein, M, von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Temkin, N, Tenovuo, O, Theadom, A, Thomas, I, Espin, A, Turgeon, A, Unterberg, A, Van Praag, D, van Veen, E, Verheyden, J, Vyvere, T, Wang, K, Wiegers, E, Williams, W, Wilson, L, Wisniewski, S, Younsi, A, Yue, J, Yuh, E, Zeiler, F, Zeldovich, M, Zemek, R, Maas, Andrew I R, Menon, David K, Manley, Geoffrey T, Abrams, Mathew, Åkerlund, Cecilia, Andelic, Nada, Aries, Marcel, Bashford, Tom, Bell, Michael J, Bodien, Yelena G, Brett, Benjamin L, Büki, András, Chesnut, Randall M, Citerio, Giuseppe, Clark, David, Clasby, Betony, Cooper, D Jamie, Czeiter, Endre, Czosnyka, Marek, Dams-O'Connor, Kristen, De Keyser, Véronique, Diaz-Arrastia, Ramon, Ercole, Ari, van Essen, Thomas A, Falvey, Éanna, Ferguson, Adam R, Figaji, Anthony, Fitzgerald, Melinda, Foreman, Brandon, Gantner, Dashiell, Gao, Guoyi, Giacino, Joseph, Gravesteijn, Benjamin, Guiza, Fabian, Gupta, Deepak, Gurnell, Mark, Haagsma, Juanita A, Hammond, Flora M, Hawryluk, Gregory, Hutchinson, Peter, van der Jagt, Mathieu, Jain, Sonia, Jain, Swati, Jiang, Ji-yao, Kent, Hope, Kolias, Angelos, Kompanje, Erwin J O, Lecky, Fiona, Lingsma, Hester F, Maegele, Marc, Majdan, Marek, Markowitz, Amy, McCrea, Michael, Meyfroidt, Geert, Mikolić, Ana, Mondello, Stefania, Mukherjee, Pratik, Nelson, David, Nelson, Lindsay D, Newcombe, Virginia, Okonkwo, David, Orešič, Matej, Peul, Wilco, Pisică, Dana, Polinder, Suzanne, Ponsford, Jennie, Puybasset, Louis, Raj, Rahul, Robba, Chiara, Røe, Cecilie, Rosand, Jonathan, Schueler, Peter, Sharp, David J, Smielewski, Peter, Stein, Murray B, von Steinbüchel, Nicole, Stewart, William, Steyerberg, Ewout W, Stocchetti, Nino, Temkin, Nancy, Tenovuo, Olli, Theadom, Alice, Thomas, Ilias, Espin, Abel Torres, Turgeon, Alexis F, Unterberg, Andreas, Van Praag, Dominique, van Veen, Ernest, Verheyden, Jan, Vyvere, Thijs Vande, Wang, Kevin K W, Wiegers, Eveline J A, Williams, W Huw, Wilson, Lindsay, Wisniewski, Stephen R, Younsi, Alexander, Yue, John, Yuh, Esther L, Zeiler, Frederick A, Zeldovich, Marina, and Zemek, Roger

Published
2022

16. A genome-wide association study of outcome from traumatic brain injury

Author

Kals, M, Kunzmann, K, Parodi, L, Radmanesh, F, Wilson, L, Izzy, S, Anderson, C, Puccio, A, Okonkwo, D, Temkin, N, Steyerberg, E, Stein, M, Manley, G, Citerio, G, Kals M, Kunzmann K, Parodi L, Radmanesh F, Wilson L, Izzy S, Anderson CD, Puccio AM, Okonkwo DO, Temkin N, Steyerberg EW, Stein MB, Manley GT, Citerio G, Kals, M, Kunzmann, K, Parodi, L, Radmanesh, F, Wilson, L, Izzy, S, Anderson, C, Puccio, A, Okonkwo, D, Temkin, N, Steyerberg, E, Stein, M, Manley, G, Citerio, G, Kals M, Kunzmann K, Parodi L, Radmanesh F, Wilson L, Izzy S, Anderson CD, Puccio AM, Okonkwo DO, Temkin N, Steyerberg EW, Stein MB, Manley GT, and Citerio G

Abstract

Background: Factors such as age, pre-injury health, and injury severity, account for less than 35% of outcome variability in traumatic brain injury (TBI). While some residual outcome variability may be attributable to genetic factors, published candidate gene association studies have often been underpowered and subject to publication bias. Methods: We performed the first genome- and transcriptome-wide association studies (GWAS, TWAS) of genetic effects on outcome in TBI. The study population consisted of 5268 patients from prospective European and US studies, who attended hospital within 24 h of TBI, and satisfied local protocols for computed tomography. Findings: The estimated heritability of TBI outcome was 0·26. GWAS revealed no genetic variants with genome-wide significance (p < 5 × 10−8), but identified 83 variants in 13 independent loci which met a lower pre-specified sub-genomic statistical threshold (p < 10−5). Similarly, none of the genes tested in TWAS met tissue-wide significance. An exploratory analysis of 75 published candidate variants associated with 28 genes revealed one replicable variant (rs1800450 in the MBL2 gene) which retained significance after correction for multiple comparison (p = 5·24 × 10−4). Interpretation: While multiple novel loci reached less stringent thresholds, none achieved genome-wide significance. The overall heritability estimate, however, is consistent with the hypothesis that common genetic variation substantially contributes to inter-individual variability in TBI outcome. The meta-analytic approach to the GWAS and the availability of summary data allows for a continuous extension with additional cohorts as data becomes available. Funding: A full list of funding bodies that contributed to this study can be found in the Acknowledgements section.

Published
2022

20. Clinical predictors of 3- and 6-month outcome for mild traumatic brain injury patients with a negative head CT scan in the emergency department: A TRACK-TBI pilot study

Author

Madhok, D.Y. (Debbie Y.), Yue, J.K. (John), Sun, X. (Xiaoying), Suen, C.G. (Catherine G.), Coss, N.A. (Nathan A.), Jain, S. (Sonia), Manley, G. (Geoffrey), Cooper, S.R. (Shelly), Dams-O’connor, K. (Kristen), Gordon, W.A. (Wayne), Hricik, A.J. (Allison), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Okonkwo, D. (David), Mukherjee, P. (Pratik), Morabito, D. (Diane), Puccio, A.M. (Ava), Schnyer, D.M. (David), Taylor, S.R. (Sabrina R.), Valadka, A.B. (Alex), Vassar, M.J. (Mary), Yuh, E.L. (Esther), Madhok, D.Y. (Debbie Y.), Yue, J.K. (John), Sun, X. (Xiaoying), Suen, C.G. (Catherine G.), Coss, N.A. (Nathan A.), Jain, S. (Sonia), Manley, G. (Geoffrey), Cooper, S.R. (Shelly), Dams-O’connor, K. (Kristen), Gordon, W.A. (Wayne), Hricik, A.J. (Allison), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Okonkwo, D. (David), Mukherjee, P. (Pratik), Morabito, D. (Diane), Puccio, A.M. (Ava), Schnyer, D.M. (David), Taylor, S.R. (Sabrina R.), Valadka, A.B. (Alex), Vassar, M.J. (Mary), and Yuh, E.L. (Esther)

Abstract

Aconsiderable subset of mild traumatic brain injury (mTBI) patients fail to return to baseline functional status at or beyond 3 months postinjury. Identifying at-risk patients for poor outcome in the emergency department (ED) may improve surveillance strategies and referral to care. Subjects with mTBI (Glasgow Coma Scale 13–15) and negative ED initial head CT < 24 h of injury, completing 3- or 6-month functional outcome (Glasgow Outcome Scale-Extended; GOSE), were extracted from the prospective, multicenter Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study. Outcomes were dichotomized to full recovery (GOSE = 8) vs functional deficits (GOSE < 8). Univariate predictors with p < 0.10 were considered for multivariable regression. Adjusted odds ratios (AOR) were reported for outcome predictors. Significance was assessed at p < 0.05. Subjects who completed GOSE at 3- and 6-month were 211 (GOSE < 8: 60%) and 185 (GOSE < 8: 65%). Risk factors for 6-month GOSE < 8 included less education (AOR = 0.85 per-year increase, 95% CI: (0.74–0.98)), prior psychiatric history (AOR = 3.75 (1.73–8.12)), Asian/minority race (American Indian/Alaskan/Hawaiian/Pacific Islander) (AOR = 23.99 (2.93–196.84)), and Hispanic ethnicity (AOR = 3.48 (1.29–9.37)). Risk factors for 3-month GOSE < 8 were similar with the addition of injury by assault predicting poorer outcome (AOR = 3.53 (1.17–10.63)). In mTBI patients seen in urban trauma center EDs with negative CT, education, injury by assault, Asian/minority race, and prior psychiatric history emerged as risk factors for prolonged disability.

Published
2020
Full Text
View/download PDF

21. A management algorithm for adult patients with both brain oxygen and intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC)

Author

Chesnut, R, Aguilera, S, Buki, A, Bulger, E, Citerio, G, Cooper, D, Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Hawryluk, G, Chesnut, Randall, Aguilera, Sergio, Buki, Andras, Bulger, Eileen, Citerio, Giuseppe, Cooper, D Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K, Meyfroidt, Geert, Michael, Daniel B, Oddo, Mauro, Okonkwo, David, Patel, Mayur, Robertson, Claudia, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul, Videtta, Walter, Wright, David W, Zammit, Christopher, Hawryluk, Gregory W J, Chesnut, R, Aguilera, S, Buki, A, Bulger, E, Citerio, G, Cooper, D, Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Hawryluk, G, Chesnut, Randall, Aguilera, Sergio, Buki, Andras, Bulger, Eileen, Citerio, Giuseppe, Cooper, D Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K, Meyfroidt, Geert, Michael, Daniel B, Oddo, Mauro, Okonkwo, David, Patel, Mayur, Robertson, Claudia, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul, Videtta, Walter, Wright, David W, Zammit, Christopher, and Hawryluk, Gregory W J

Abstract

Background: Current guidelines for the treatment of adult severe traumatic brain injury (sTBI) consist of high-quality evidence reports, but they are no longer accompanied by management protocols, as these require expert opinion to bridge the gap between published evidence and patient care. We aimed to establish a modern sTBI protocol for adult patients with both intracranial pressure (ICP) and brain oxygen monitors in place. Methods: Our consensus working group consisted of 42 experienced and actively practicing sTBI opinion leaders from six continents. Having previously established a protocol for the treatment of patients with ICP monitoring alone, we addressed patients who have a brain oxygen monitor in addition to an ICP monitor. The management protocols were developed through a Delphi-method-based consensus approach and were finalized at an in-person meeting. Results: We established three distinct treatment protocols, each with three tiers whereby higher tiers involve therapies with higher risk. One protocol addresses the management of ICP elevation when brain oxygenation is normal. A second addresses management of brain hypoxia with normal ICP. The third protocol addresses the situation when both intracranial hypertension and brain hypoxia are present. The panel considered issues pertaining to blood transfusion and ventilator management when designing the different algorithms. Conclusions: These protocols are intended to assist clinicians in the management of patients with both ICP and brain oxygen monitors but they do not reflect either a standard-of-care or a substitute for thoughtful individualized management. These protocols should be used in conjunction with recommendations for basic care, management of critical neuroworsening and weaning treatment recently published in conjunction with the Seattle International Brain Injury Consensus Conference.

Published
2020

24. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research

Author

Maas, A, Menon, D, Adelson, P, Andelic, N, Bell, M, Belli, A, Bragge, P, Brazinova, A, Büki, A, Chesnut, R, CITERIO, GIUSEPPE, Coburn, M, Cooper, D, Crowder, A, Czeiter, E, Czosnyka, M, Diaz arrastia, R, Dreier, J, Duhaime, A, Ercole, A, Van Essen, T, Feigin, V, Gao, G, Giacino, J, Gonzalez lara, L, Gruen, R, Gupta, D, Hartings, J, Hill, S, Jiang, J, Ketharanathan, N, Kompanje, E, Lanyon, L, Laureys, S, Lecky, F, Levin, H, Lingsma, H, Maegele, M, Majdan, M, Manley, G, Marsteller, J, Mascia, L, Mcfadyen, C, Mondello, S, Newcombe, V, Palotie, A, Parizel, P, Peul, W, Piercy, J, Polinder, S, Puybasset, L, Rasmussen, T, Rossaint, R, Smielewski, P, Söderberg, J, Stanworth, S, Stein, M, Von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Synnot, A, Te Ao, B, Tenovuo, O, Theadom, A, Tibboel, D, Videtta, W, Wang, K, Williams, W, Wilson, L, Yaffe, K, Adams, H, Agnoletti, V, Allanson, J, Amrein, K, Andaluz, N, Anke, A, Antoni, A, Van As, A, Audibert, G, Azaševac, A, Azouvi, P, Azzolini, M, Baciu, C, Badenes, R, Barlow, K, Bartels, R, Bauerfeind, U, Beauchamp, M, Beer, D, Beer, R, Belda, F, Bellander, B, Bellier, R, Benali, H, Benard, T, Beqiri, V, Beretta, L, Bernard, F, Bertolini, G, Bilotta, F, Blaabjerg, M, Den Boogert, H, Boutis, K, Bouzat, P, Brooks, B, Brorsson, C, Bullinger, M, Burns, E, Calappi, E, Cameron, P, Carise, E, Castaño león, A, Causin, F, Chevallard, G, Chieregato, A, Christie, B, Cnossen, M, Coles, J, Collett, J, Della Corte, F, Craig, W, Csato, G, Csomos, A, Curry, N, Dahyot fizelier, C, Dawes, H, Dematteo, C, Depreitere, B, Dewey, D, Van Dijck, J, Đilvesi, Đ, Dippel, D, Dizdarevic, K, Donoghue, E, Duek, O, Dulière, G, Dzeko, A, Eapen, G, Emery, C, English, S, Esser, P, Ezer, E, Fabricius, M, Feng, J, Fergusson, D, Figaji, A, Fleming, J, Foks, K, Francony, G, Freedman, S, Freo, U, Frisvold, S, Gagnon, I, Galanaud, D, Gantner, D, Giraud, B, Glocker, B, Golubovic, J, Gómez López, P, Gordon, W, Gradisek, P, Gravel, J, Griesdale, D, Grossi, F, Haagsma, J, Håberg, A, Haitsma, I, Van Hecke, W, Helbok, R, Helseth, E, Van Heugten, C, Hoedemaekers, C, Höfer, S, Horton, L, Hui, J, Huijben, J, Hutchinson, P, Jacobs, B, Van Der Jagt, M, Jankowski, S, Janssens, K, Jelaca, B, Jones, K, Kamnitsas, K, Kaps, R, Karan, M, Katila, A, Kaukonen, K, De Keyser, V, Kivisaari, R, Kolias, A, Kolumbán, B, Kolundžija, K, Kondziella, D, Koskinen, L, Kovács, N, Kramer, A, Kutsogiannis, D, Kyprianou, T, Lagares, A, Lamontagne, F, Latini, R, Lauzier, F, Lazar, I, Ledig, C, Lefering, R, Legrand, V, Levi, L, Lightfoot, R, Lozano, A, Macdonald, S, Major, S, Manara, A, Manhes, P, Maréchal, H, Martino, C, Masala, A, Masson, S, Mattern, J, Mcfadyen, B, Mcmahon, C, Meade, M, Melegh, B, Menovsky, T, Moore, L, Morgado Correia, M, Morganti kossmann, M, Muehlan, H, Mukherjee, P, Murray, L, Van Der Naalt, J, Negru, A, Nelson, D, Nieboer, D, Noirhomme, Q, Nyirádi, J, Oddo, M, Okonkwo, D, Oldenbeuving, A, Ortolano, F, Osmond, M, Payen, J, Perlbarg, V, Persona, P, Pichon, N, Piippo karjalainen, A, Pili floury, S, Pirinen, M, Ple, H, Poca, M, Posti, J, Van Praag, D, Ptito, A, Radoi, A, Ragauskas, A, Raj, R, Real, R, Reed, N, Rhodes, J, Robertson, C, Rocka, S, Røe, C, Røise, O, Roks, G, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossi, S, Rueckert, D, De Ruiter, G, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Salvato, G, Sánchez porras, R, Sándor, J, Sangha, G, Schäfer, N, Schmidt, S, Schneider, K, Schnyer, D, Schöhl, H, Schoonman, G, Schou, R, Sir, Ö, Skandsen, T, Smeets, D, Sorinola, A, Stamatakis, E, Stevanovic, A, Stevens, R, Sundström, N, Taccone, F, Takala, R, Tanskanen, P, Taylor, M, Telgmann, R, Temkin, N, Teodorani, G, Thomas, M, Tolias, C, Trapani, T, Turgeon, A, Vajkoczy, P, Valadka, A, Valeinis, E, Vallance, S, Vámos, Z, VARGIOLU, ALESSIA, Vega, E, Verheyden, J, Vik, A, Vilcinis, R, Vleggeert lankamp, C, Vogt, L, Volovici, V, Voormolen, D, Vulekovic, P, Vande Vyvere, T, Van Waesberghe, J, Wessels, L, Wildschut, E, Williams, G, Winkler, M, Wolf, S, Wood, G, Xirouchaki, N, Younsi, A, Zaaroor, M, Zelinkova, V, Zemek, R, Zumbo, F, Citerio, G, Vargiolu, A, Zumbo, F., Maas, Andrew I R, Menon, David K, Adelson, P David, Andelic, Nada, Bell, Michael J, Belli, Antonio, Bragge, Peter, Brazinova, Alexandra, Büki, Andrá, Chesnut, Randall M, Citerio, Giuseppe, Coburn, Mark, Cooper, D Jamie, Crowder, A Tamara, Czeiter, Endre, Czosnyka, Marek, Diaz-Arrastia, Ramon, Dreier, Jens P, Duhaime, Ann-Christine, Ercole, Ari, van Essen, Thomas A, Feigin, Valery L, Gao, Guoyi, Giacino, Joseph, Gonzalez-Lara, Laura E, Gruen, Russell L, Gupta, Deepak, Hartings, Jed A, Hill, Sean, Jiang, Ji-yao, Ketharanathan, Naomi, Kompanje, Erwin J O, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Levin, Harvey, Lingsma, Hester F, Maegele, Marc, Majdan, Marek, Manley, Geoffrey, Marsteller, Jill, Mascia, Luciana, Mcfadyen, Charle, Mondello, Stefania, Newcombe, Virginia, Palotie, Aarno, Parizel, Paul M, Peul, Wilco, Piercy, Jame, Polinder, Suzanne, Puybasset, Loui, Rasmussen, Todd E, Rossaint, Rolf, Smielewski, Peter, Söderberg, Jeannette, Stanworth, Simon J, Stein, Murray B, von Steinbüchel, Nicole, Stewart, William, Steyerberg, Ewout W, Stocchetti, Nino, Synnot, Anneliese, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Tibboel, Dick, Videtta, Walter, Wang, Kevin K W, Williams, W Huw, Wilson, Lindsay, Yaffe, Kristine, InTBIR Participants, Investigator, Beretta, Luigi, InTBIR Participants Investigators, Menon, David [0000-0002-3228-9692], Czosnyka, Marek [0000-0003-2446-8006], Ercole, Ari [0000-0001-8350-8093], Newcombe, Virginia [0000-0001-6044-9035], Smielewski, Peter [0000-0001-5096-3938], Apollo - University of Cambridge Repository, Maas A.I.R., Menon D.K., David Adelson P.D., Andelic N., Bell M.J., Belli A., Bragge P., Brazinova A., Buki A., Chesnut R.M., Citerio G., Coburn M., Jamie Cooper D., Tamara Crowder A., Czeiter E., Czosnyka M., Diaz-Arrastia R., Dreier J.P., Duhaime A.-C., Ercole A., van Essen T.A., Feigin V.L., Gao G., Giacino J., Gonzalez-Lara L.E., Gruen R.L., Gupta D., Hartings J.A., Hill S., Jiang J.-Y., Ketharanathan N., Kompanje E.J.O., Lanyon L., Laureys S., Lecky F., Levin H., Lingsma H.F., Maegele M., Majdan M., Manley G., Marsteller J., Mascia L., McFadyen C., Mondello S., Newcombe V., Palotie A., Parizel P.M., Peul W., Piercy J., Polinder S., Puybasset L., Rasmussen T.E., Rossaint R., Smielewski P., Soderberg J., Stanworth S.J., Stein M.B., von Steinbuchel N., Stewart W., Steyerberg E.W., Stocchetti N., Synnot A., Te Ao B., Tenovuo O., Theadom A., Tibboel D., Videtta W., Wang K.K.W., Huw Williams W., Wilson L., Yaffe K., Adams H., Allanson J., Coles J., Hutchinson P.J., Kolias A.G., Sahakian B.J., Stamatakis E., Williams G., Agnoletti V., Martino C., Masala A., Teodorani G., Zumbo F., Amrein K., Ezer E., Kolumban B., Kovacs N., Melegh B., Nyiradi J., Sorinola A., Vamos Z., Andaluz N., Anke A., Frisvold S.K., Antoni A., van As A.B., Figaji A., Audibert G., Azasevac A., Dilvesi D., Golubovic J., Jelaca B., Karan M., Kolundzija K., Negru A., Vulekovic P., Azouvi P., Azzolini M.L., Beretta L., Baciu C., Beqiri V., Chevallard G., Chieregato A., Sacchi M., Badenes R., Belda F.J., Bilotta F., Lozano A., Barlow K.M., Schneider K.J., Bartels R., den Boogert H., Hoedemaekers C., Sir O., Bauerfeind U., Lefering R., Schafer N., Beauchamp M., Gravel J., Beer D., Beer R., Helbok R., Hofer S., Bellander B.-M., Nelson D., Bellier R., Benard T., Carise E., Dahyot-Fizelier C., Giraud B., Benali H., Bernard F., Bertolini G., Masson S., Blaabjerg M., Rosenlund C., Schou R.F., Boutis K., Bouzat P., Francony G., Manhes P., Payen J.-F., Brooks B., Dewey D., Emery C.A., Freedman S., Kramer A., Brorsson C., Koskinen L.-O., Sundstrom N., Bullinger M., Burns E., Calappi E., Ortolano F., Cameron P., Castano-Leon A.M., Gomez Lopez P.A., Lagares A., Causin F., Freo U., Persona P., Rossi S., Christie B., Cnossen M., Dippel D., Foks K., Haagsma J.A., Haitsma I., Huijben J.A., van der Jagt M., Nieboer D., Volovici V., Voormolen D.C., Collett J., Dawes H., Esser P., van Heugten C., Della Corte F., Grossi F., Craig W., Csato G., Csomos A., Curry N., Dematteo C., Meade M., Depreitere B., van Dijck J., de Ruiter G.C.W., Vleggeert-Lankamp C., Dizdarevic K., Donoghue E., Gantner D., Murray L., Trapani T., Vallance S., Duek O., Lazar I., Duliere G.-L., Marechal H., Dzeko A., Eapen G., Jankowski S., English S., Fergusson D., Osmond M., Fabricius M., Kondziella D., Feng J., Hui J., Fleming J., Latini R., Gagnon I., Ptito A., Galanaud D., Glocker B., Kamnitsas K., Ledig C., Rueckert D., Gordon W.A., Gradisek P., Griesdale D., Haberg A.K., van Hecke W., Smeets D., Verheyden J., Vyvere T.V., Helseth E., Roe C., Roise O., Horton L., Jacobs B., van der Naalt J., Janssens K., De Keyser V., Menovsky T., Van Praag D., Jones K.M., Kaps R., Katila A., Posti J., Takala R., Kaukonen K.-M., Kivisaari R., Piippo-Karjalainen A., Raj R., Tanskanen P., Kutsogiannis D., Kyprianou T., Lamontagne F., Lauzier F., Moore L., Turgeon A., Legrand V., Levi L., Zaaroor M., Lightfoot R., Macdonald S., Major S., Vajkoczy P., Wessels L., Winkler M.K.L., Wolf S., Manara A., Thomas M., Mattern J., Sakowitz O., Vogt L., Younsi A., McFadyen B., McMahon C., Correia M.M., Morganti-Kossmann M.C., Rosenfeld J.V., Muehlan H., Schmidt S., Mukherjee P., Noirhomme Q., Oddo M., Okonkwo D.O., Oldenbeuving A.W., Roks G., Schoonman G.G., Perlbarg V., Pichon N., Pili-Floury S., Pirinen M., Ples H., Poca M.A., Radoi A., Sahuquillo J., Ragauskas A., Rocka S., Real R.G.L., Telgmann R., Reed N., Rhodes J., Robertson C., Rosand J., Rosenthal G., Salvato G., Sanchez-Porras R., Sandor J., Sangha G., Schnyer D., Schohl H., Skandsen T., Stevanovic A., van Waesberghe J.V., Stevens R.D., Taccone F.S., Taylor M.S., Zelinkova V., Temkin N., Tolias C.M., Valadka A.B., Valeinis E., Vargiolu A., Vega E., Vik A., Vilcinis R., Wildschut E., Wood G., Xirouchaki N., Zemek R., Maas, A, Menon, D, Adelson, P, Andelic, N, Bell, M, Belli, A, Bragge, P, Brazinova, A, Büki, A, Chesnut, R, Citerio, G, Coburn, M, Cooper, D, Crowder, A, Czeiter, E, Czosnyka, M, Diaz arrastia, R, Dreier, J, Duhaime, A, Ercole, A, Van Essen, T, Feigin, V, Gao, G, Giacino, J, Gonzalez lara, L, Gruen, R, Gupta, D, Hartings, J, Hill, S, Jiang, J, Ketharanathan, N, Kompanje, E, Lanyon, L, Laureys, S, Lecky, F, Levin, H, Lingsma, H, Maegele, M, Majdan, M, Manley, G, Marsteller, J, Mascia, L, Mcfadyen, C, Mondello, S, Newcombe, V, Palotie, A, Parizel, P, Peul, W, Piercy, J, Polinder, S, Puybasset, L, Rasmussen, T, Rossaint, R, Smielewski, P, Söderberg, J, Stanworth, S, Stein, M, Von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Synnot, A, Te Ao, B, Tenovuo, O, Theadom, A, Tibboel, D, Videtta, W, Wang, K, Williams, W, Wilson, L, Yaffe, K, Adams, H, Agnoletti, V, Allanson, J, Amrein, K, Andaluz, N, Anke, A, Antoni, A, Van As, A, Audibert, G, Azaševac, A, Azouvi, P, Azzolini, M, Baciu, C, Badenes, R, Barlow, K, Bartels, R, Bauerfeind, U, Beauchamp, M, Beer, D, Beer, R, Belda, F, Bellander, B, Bellier, R, Benali, H, Benard, T, Beqiri, V, Beretta, L, Bernard, F, Bertolini, G, Bilotta, F, Blaabjerg, M, Den Boogert, H, Boutis, K, Bouzat, P, Brooks, B, Brorsson, C, Bullinger, M, Burns, E, Calappi, E, Cameron, P, Carise, E, Castaño león, A, Causin, F, Chevallard, G, Chieregato, A, Christie, B, Cnossen, M, Coles, J, Collett, J, Della Corte, F, Craig, W, Csato, G, Csomos, A, Curry, N, Dahyot fizelier, C, Dawes, H, Dematteo, C, Depreitere, B, Dewey, D, Van Dijck, J, Đilvesi, Đ, Dippel, D, Dizdarevic, K, Donoghue, E, Duek, O, Dulière, G, Dzeko, A, Eapen, G, Emery, C, English, S, Esser, P, Ezer, E, Fabricius, M, Feng, J, Fergusson, D, Figaji, A, Fleming, J, Foks, K, Francony, G, Freedman, S, Freo, U, Frisvold, S, Gagnon, I, Galanaud, D, Gantner, D, Giraud, B, Glocker, B, Golubovic, J, Gómez López, P, Gordon, W, Gradisek, P, Gravel, J, Griesdale, D, Grossi, F, Haagsma, J, Håberg, A, Haitsma, I, Van Hecke, W, Helbok, R, Helseth, E, Van Heugten, C, Hoedemaekers, C, Höfer, S, Horton, L, Hui, J, Huijben, J, Hutchinson, P, Jacobs, B, Van Der Jagt, M, Jankowski, S, Janssens, K, Jelaca, B, Jones, K, Kamnitsas, K, Kaps, R, Karan, M, Katila, A, Kaukonen, K, De Keyser, V, Kivisaari, R, Kolias, A, Kolumbán, B, Kolundžija, K, Kondziella, D, Koskinen, L, Kovács, N, Kramer, A, Kutsogiannis, D, Kyprianou, T, Lagares, A, Lamontagne, F, Latini, R, Lauzier, F, Lazar, I, Ledig, C, Lefering, R, Legrand, V, Levi, L, Lightfoot, R, Lozano, A, Macdonald, S, Major, S, Manara, A, Manhes, P, Maréchal, H, Martino, C, Masala, A, Masson, S, Mattern, J, Mcfadyen, B, Mcmahon, C, Meade, M, Melegh, B, Menovsky, T, Moore, L, Morgado Correia, M, Morganti kossmann, M, Muehlan, H, Mukherjee, P, Murray, L, Van Der Naalt, J, Negru, A, Nelson, D, Nieboer, D, Noirhomme, Q, Nyirádi, J, Oddo, M, Okonkwo, D, Oldenbeuving, A, Ortolano, F, Osmond, M, Payen, J, Perlbarg, V, Persona, P, Pichon, N, Piippo karjalainen, A, Pili floury, S, Pirinen, M, Ple, H, Poca, M, Posti, J, Van Praag, D, Ptito, A, Radoi, A, Ragauskas, A, Raj, R, Real, R, Reed, N, Rhodes, J, Robertson, C, Rocka, S, Røe, C, Røise, O, Roks, G, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossi, S, Rueckert, D, De Ruiter, G, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Salvato, G, Sánchez porras, R, Sándor, J, Sangha, G, Schäfer, N, Schmidt, S, Schneider, K, Schnyer, D, Schöhl, H, Schoonman, G, Schou, R, Sir, Ö, Skandsen, T, Smeets, D, Sorinola, A, Stamatakis, E, Stevanovic, A, Stevens, R, Sundström, N, Taccone, F, Takala, R, Tanskanen, P, Taylor, M, Telgmann, R, Temkin, N, Teodorani, G, Thomas, M, Tolias, C, Trapani, T, Turgeon, A, Vajkoczy, P, Valadka, A, Valeinis, E, Vallance, S, Vámos, Z, Vargiolu, A, Vega, E, Verheyden, J, Vik, A, Vilcinis, R, Vleggeert lankamp, C, Vogt, L, Volovici, V, Voormolen, D, Vulekovic, P, Vande Vyvere, T, Van Waesberghe, J, Wessels, L, Wildschut, E, Williams, G, Winkler, M, Wolf, S, Wood, G, Xirouchaki, N, Younsi, A, Zaaroor, M, Zelinkova, V, Zemek, R, Zumbo, F, Pediatric Surgery, Intensive Care, and Public Health

Subjects
medicine.medical_specialty, EVIDENCE-BASED MEDICINE, Treatment outcome, Poison control, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], EMERGENCY-DEPARTMENT VISITS, Review, PLACEBO-CONTROLLED TRIAL, Middle income country, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, 0302 clinical medicine, Intensive care, Brain Injuries, Traumatic, Journal Article, medicine, traumatic barin injury, Humans, 030212 general & internal medicine, Clinical care, Neurologic disease, Psychiatry, DIAGNOSTIC MANAGEMENT STRATEGIES, business.industry, RANDOMIZED CONTROLLED-TRIAL, ACUTE SUBDURAL-HEMATOMA, SEVERE HEAD-INJURY, ROAD TRAFFIC INJURIES, brain injury, Hospital care, 3. Good health, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Brain Injuries, Health care cost, PATIENT-REPORTED OUTCOMES, Human medicine, Neurology (clinical), business, Humanities, 030217 neurology & neurosurgery, GLASGOW COMA SCALE
Abstract

Executive summary A concerted effort to tackle the global health problem posed by traumatic brain injury (TBI) is long overdue. TBI is a public health challenge of vast, but insufficiently recognised, proportions. Worldwide, more than 50 million people have a TBI each year, and it is estimated that about half the world’s population will have one or more TBIs over their lifetime. TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages in all countries, with a disproportionate burden of disability and death occurring in low-income and middle-income countries (LMICs). It has been estimated that TBI costs the global economy approximately $US400 billion annually. Deficiencies in prevention, care, and research urgently need to be addressed to reduce the huge burden and societal costs of TBI. This Commission highlights priorities and provides expert recommendations for all stakeholders— policy makers, funders, health-care professionals, researchers, and patient representatives—on clinical and research strategies to reduce this growing public health problem and improve the lives of people with TBI. The epidemiology of TBI is changing: in high-income countries, the number of elderly people with TBI is increasing, mainly due to falls, while in LMICs, the burden of TBI from road traffic incidents is increasing. Data on the frequency of TBI and TBI-related deaths and on the economic impact of brain trauma are often incomplete and vary between countries. Improved, accurate epidemiological monitoring and robust healtheconomic data collection are needed to inform healthcare policy and prevention programmes. Highly developed and coordinated systems of care are crucial for management of patients with TBI. However, in practice, implementation of such frameworks varies greatly and disconnects exist in the chain of care. Optimisation of systems of care should be high on the policy agenda and could yield substantial gains in terms of both patient outcomes and costs to society. TBI is a complex condition, and strong evidence to support treatment guidelines and recommendations is scarce. Most multicentre clinical trials of medical and surgical interventions have failed to show efficacy, despite promising preclinical results. At the bedside, treatment strategies are generally based on guidelines that promote a one-size-fits-all approach and are insufficiently targeted to the needs of individual patients. Attempts to individualise treatment are challenging owing to the diversity of TBI, and are hampered by the use of simplistic methods to characterise its initial type and severity. Advances in genomics, blood biomarkers, magnetic resonance imaging (MRI), and pathophysiological monitoring, combined with informatics to integrate data from multiple sources, offer new research avenues to improve disease characterisation and monitoring of disease evolution. These tools can also aid understanding of disease mechanisms and facilitate targeted treatment strategies for individual patients. Individualised management in the postacute phase and evaluation of the effectiveness of treatment and care processes depend on accurate quantification of outcomes. In practice, however, the use of simplistic methods hinders efforts to quantify outcomes after TBI of all severities. Development and validation of multidimensional approaches will be essential to improve measurement of clinical outcomes, for both research and patient care. In particular, we need to find better ways to characterise the currently under-recognised risk of long-term disabling sequelae in patients with relatively mild injuries. Prognostic models are important to help clinicians to provide reliable information to patients and relatives, and to facilitate comparative audit of care between centres and countries. There is an urgent need for further development, validation, and implementation of prognostic models in TBI, particularly for less severe TBI. This multitude of challenges in TBI—encompassing systems of care, clinical management, and research strategy—demands novel approaches to the generation of new evidence and its implementation in clinical practice. Comparative effectiveness research (CER) offers opportunities to capitalise on the diversity of TBI and systems of care and enables assessment of therapies in real-world conditions; high-quality CER studies can provide strong evidence to support guideline recommendations. The global challenges posed by TBI necessitate global collaborations and a change in research culture to endorse broad data sharing. This Commission covers a range of topics that need to be addressed to confront the global burden of TBI and reduce its effects on individuals and society: epidemiology (section 1); health economics (section 2); prevention (section 3); systems of care (section 4); clinical management (section 5); characterisation of TBI (section 6); outcome assessment (section 7); prognosis (section 8); and new directions for acquiring and implementing evidence (section 9). Table 1 summarises key messages from the Commission and provides recommendations to advance clinical care and research in TBI. We must increase awareness of the scale of the challenge posed by TBI. If we are to tackle the individual and societal burden of TBI, these efforts need to go beyond a clinical and research audience and address the public, politicians, and other stakeholders. We need to develop and implement policies for better prevention and systems of care in order to improve outcomes for individuals with TBI. We also need a commitment to substantial long-term investment in TBI research across a range of disciplines to determine best practice and facilitate individualised management strategies. A combination of innovative research methods and global collaboration, and ways to effectively translate progress in basic and clinical research into clinical practice and public health policy, will be vital for progress in the field.

Published
2017

25. Pre-injury Comorbidities Are Associated With Functional Impairment and Post-concussive Symptoms at 3-and 6-Months After Mild Traumatic Brain Injury: A TRACK-TBI Study

Author

Yue, J.K. (John), Cnossen, M.C. (Maryse), Winkler, EA, Deng, H.S., Phelps, R.R.L., Coss, N.A., Sharma, S. (Sapna), Robinson, C.K., Suen, C.G., Vassar, M.J. (Mary), Schnyer, D.M. (David), Puccio, A.M. (Ava), Gardner, RC, Yuh, E.L. (Esther), Mukherjee, P. (Pratik), Valadka, AB, Okonkwo, D. (David), Lingsma, H.F. (Hester), Manley, G. (Geoffrey), Cooper, S.R. (Shelly), Dams-O'connor, K. (Kristen), Gordon, W.A. (Wayne), Hricik, A.J. (Allison), Maas, A. (Arne), Menon, D.K. (David ), Morabito, DJ, Yue, J.K. (John), Cnossen, M.C. (Maryse), Winkler, EA, Deng, H.S., Phelps, R.R.L., Coss, N.A., Sharma, S. (Sapna), Robinson, C.K., Suen, C.G., Vassar, M.J. (Mary), Schnyer, D.M. (David), Puccio, A.M. (Ava), Gardner, RC, Yuh, E.L. (Esther), Mukherjee, P. (Pratik), Valadka, AB, Okonkwo, D. (David), Lingsma, H.F. (Hester), Manley, G. (Geoffrey), Cooper, S.R. (Shelly), Dams-O'connor, K. (Kristen), Gordon, W.A. (Wayne), Hricik, A.J. (Allison), Maas, A. (Arne), Menon, D.K. (David ), and Morabito, DJ

Abstract

Introduction: Over 70% of traumatic brain injuries (TBI) are classified as mild (mTBI), which present heterogeneously. Associations between pre-injury comorbidities and outcomes are not well-understood, and understanding their status as risk factors may improve mTBI management and prognostication. Methods: mTBI subjects (GCS 13–15) from TRACK-TBI Pilot completing 3- and 6-month functional [Glasgow Outcome Scale-Extended (GOSE)] and post-concussive outcomes [Acute Concussion Evaluation (ACE) physical/cognitive/sleep/emotional subdomains] were extracted. Pre-injury comorbidities >10% incidence were included in regressions for functional disability (GOSE ≤ 6) and post-concussive symptoms by subdomain. Odds ratios (OR) and mean differences (B) were reported. Significance was assessed at p < 0.0083 (Bonferroni correction). Results: In 260 subjects sustaining blunt mTBI, mean age was 44.0-years and 70.4% were male. Baseline comorbidities >10% incidence included psychiatric-30.0%, cardiac (hypertension)-23.8%, cardiac (structural/valvular/ischemic)-20.4%, gastrointestinal15.8%, pulmonary-15.0%, and headache/migraine-11.5%. At 3- and 6-months separately, 30.8% had GOSE ≤ 6. At 3-months, psychiatric (GOSE ≤ 6: OR = 2.75, 95% CI [1.44–5.27]; ACE-physical: B = 1.06 [0.38–1.73]; ACE-cognitive: B = 0.72 [0.26–1.17]; ACE-sleep: B = 0.46 [0.17–0.75]; ACE-emotional: B = 0.64 [0.25–1.03]), headache/migraine (GOSE ≤ 6: OR = 4.10 [1.67–10.07]; ACE-sleep: B = 0.57 [0.15–1.00]; ACE-emotional: B = 0.92 [0.35–1.49]), and gastrointestinal history (ACE-physical: B = 1.25 [0.41–2.10]) were multivariable predictors of worse outcomes. At 6-mon

Published
2019
Full Text
View/download PDF

26. WSES consensus conference guidelines: monitoring and management of severe adult traumatic brain injury patients with polytrauma in the first 24 hours

Author

Picetti, E, Rossi, S, Abu-Zidan, F, Ansaloni, L, Armonda, R, Baiocchi, G, Bala, M, Balogh, Z, Berardino, M, Biffl, W, Bouzat, P, Buki, A, Ceresoli, M, Chesnut, R, Chiara, O, Citerio, G, Coccolini, F, Coimbra, R, Di Saverio, S, Fraga, G, Gupta, D, Helbok, R, Hutchinson, P, Kirkpatrick, A, Kinoshita, T, Kluger, Y, Leppaniemi, A, Maas, A, Maier, R, Minardi, F, Moore, E, Myburgh, J, Okonkwo, D, Otomo, Y, Rizoli, S, Rubiano, A, Sahuquillo, J, Sartelli, M, Scalea, T, Servadei, F, Stahel, P, Stocchetti, N, Taccone, F, Tonetti, T, Velmahos, G, Weber, D, Catena, F, Picetti, Edoardo, Rossi, Sandra, Abu-Zidan, Fikri M., Ansaloni, Luca, Armonda, Rocco, Baiocchi, Gian Luca, Bala, Miklosh, Balogh, Zsolt J., Berardino, Maurizio, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Ceresoli, Marco, Chesnut, Randall M., Chiara, Osvaldo, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Fraga, Gustavo P., Gupta, Deepak, Helbok, Raimund, Hutchinson, Peter J., Kirkpatrick, Andrew W., Kinoshita, Takahiro, Kluger, Yoram, Leppaniemi, Ari, Maas, Andrew I. R., Maier, Ronald V., Minardi, Francesco, Moore, Ernest E., Myburgh, John A., Okonkwo, David O., Otomo, Yasuhiro, Rizoli, Sandro, Rubiano, Andres M., Sahuquillo, Juan, Sartelli, Massimo, Scalea, Thomas M., Servadei, Franco, Stahel, Philip F., Stocchetti, Nino, Taccone, Fabio S., Tonetti, Tommaso, Velmahos, George, Weber, Dieter, Catena, Fausto, Picetti, E, Rossi, S, Abu-Zidan, F, Ansaloni, L, Armonda, R, Baiocchi, G, Bala, M, Balogh, Z, Berardino, M, Biffl, W, Bouzat, P, Buki, A, Ceresoli, M, Chesnut, R, Chiara, O, Citerio, G, Coccolini, F, Coimbra, R, Di Saverio, S, Fraga, G, Gupta, D, Helbok, R, Hutchinson, P, Kirkpatrick, A, Kinoshita, T, Kluger, Y, Leppaniemi, A, Maas, A, Maier, R, Minardi, F, Moore, E, Myburgh, J, Okonkwo, D, Otomo, Y, Rizoli, S, Rubiano, A, Sahuquillo, J, Sartelli, M, Scalea, T, Servadei, F, Stahel, P, Stocchetti, N, Taccone, F, Tonetti, T, Velmahos, G, Weber, D, Catena, F, Picetti, Edoardo, Rossi, Sandra, Abu-Zidan, Fikri M., Ansaloni, Luca, Armonda, Rocco, Baiocchi, Gian Luca, Bala, Miklosh, Balogh, Zsolt J., Berardino, Maurizio, Biffl, Walter L., Bouzat, Pierre, Buki, Andras, Ceresoli, Marco, Chesnut, Randall M., Chiara, Osvaldo, Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Di Saverio, Salomone, Fraga, Gustavo P., Gupta, Deepak, Helbok, Raimund, Hutchinson, Peter J., Kirkpatrick, Andrew W., Kinoshita, Takahiro, Kluger, Yoram, Leppaniemi, Ari, Maas, Andrew I. R., Maier, Ronald V., Minardi, Francesco, Moore, Ernest E., Myburgh, John A., Okonkwo, David O., Otomo, Yasuhiro, Rizoli, Sandro, Rubiano, Andres M., Sahuquillo, Juan, Sartelli, Massimo, Scalea, Thomas M., Servadei, Franco, Stahel, Philip F., Stocchetti, Nino, Taccone, Fabio S., Tonetti, Tommaso, Velmahos, George, Weber, Dieter, and Catena, Fausto

Abstract

The acute phase management of patients with severe traumatic brain injury (TBI) and polytrauma represents a major challenge. Guidelines for the care of these complex patients are lacking, and worldwide variability in clinical practice has been documented in recent studies. Consequently, the World Society of Emergency Surgery (WSES) decided to organize an international consensus conference regarding the monitoring and management of severe adult TBI polytrauma patients during the first 24 hours after injury. A modified Delphi approach was adopted, with an agreement cut-off of 70%. Forty experts in this field (emergency surgeons, neurosurgeons, and intensivists) participated in the online consensus process. Sixteen recommendations were generated, with the aim of promoting rational care in this difficult setting

Published
2019

27. A management algorithm for patients with intracranial pressure monitoring: the Seattle International Severe Traumatic Brain Injury Consensus Conference (SIBICC)

Author

Hawryluk, G, Aguilera, S, Buki, A, Bulger, E, Citerio, G, Cooper, D, Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Chesnut, R, Hawryluk, Gregory W. J., Aguilera, Sergio, Buki, Andras, Bulger, Eileen, Citerio, Giuseppe, Cooper, D. Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romergryko, Ghajar, Jamshid, Harris, Odette, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K., Meyfroidt, Geert, Michael, Daniel B., Oddo, Mauro, Okonkwo, David, Patel, Mayur, Robertson, Claudia, Rosenfeld, Jeffrey V., Rubiano, Andres M., Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S., Vespa, Paul, Videtta, Walter, Wright, David W., Zammit, Christopher, Chesnut, Randall M., Hawryluk, G, Aguilera, S, Buki, A, Bulger, E, Citerio, G, Cooper, D, Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, Chesnut, R, Hawryluk, Gregory W. J., Aguilera, Sergio, Buki, Andras, Bulger, Eileen, Citerio, Giuseppe, Cooper, D. Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romergryko, Ghajar, Jamshid, Harris, Odette, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K., Meyfroidt, Geert, Michael, Daniel B., Oddo, Mauro, Okonkwo, David, Patel, Mayur, Robertson, Claudia, Rosenfeld, Jeffrey V., Rubiano, Andres M., Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S., Vespa, Paul, Videtta, Walter, Wright, David W., Zammit, Christopher, and Chesnut, Randall M.

Abstract

Background: Management algorithms for adult severe traumatic brain injury (sTBI) were omitted in later editions of the Brain Trauma Foundation’s sTBI Management Guidelines, as they were not evidence-based. Methods: We used a Delphi-method-based consensus approach to address management of sTBI patients undergoing intracranial pressure (ICP) monitoring. Forty-two experienced, clinically active sTBI specialists from six continents comprised the panel. Eight surveys iterated queries and comments. An in-person meeting included whole- and small-group discussions and blinded voting. Consensus required 80% agreement. We developed heatmaps based on a traffic-light model where panelists’ decision tendencies were the focus of recommendations. Results: We provide comprehensive algorithms for ICP-monitor-based adult sTBI management. Consensus established 18 interventions as fundamental and ten treatments not to be used. We provide a three-tier algorithm for treating elevated ICP. Treatments within a tier are considered empirically equivalent. Higher tiers involve higher risk therapies. Tiers 1, 2, and 3 include 10, 4, and 3 interventions, respectively. We include inter-tier considerations, and recommendations for critical neuroworsening to assist the recognition and treatment of declining patients. Novel elements include guidance for autoregulation-based ICP treatment based on MAP Challenge results, and two heatmaps to guide (1) ICP-monitor removal and (2) consideration of sedation holidays for neurological examination. Conclusions: Our modern and comprehensive sTBI-management protocol is designed to assist clinicians managing sTBI patients monitored with ICP-monitors alone. Consensus-based (class III evidence), it provides management recommendations based on combined expert opinion. It reflects neither a standard-of-care nor a substitute for thoughtful individualized management.

Published
2019

28. Consensus statement from the International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury: Consensus statement

Author

Hutchinson, P, Kolias, A, Tajsic, T, Adeleye, A, Aklilu, A, Apriawan, T, Bajamal, A, Barthélemy, E, Devi, B, Bhat, D, Bulters, D, Chesnut, R, Citerio, G, Cooper, D, Czosnyka, M, Edem, I, El-Ghandour, N, Figaji, A, Fountas, K, Gallagher, C, Hawryluk, G, Iaccarino, C, Joseph, M, Khan, T, Laeke, T, Levchenko, O, Liu, B, Liu, W, Maas, A, Manley, G, Manson, P, Mazzeo, A, Menon, D, Michael, D, Muehlschlegel, S, Okonkwo, D, Park, K, Rosenfeld, J, Rosseau, G, Rubiano, A, Shabani, H, Stocchetti, N, Timmons, S, Timofeev, I, Uff, C, Ullman, J, Valadka, A, Waran, V, Wells, A, Wilson, M, Servadei, F, Hutchinson, Peter J, Kolias, Angelos G, Tajsic, Tamara, Adeleye, Amos, Aklilu, Abenezer Tirsit, Apriawan, Tedy, Bajamal, Abdul Hafid, Barthélemy, Ernest J, Devi, B Indira, Bhat, Dhananjaya, Bulters, Diederik, Chesnut, Randall, Citerio, Giuseppe, Cooper, D Jamie, Czosnyka, Marek, Edem, Idara, El-Ghandour, Nasser M F, Figaji, Anthony, Fountas, Kostas N, Gallagher, Clare, Hawryluk, Gregory W J, Iaccarino, Corrado, Joseph, Mathew, Khan, Tariq, Laeke, Tsegazeab, Levchenko, Oleg, Liu, Baiyun, Liu, Weiming, Maas, Andrew, Manley, Geoffrey T, Manson, Paul, Mazzeo, Anna T, Menon, David K, Michael, Daniel B, Muehlschlegel, Susanne, Okonkwo, David O, Park, Kee B, Rosenfeld, Jeffrey V, Rosseau, Gail, Rubiano, Andres M, Shabani, Hamisi K, Stocchetti, Nino, Timmons, Shelly D, Timofeev, Ivan, Uff, Chris, Ullman, Jamie S, Valadka, Alex, Waran, Vicknes, Wells, Adam, Wilson, Mark H, Servadei, Franco, Hutchinson, P, Kolias, A, Tajsic, T, Adeleye, A, Aklilu, A, Apriawan, T, Bajamal, A, Barthélemy, E, Devi, B, Bhat, D, Bulters, D, Chesnut, R, Citerio, G, Cooper, D, Czosnyka, M, Edem, I, El-Ghandour, N, Figaji, A, Fountas, K, Gallagher, C, Hawryluk, G, Iaccarino, C, Joseph, M, Khan, T, Laeke, T, Levchenko, O, Liu, B, Liu, W, Maas, A, Manley, G, Manson, P, Mazzeo, A, Menon, D, Michael, D, Muehlschlegel, S, Okonkwo, D, Park, K, Rosenfeld, J, Rosseau, G, Rubiano, A, Shabani, H, Stocchetti, N, Timmons, S, Timofeev, I, Uff, C, Ullman, J, Valadka, A, Waran, V, Wells, A, Wilson, M, Servadei, F, Hutchinson, Peter J, Kolias, Angelos G, Tajsic, Tamara, Adeleye, Amos, Aklilu, Abenezer Tirsit, Apriawan, Tedy, Bajamal, Abdul Hafid, Barthélemy, Ernest J, Devi, B Indira, Bhat, Dhananjaya, Bulters, Diederik, Chesnut, Randall, Citerio, Giuseppe, Cooper, D Jamie, Czosnyka, Marek, Edem, Idara, El-Ghandour, Nasser M F, Figaji, Anthony, Fountas, Kostas N, Gallagher, Clare, Hawryluk, Gregory W J, Iaccarino, Corrado, Joseph, Mathew, Khan, Tariq, Laeke, Tsegazeab, Levchenko, Oleg, Liu, Baiyun, Liu, Weiming, Maas, Andrew, Manley, Geoffrey T, Manson, Paul, Mazzeo, Anna T, Menon, David K, Michael, Daniel B, Muehlschlegel, Susanne, Okonkwo, David O, Park, Kee B, Rosenfeld, Jeffrey V, Rosseau, Gail, Rubiano, Andres M, Shabani, Hamisi K, Stocchetti, Nino, Timmons, Shelly D, Timofeev, Ivan, Uff, Chris, Ullman, Jamie S, Valadka, Alex, Waran, Vicknes, Wells, Adam, Wilson, Mark H, and Servadei, Franco

Abstract

Background: Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in 2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach. Methods: The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries. Results: The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval. Conclusions: In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.

Published
2019

29. Military Blast Exposure and Chronic Neurodegeneration: Summary of Working Groups and Expert Panel Findings and Recommendations

Author

Brix, K.A., Brody, D.L., Grimes, J.B., Yitzhak, A., Agoston, D., Aldag, M., Armstrong, R., Arun, P., Audette, M., Babcock, D., Balaban, C., Banton, R., Bellgowan, P., Borkholder, D., Broglio, S., Brokaw, E., Cantu, R., Carr, W., Chapman, S., Cmarik, J., Colder, B., Colombe, J., Cook, D., Cozzarelli, T., Da Silva, U.O., Daphalapurkar, N., Dardzinski, B., DeGraba, T., DeMar, J., DeWitt, D., Dickstein, D., Duckworth, J., Elder, G., Fazel-Rezai, R., Fine, M., Fiskum, G., Fournier, A., Ganpule, S., Gill, J., Glenn, J.F., Greene, C., Greig, N., Haering, C., Harrington, J., Hein, A., Helmick, K., Hicks, R., Hinds, S., Hoffman, S., Horkayne-Szakaly, I., Iacono, D., Ishii, E., Jones, R.V., Karami, G., Krawczyk, D., Labutta, R., Latta, R., Lattimore, T., Leggieri, M., Leonessa, F., Lin, A., Ling, G., Long, M., Lu, K.P., Panker, S.M., McCabe, J., Merkle, A., Montenigro, P., Mueller, G.P., Ng, L., Nigam, S., O'Donnell, J., Okonkwo, D., Pauli, I., Perl, D., Peskind, E., Pfister, B., Philippens, M., Piehler, T., Proctor, J., Przekwas, A., Qashu, F., Raskind, M., Razumovsky, A., Reifman, J., Reyes, P., Rigby, P., Risling, M., Robinson, M., Rooks, T., Rosen, C., Rosseau, G., Sammons-Jackson, W., Santago, A., Shoge, R., Sours, C., Stone, J., Templin, M., Tepe, V., Thielen, P., Thomas, M., Timmes, T., Tortella, F., Tucker, L., Tweedie, D., Hamm, D.V., Christie Vu, B., Wang, Y., West, T., Wilde, E., Willis, A., Wu, J., Zai, L., Zander, N., Zheng, J., and Ziejewski, M.

Subjects
Blast injury, Positron emission tomography, TS - Technical Sciences, Chronic traumatic encephalopathy, Neuroimaging, Cerebrospinal fluid, Diffusion tensor imaging, Traumatic brain injury, Chronic traumatic encephalopathy (CTE), Army, Risk factor, Disease course, Nerve degeneration, EBP - Explosions, Ballistics & Protection, Traumatic brain injury (TBI), 2015 Observation, Weapon & Protection Systems, Expert system, Blast-related injury, Human, Risk assessment
Abstract

The potential relationship between chronic traumatic encephalopathy (CTE) and head injuries such as blast-related traumatic brain injury (TBI) is an important area of study, particularly for military and contact sports populations, yet little is known about this relationship. To address this topic, the Department of Defense (DoD) Blast Injury Research Program Coordinating Office organized the 2015 International State-of-The-Science Meeting, which brought together subject matter experts from the DoD, other federal agencies, academia, industry, foreign allies, and the sports community. Over the course of the meeting, this community of experts reached a consensus regarding the current body of knowledge and the future of the field. The overarching finding was that there is insufficient existing scientific evidence to link blast-related TBI with CTE. The meeting's Expert Panel also agreed on 13 additional findings describing research and knowledge gaps, clinical gaps, and research opportunities that, if addressed with focused effort, would further the understanding of the relationship between blast-related TBI and CTE. To this end, the Expert Panel also developed six recommendations for advancing research, each with short-and long-Term goals. Among the six recommendations, the Expert Panel identified the first four as highest priority for addressing pressing research needs. These four high-priority recommendations include, in order of priority: (1) more collection and study of clinical neuropathology samples, (2) standardization of clinical diagnostic criteria, (3) development of clinically appropriate and standardized animal models, and (4) development of noninvasive serial assessment strategies (i.e., imaging or biospecimen biomarkers). © Copyright 2017, Mary Ann Liebert, Inc. 2017.

Published
2017

31. COMT Val158Met polymorphism is associated with post-traumatic stress disorder and functional outcome following mild traumatic brain injury

Author

Winkler, E.A. (Ethan A.), Yue, J.K. (John), Ferguson, A.R. (Adam), Temkin, N.R. (Nancy), Stein, M.B. (Murray B.), Barber, J. (Jason), Yuh, E.L. (Esther L.), Sharma, S. (Sourabh), Satris, G.G. (Gabriela G.), McAllister, T.W. (Thomas W.), Rosand, J. (Jonathan), Sorani, M.D. (Marco), Lingsma, H.F. (Hester), Tarapore, P.E. (Phiroz E.), Burchard, E.G. (Esteban), Hu, D. (Donglei), Eng, C. (Celeste), Wang, K.K.W. (Kevin K.W.), Mukherjee, P. (Pratik), Okonkwo, D. (David), Diaz-Arrastia, R. (Ramon), Manley, G. (Geoffrey), Winkler, E.A. (Ethan A.), Yue, J.K. (John), Ferguson, A.R. (Adam), Temkin, N.R. (Nancy), Stein, M.B. (Murray B.), Barber, J. (Jason), Yuh, E.L. (Esther L.), Sharma, S. (Sourabh), Satris, G.G. (Gabriela G.), McAllister, T.W. (Thomas W.), Rosand, J. (Jonathan), Sorani, M.D. (Marco), Lingsma, H.F. (Hester), Tarapore, P.E. (Phiroz E.), Burchard, E.G. (Esteban), Hu, D. (Donglei), Eng, C. (Celeste), Wang, K.K.W. (Kevin K.W.), Mukherjee, P. (Pratik), Okonkwo, D. (David), Diaz-Arrastia, R. (Ramon), and Manley, G. (Geoffrey)

Abstract

Mild traumatic brain injury (mTBI) results in variable clinical trajectories and outcomes. The source of variability remains unclear, but may involve genetic variations, such as single nucleotide polymorphisms (SNPs). A SNP in catechol-o-methyltransferase (COMT) is suggested to influence development of post-traumatic stress disorder (PTSD), but its role in TBI remains unclear. Here, we utilize the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study to investigate whether the COMT Val158Met polymorphism is associated with PTSD and global functional outcome as measured by the PTSD Checklist – Civilian Version and Glasgow Outcome Scale Extended (GOSE), respectively. Results in 93 predominately Caucasian subjects with mTBI show that the COMT Met158 allele is associated with lower incidence of PTSD (univariate odds ratio (OR) of 0.25, 95% CI [0.09–0.69]) and higher GOSE scores (univariate OR 2.87, 95% CI [1.20–6.86]) 6-months following injury. The COMT Val158Met genotype and PTSD association persists after controlling for race (multivariable OR of 0.29, 95% CI [0.10–0.83]) and pre-existing psychiatric disorders/substance abuse (multivariable OR of 0.32, 95% CI [0.11–0.97]). PTSD emerged as a strong predictor of poorer outcome on GOSE (multivariable OR 0.09, 95% CI [0.03–0.26]), which persists after controlling for age, GCS, and race. When accounting for PTSD in multivariable analysis, the association of COMT genotype and GOSE did not remain significant (multivariable OR 1.73, 95% CI [0.69–4.35]). Whether COMT genotype indirectly influences global functional outcome through PTSD remains to be determined and larger studies in more diverse populations are needed to confirm these findings.

Published
2017
Full Text
View/download PDF

32. DRD2 C957T polymorphism is associated with improved 6-month verbal learning following traumatic brain injury

Author

Yue, J.K. (John), Winkler, E.A. (Ethan A.), Rick, J.W. (Jonathan W.), Burke, J.F. (John F.), McAllister, T.W. (Thomas W.), Oh, S.S. (Sam S.), Burchard, E.G. (Esteban), Hu, D. (Donglei), Rosand, J. (Jonathan), Temkin, N.R. (Nancy), Korley, F.K. (Frederick K.), Sorani, M.D. (Marco), Ferguson, A.R. (Adam), Lingsma, H.F. (Hester), Sharma, S. (Sourabh), Robinson, C.K. (Caitlin K.), Yuh, E.L. (Esther), Tarapore, P.E. (Phiroz E.), Wang, K.K.W. (Kevin K.W.), Puccio, A.M. (Ava), Mukherjee, P. (Pratik), Diaz-Arrastia, R. (Ramon), Gordon, W.A. (Wayne A.), Valadka, A.B. (Alex B.), Okonkwo, D. (David), Manley, G. (Geoffrey), Track-Tbi Investigators, Yue, J.K. (John), Winkler, E.A. (Ethan A.), Rick, J.W. (Jonathan W.), Burke, J.F. (John F.), McAllister, T.W. (Thomas W.), Oh, S.S. (Sam S.), Burchard, E.G. (Esteban), Hu, D. (Donglei), Rosand, J. (Jonathan), Temkin, N.R. (Nancy), Korley, F.K. (Frederick K.), Sorani, M.D. (Marco), Ferguson, A.R. (Adam), Lingsma, H.F. (Hester), Sharma, S. (Sourabh), Robinson, C.K. (Caitlin K.), Yuh, E.L. (Esther), Tarapore, P.E. (Phiroz E.), Wang, K.K.W. (Kevin K.W.), Puccio, A.M. (Ava), Mukherjee, P. (Pratik), Diaz-Arrastia, R. (Ramon), Gordon, W.A. (Wayne A.), Valadka, A.B. (Alex B.), Okonkwo, D. (David), Manley, G. (Geoffrey), and Track-Tbi Investigators

Abstract

Traumatic brain injury (TBI) often leads to heterogeneous clinical outcomes, which may be influenced by genetic variation. A single-nucleotide polymorphism (SNP) in the dopamine D2 receptor (DRD2) may influence cognitive deficits following TBI. However, part of the association with DRD2 has been attributed to genetic variability within the adjacent ankyrin repeat and kinase domain containing 1 protein (ANKK1). Here, we utilize the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study to investigate whether a novel DRD2 C957T polymorphism (rs6277) influences outcome on a cognitive battery at 6 months following TBI—California Verbal Learning Test (CVLT-II), Wechsler Adult Intelligence Test Processing Speed Index Composite Score (WAIS-PSI), and Trail Making Test (TMT). Results in 128 Caucasian subjects show that the rs6277 T-allele associates with better verbal learning and recall on CVLT-II Trials 1–5 (T-allele carrier 52.8 ± 1.3 points, C/C 47.9 ± 1.7 points; mean increase 4.9 points, 95% confidence interval [0.9 to 8.8]; p = 0.018), Short-Delay Free Recall (T-carrier 10.9 ± 0.4 points, C/C 9.7 ± 0.5 points; mean increase 1.2 points [0.1 to 2.5]; p = 0.046), and Long-Delay Free Recall (T-carrier 11.5 ± 0.4 points, C/C 10.2 ± 0.5 points; mean increase 1.3 points [0.1 to 2.5]; p = 0.041) after adjusting for age, education years, Glasgow Coma Scale, presence of acute intracranial pathology on head computed tomography scan, and genotype of the ANKK1 SNP rs1800497 using multivariable regression. No association was found between DRD2 C947T and non-verbal processing speed (WAIS-PSI) or mental flexibility (TMT) at 6 months. Hence, DRD2 C947T (rs6277) may be associated with better performance on select cognitive domains independent of ANKK1 following TBI.

Published
2017
Full Text
View/download PDF

33. An automatic image analysis methodology for the measurement of droplet size distributions in liquid–liquid dispersion: round object detection.

Author

Gawryszewski, K., Rana, Z. A., Jenkins, K. W., Ioannou, P., and Okonkwo, D.

Subjects
IMAGE analysis, COMPUTER vision, CHEMICAL reactors, LIQUID-liquid extraction, FOOD industry
Abstract

This article presents an efficient and economical automatic image analysis technique for the droplet characterization in a liquid–liquid dispersion. The methodology employs a combination of the Satoshi Suzuki's [Topological structural analysis of digitized binary images by border following. Comput Vis Graph Image Process. 1985;30:32–46] find contours algorithm and the method of minimal enclosing circle identification, proposed by Emo Welzl [Smallest enclosing disks (balls and ellipsoids). Berlin, Heidelberg: Springer; 1991. p. 359–370. chapter 24], to achieve the objectives. The round object detection algorithm has been designed for the identification and verification of correct droplets in the mixture which helped to increase the accuracy of automatic detection. Tests have been performed on various sets of images obtained during several emulsification processes and contain examples of droplets which differ in size, density, volume and appearance etc. An effective communication between the two methodologies and newly introduced algorithms demonstrated an accuracy of 90% or above in the measurement of droplet size distribution and Sauter mean diameters through an automatic vision-based system. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

34. Circulating brain-derived neurotrophic factor has diagnostic and prognostic value in traumatic brain injury

Author

Korley, F.K. (Frederick K.), Diaz-Arrastia, R. (Ramon), Wu, A.H.B. (Alan H. B.), Yue, J.K. (John), Manley, G. (Geoffrey), Sair, H.I. (Haris I.), Eyk, J.E. (Jennifer) van, Everett, A.D. (Allen D.), Okonkwo, D. (David), Valadka, A.B. (Alex), Gordon, W.A. (Wayne A.), Maas, A.I.R. (Andrew), Mukherjee, P. (Pratik), Yuh, E.L. (Esther), Lingsma, H.F. (Hester), Puccio, A.M. (Ava), Schnyer, D.M. (David), Korley, F.K. (Frederick K.), Diaz-Arrastia, R. (Ramon), Wu, A.H.B. (Alan H. B.), Yue, J.K. (John), Manley, G. (Geoffrey), Sair, H.I. (Haris I.), Eyk, J.E. (Jennifer) van, Everett, A.D. (Allen D.), Okonkwo, D. (David), Valadka, A.B. (Alex), Gordon, W.A. (Wayne A.), Maas, A.I.R. (Andrew), Mukherjee, P. (Pratik), Yuh, E.L. (Esther), Lingsma, H.F. (Hester), Puccio, A.M. (Ava), and Schnyer, D.M. (David)

Abstract

Brain-derived neurotrophic factor (BDNF) is important for neuronal survival and regeneration. We investigated the

Published
2016
Full Text
View/download PDF

35. Plasma Anti-Glial Fibrillary Acidic Protein Autoantibody Levels during the Acute and Chronic Phases of Traumatic Brain Injury: A Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot Study

Author

Wang, K.K.W. (Kevin K. W.), Yang, Z. (Zhihui), Yue, J.K. (John), Zhang, Z. (Zhiqun), Winkler, E.A. (Ethan A.), Puccio, A.M. (Ava), Diaz-Arrastia, R. (Ramon), Lingsma, H.F. (Hester), Yuh, E.L. (Esther), Mukherjee, P. (Pratik), Valadka, A.B. (Alex B.), Gordon, W.A. (Wayne A.), Okonkwo, D. (David), Manley, G. (Geoffrey), Cooper, S.R. (Shelly), Dams-O'connor, K. (Kristen), Hricik, A.J. (Allison), Inoue, T. (Tomoo), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Schnyer, D.M. (David), Sinha, T.K. (Tuhin), Vassar, M.J. (Mary), Wang, K.K.W. (Kevin K. W.), Yang, Z. (Zhihui), Yue, J.K. (John), Zhang, Z. (Zhiqun), Winkler, E.A. (Ethan A.), Puccio, A.M. (Ava), Diaz-Arrastia, R. (Ramon), Lingsma, H.F. (Hester), Yuh, E.L. (Esther), Mukherjee, P. (Pratik), Valadka, A.B. (Alex B.), Gordon, W.A. (Wayne A.), Okonkwo, D. (David), Manley, G. (Geoffrey), Cooper, S.R. (Shelly), Dams-O'connor, K. (Kristen), Hricik, A.J. (Allison), Inoue, T. (Tomoo), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Schnyer, D.M. (David), Sinha, T.K. (Tuhin), and Vassar, M.J. (Mary)

Abstract

We described recently a subacute serum autoantibody response toward glial fibrillary acidic protein (GFAP) and its breakdown products 5-10 days after severe traumatic brain injury (TBI). Here, we expanded our anti-GFAP autoantibody (AutoAb[GFAP]) investigation to the multicenter observational study Transforming Research and Clinical Knowledge in TBI Pilot (TRACK-TBI Pilot) to cover the full spectrum of TBI (Glasgow Coma Scale 3-15) by using acute (<24 h) plasma samples from 196 patients with acute TBI admitted to three Level I trauma centers, and a second cohort of 21 participants with chronic TBI admitted to inpatient TBI rehabilitation. We find that acute patients self-reporting previous TBI with loss of consciousness (LOC) (n = 43) had higher day 1 AutoAb[GFAP] (mean ± standard error: 9.11 ± 1.42; n = 43) than healthy controls (2.90 ± 0.92; n = 16; p = 0.032) and acute patients reporting no previous TBI (2.97 ± 0.37; n = 106; p < 0.001), but not acute patients re

Published
2016
Full Text
View/download PDF

36. A Consensus-Based Interpretation of the Benchmark Evidence from South American Trials: Treatment of Intracranial Pressure Trial

Author

Chesnut, R, Bleck, T, Citerio, G, Claassen, J, Cooper, D, Coplin, W, Diringer, M, Grande, P, Hemphill, J, Hutchinson, P, Leroux, P, Mayer, S, Menon, D, Myburgh, J, Okonkwo, D, Robertson, C, Sahuquillo, J, Stocchetti, N, Sung, G, Temkin, N, Vespa, P, Videtta, W, Yonas, H, Chesnut, RM, Bleck, TP, Cooper, DJ, Coplin, WM, Diringer, MN, Grande, PO, Hemphill, JC, Hutchinson, PJ, Mayer, SA, Menon, DK, Myburgh, JA, Okonkwo, DO, Robertson, CS, Vespa, PM, Chesnut, R, Bleck, T, Citerio, G, Claassen, J, Cooper, D, Coplin, W, Diringer, M, Grande, P, Hemphill, J, Hutchinson, P, Leroux, P, Mayer, S, Menon, D, Myburgh, J, Okonkwo, D, Robertson, C, Sahuquillo, J, Stocchetti, N, Sung, G, Temkin, N, Vespa, P, Videtta, W, Yonas, H, Chesnut, RM, Bleck, TP, Cooper, DJ, Coplin, WM, Diringer, MN, Grande, PO, Hemphill, JC, Hutchinson, PJ, Mayer, SA, Menon, DK, Myburgh, JA, Okonkwo, DO, Robertson, CS, and Vespa, PM

Abstract

Widely-varying published and presented analyses of the Benchmark Evidence From South American Trials: Treatment of Intracranial Pressure (BEST TRIP) randomized controlled trial of intracranial pressure (ICP) monitoring have suggested denying trial generalizability, questioning the need for ICP monitoring in severe traumatic brain injury (sTBI), re-assessing current clinical approaches to monitored ICP, and initiating a general ICP-monitoring moratorium. In response to this dissonance, 23 clinically-active, international opinion leaders in acute-care sTBI management met to draft a consensus statement to interpret this study. A Delphi method-based approach employed iterative pre-meeting polling to codify the group's general opinions, followed by an in-person meeting wherein individual statements were refined. Statements required an agreement threshold of more than 70% by blinded voting for approval. Seven precisely-worded statements resulted, with agreement levels of 83% to 100%. These statements, which should be read in toto to properly reflect the group's consensus positions, conclude that the BEST TRIP trial: 1) studied protocols, not ICP-monitoring per se; 2) applies only to those protocols and specific study groups and should not be generalized to other treatment approaches or patient groups; 3) strongly calls for further research on ICP interpretation and use; 4) should be applied cautiously to regions with much different treatment milieu; 5) did not investigate the utility of treating monitored ICP in the specific patient group with established intracranial hypertension; 6) should not change the practice of those currently monitoring ICP; and 7) provided a protocol, used in non-monitored study patients, that should be considered when treating without ICP monitoring. Consideration of these statements can clarify study interpretation.

Published
2015

37. ED disposition of the Glasgow Coma Scale 13 to 15 traumatic brain injury patient: Analysis of the Transforming Research and Clinical Knowledge in TBI study

Author

Ratcliff, J.J. (Jonathan), Adeoye, O. (Opeolu), Lindsell, D., Hart, K.W. (Kimberly), Pancioli, A. (Arthur), McMullan, D.J. (Dominic), Yue, J.K. (John), Nishijima, D.K. (Daniel), Gordon, W.A. (Wayne), Valadka, A.B. (Alex), Okonkwo, D. (David), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), Manley, G. (Geoffrey), Ratcliff, J.J. (Jonathan), Adeoye, O. (Opeolu), Lindsell, D., Hart, K.W. (Kimberly), Pancioli, A. (Arthur), McMullan, D.J. (Dominic), Yue, J.K. (John), Nishijima, D.K. (Daniel), Gordon, W.A. (Wayne), Valadka, A.B. (Alex), Okonkwo, D. (David), Lingsma, H.F. (Hester), Maas, A.I.R. (Andrew), and Manley, G. (Geoffrey)

Abstract

Objective Mild traumatic brain injury (mTBI) patients are frequently admitted to high levels of care despite limited evidence suggesting benefit. Such decisions may contribute to the significant cost of caring for mTBI patients. Understanding the factors that drive disposition decision making and how disposition is associated with outcomes is necessary for developing an evidence-base supporting disposition decisions. We evaluated factors associated with emergency department triage of mTBI patients to 1 of 3 levels of care: home, inpatient floor, or intensive care unit (ICU). Methods This multicenter, prospective, cohort study included patients with isolated head trauma, a cranial computed tomography as part of routine care, and a Glasgow Coma Scale (GCS) score of 13 to 15. Data analysis was performed using multinomial logistic regression. Results Of the 304 patients included, 167 (55%) were discharged home, 76 (25%) were admitted to the inpatient floor, and 61 (20%) were admitted to the ICU. In the multivariable model, admission to the ICU, compared with floor admission, varied by study site, odds ratio (OR) 0.18 (95% confidence interval [CI], 0.06-0.57); antiplatelet/anticoagulation therapy, OR 7.46 (95% CI, 1.79-31.13); skull fracture, OR 7.60 (95% CI, 2.44-23.73); and lower GCS, OR 2.36 (95% CI, 1.05-5.30). No difference in outcome was observed between the 3 levels of care. Conclusion Clinical characteristics and local practice patterns contribute to mTBI disposition decisions. Level of care was not associated with outcomes. Intracranial hemorrhage, GCS 13 to 14, skull fracture, and current antiplatelet/anticoagulant therapy influenced disposition decisions.

Published
2014
Full Text
View/download PDF

43. Effect of frailty on 6-month outcome after traumatic brain injury: a multicentre cohort study with external validation

Author

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

Subjects
Male, Traumatic/therapy, Frailty, Brain Injuries, Traumatic/therapy, traumatic brain injury, Reproducibility of Results, Middle Aged, Cohort Studies, Brain Injuries, Brain Injuries, Traumatic, outcome, Humans, Glasgow Coma Scale, Neurology (clinical), Human medicine, Prospective Studies, Aged
Abstract

Background: Frailty is known to be associated with poorer outcomes in individuals admitted to hospital for medical conditions requiring intensive care. However, little evidence is available for the effect of frailty on patients’ outcomes after traumatic brain injury. Many frailty indices have been validated for clinical practice and show good performance to predict clinical outcomes. However, each is specific to a particular clinical context. We aimed to develop a frailty index to predict 6-month outcomes in patients after a traumatic brain injury. Methods: A cumulative deficit approach was used to create a novel frailty index based on 30 items dealing with disease states, current medications, and laboratory values derived from data available from CENTER-TBI, a prospective, longitudinal observational study of patients with traumatic brain injury presenting within 24 h of injury and admitted to a ward or an intensive care unit at 65 centres in Europe between Dec 19, 2014, and Dec 17, 2017. From the individual cumulative CENTER-TBI frailty index (range 0–30), we obtained a standardised value (range 0–1), with high scores indicating higher levels of frailty. The effect of frailty on 6-month outcome evaluated with the extended Glasgow Outcome Scale (GOSE) was assessed through a proportional odds logistic model adjusted for known outcome predictors. An unfavourable outcome was defined as death or severe disability (GOSE score ≤4). External validation was performed on data from TRACK-TBI, a prospective observational study co-designed with CENTER-TBI, which enrolled patients with traumatic brain injury at 18 level I trauma centres in the USA from Feb 26, 2014, to July 27, 2018. CENTER-TBI is registered with ClinicalTrials.gov, NCT02210221; TRACK-TBI is registered at ClinicalTrials.gov, NCT02119182. Findings: 2993 participants (median age was 51 years [IQR 30–67], 2058 [69%] were men) were included in this analysis. The overall median CENTER-TBI frailty index score was 0·07 (IQR 0·03–0·15), with a median score of 0·17 (0·08–0·27) in older adults (aged ≥65 years). The CENTER-TBI frailty index score was significantly associated with the probability of an increasingly unfavourable outcome (cumulative odds ratio [OR] 1·03, 95% CI 1·02–1·04; p

Published
2022

44. Pathological Computed Tomography Features Associated With Adverse Outcomes After Mild Traumatic Brain Injury: A TRACK-TBI Study With External Validation in CENTER-TBI

Author

Ramon Diaz-Arrastia, Thomas W. McAllister, Joel H. Kramer, Brandon Foreman, Alex B. Valadka, Dana Pisică, Sureyya Dikmen, Randall Merchant, Adam R. Ferguson, C. Dirk Keene, Raquel C. Gardner, Xiaoying Sun, Geoffrey T. Manley, Arthur W. Toga, Yelena G. Bodien, John D. Corrigan, Andrew I R Maas, Joseph T. Giacino, Christopher J. Madden, Pratik Mukherjee, Florence Noel, Claudia S. Robertson, Amber Nolan, Ross Zafonte, Murray B. Stein, Hester F. Lingsma, Nancy R. Temkin, Natalie Kreitzer, Opeolu Adeoye, J. Claude Hemphill, Rao P. Gullapalli, Kim Boase, Jan Verheyden, Luis Gonzalez, Laura B. Ngwenya, Christopher J. Lindsell, Miri Rabinowitz, Michael McCrea, Gillian Hotz, Jonathan Rosand, Shankar P. Gopinath, Harvey S. Levin, David M. Schnyer, Neeraj Badjatia, Ann-Christine Duhaime, Esther L. Yuh, Angelle M. Sander, Sabrina R Taylor, Étienne Gaudette, Eva M. Palacios, Gabriella Satris, Alastair J. Martin, David O. Okonkwo, Seth A. Seabury, Joan Machamer, Karen Crawford, Amy J. Markowitz, Richard G. Ellenbogen, V. Ramana Feeser, Lindsay D. Nelson, Mark Harris, Daniel P. Perl, Mary J. Vassar, Sonia Jain, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, American Medical Association, Yuh, E. L., Jain, S., Sun, X., Pisica, D., Harris, M. H., Taylor, S. R., Markowitz, A. J., Mukherjee, P., Verheyden, J., Giacino, J. T., Levin, H. S., Mccrea, M., Stein, M. B., Temkin, N. R., Diaz-Arrastia, R., Robertson, C. S., Lingsma, H. F., Okonkwo, D. O., Maas, A. I. R., Manley, G. T., Adeoye, O., Badjatia, N., Boase, K., Bodien, Y., Corrigan, J. D., Crawford, K., Dikmen, S., Duhaime, A. -C., Ellenbogen, R., Feeser, V. R., Ferguson, A. R., Foreman, B., Gardner, R., Gaudette, E., Gonzalez, L., Gopinath, S., Gullapalli, R., Hemphill, J. C., Hotz, G., Keene, C. D., Kramer, J., Kreitzer, N., Lindsell, C., Machamer, J., Madden, C., Martin, A., Mcallister, T., Merchant, R., Nelson, L., Ngwenya, L. B., Noel, F., Nolan, A., Palacios, E., Perl, D., Rabinowitz, M., Rosand, J., Sander, A., Satris, G., Schnyer, D., Seabury, S., Toga, A., Valadka, A., Vassar, M., Zafonte R., (TRACK-TBI Investigators for the CENTER-TBI Investigators), Beretta, L., Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, Yuh, E, Jain, S, Sun, X, Pisica, D, Harris, M, Taylor, S, Markowitz, A, Mukherjee, P, Verheyden, J, Giacino, J, Levin, H, Mccrea, M, Stein, M, Temkin, N, Diaz-Arrastia, R, Robertson, C, Lingsma, H, Okonkwo, D, Maas, A, Manley, G, Adeoye, O, Badjatia, N, Boase, K, Bodien, Y, Corrigan, J, Crawford, K, Dikmen, S, Duhaime, A, Ellenbogen, R, Feeser, V, Ferguson, A, Foreman, B, Gardner, R, Gaudette, E, Gonzalez, L, Gopinath, S, Gullapalli, R, Hemphill, J, Hotz, G, Keene, C, Kramer, J, Kreitzer, N, Lindsell, C, Machamer, J, Madden, C, Martin, A, Mcallister, T, Merchant, R, Nelson, L, Ngwenya, L, Noel, F, Nolan, A, Palacios, E, Perl, D, Rabinowitz, M, Rosand, J, Sander, A, Satris, G, Schnyer, D, Seabury, S, Toga, A, Valadka, A, Vassar, M, Zafonte, R, Citerio, G, Public Health, Neurosurgery, Molecular Neuroscience and Ageing Research (MOLAR), and TRACK-TBI Investigators for the CENTER-TBI Investigators

Subjects
Male, validity, Neurology, Neurologi, common data elements, ethnic disparities, Cohort Studies, 0302 clinical medicine, Tomography, Original Investigation, screening and diagnosis, nrecovery, Injuries and accidents, RECOVERY, Middle Aged, Prognosis, 3. Good health, X-Ray Computed, Detection, classification, 030220 oncology & carcinogenesis, TRACK-TBI Investigators for the CENTER-TBI Investigators, Biomedical Imaging, Female, Cognitive Sciences, Radiology, Intracranial Hemorrhages, Comments, Human, 4.2 Evaluation of markers and technologies, Adult, concussio, medicine.medical_specialty, Subarachnoid hemorrhage, Physical Injury - Accidents and Adverse Effects, Prognosi, Traumatic brain injury, Clinical Sciences, Traumatic Brain Injury (TBI), CONCUSSION, Head trauma, scale, models, 03 medical and health sciences, Epidural hematoma, Hematoma, Clinical Research, medicine, Online First, Humans, Brain Concussion, Traumatic Head and Spine Injury, Intracranial Hemorrhage, Aged, Neurology & Neurosurgery, business.industry, Research, Glasgow Coma Scale, Neurosciences, prediction, Petechial rash, Recovery of Function, medicine.disease, Brain Disorders, Good Health and Well Being, identification, Human medicine, Neurology (clinical), Cohort Studie, Tomography, X-Ray Computed, business, 030217 neurology & neurosurgery
Abstract

Key Points Question Are different patterns of intracranial injury on head computed tomography associated with prognosis after mild traumatic brain injury (mTBI)? Findings In this cohort study, subarachnoid hemorrhage, subdural hematoma, and contusion often co-occurred and were associated with both incomplete recovery and more severe impairment out to 12 months after injury, while intraventricular and/or petechial hemorrhage co-occurred and were associated with more severe impairment up to 12 months after injury; epidural hematoma was associated with incomplete recovery at some points but not with more severe impairment. Some intracranial hemorrhage patterns were more strongly associated with outcomes than previously validated demographic and clinical variables. Meaning In this study, different pathological features on head computed tomography carried different implications for mild traumatic brain injury prognosis to 1 year., The longitudinal, observational study aims to identify pathological computed tomography features associated with adverse outcomes after mild traumatic brain injury., Importance A head computed tomography (CT) with positive results for acute intracranial hemorrhage is the gold-standard diagnostic biomarker for acute traumatic brain injury (TBI). In moderate to severe TBI (Glasgow Coma Scale [GCS] scores 3-12), some CT features have been shown to be associated with outcomes. In mild TBI (mTBI; GCS scores 13-15), distribution and co-occurrence of pathological CT features and their prognostic importance are not well understood. Objective To identify pathological CT features associated with adverse outcomes after mTBI. Design, Setting, and Participants The longitudinal, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study enrolled patients with TBI, including those 17 years and older with GCS scores of 13 to 15 who presented to emergency departments at 18 US level 1 trauma centers between February 26, 2014, and August 8, 2018, and underwent head CT imaging within 24 hours of TBI. Evaluations of CT imaging used TBI Common Data Elements. Glasgow Outcome Scale–Extended (GOSE) scores were assessed at 2 weeks and 3, 6, and 12 months postinjury. External validation of results was performed via the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Data analyses were completed from February 2020 to February 2021. Exposures Acute nonpenetrating head trauma. Main Outcomes and Measures Frequency, co-occurrence, and clustering of CT features; incomplete recovery (GOSE scores

Published
2021

45. The evolution of white matter microstructural changes after mild traumatic brain injury: A longitudinal DTI and NODDI study.

Author

Palacios, E. M., Owen, J. P., Yuh, E. L., Wang, M. B., Vassar, M. J., Ferguson, A. R., Diaz-Arrastia, R., Giacino, J. T., Okonkwo, D. O., Robertson, C. S., Stein, M. B., Temkin, N., Jain, S., McCrea, M., MacDonald, C. L., Levin, H. S., Manley, G. T., and Mukherjee, P.

Subjects
*WHITE matter (Nerve tissue), *BRAIN injuries, *NEUROPSYCHOLOGICAL tests, *MEDICAL personnel
Abstract

The article informs that Neuroimaging biomarkers that can detect white matter (WM) pathology after mild traumatic brain injury (mTBI) and predict long-term outcome are needed to improve care and develop therapies. It mentions thatused diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) to investigate WM microstructure cross-sectionally and longitudinally after mTBI and correlate these with neuropsychological performance.

Published
2020
Full Text
View/download PDF

46. Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations

Author

Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Bulger, Eileen M, Citerio, Giuseppe, Cooper, D Jamie, Arrastia, Ramon Diaz, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romergryko G, Ghajar, Jamshid, Harris, Odette, Hawryluk, Gregory W J, Hoffer, Alan, Hutchinson, Peter, Joseph, Mathew, Kitagawa, Ryan, Manley, Geoffrey, Mayer, Stephan, Menon, David K, Meyfroidt, Geert, Michael, Daniel B, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juain, Servadei, Franco, Shutter, Lori, Stein, Deborah M, Stocchetti, Nino, Taccone, Fabio Silvio, Timmons, Shelly D, Tsai, Eve C, Ullman, Jamie S, Videtta, Walter, Wright, David W, Zammit, Christopher, Chesnut, R, Aguilera, S, Buki, A, Bulger, E, Citerio, G, Cooper, D, Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hawryluk, G, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Videtta, W, Wright, D, and Zammit, C

Subjects
Surgery, Neurology (clinical), Algorithms, Consensus development, Intracranial hypertension, Intracranial pressure monitoring, Neurocritical care, Practice guidelines, Traumatic brain injury
Abstract

BACKGROUND: Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed. OBJECTIVE: To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion. METHODS: We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression. RESULTS: Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations. CONCLUSION: Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions. ispartof: Neurosurgery vol:93 issue:2 pages:399-408 ispartof: location:United States status: published

Published
2023

47. Prognostication and Goals of Care Decisions in Severe Traumatic Brain Injury: A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference Working Group

Author

Sarigul, Buse, Bell, Randy S, Chesnut, Randall M, Aguilera, Sergio, Buki, Andras, Citerio, Giuseppe, Cooper, D James, Diaz-Arrastia, Ramon R, Diringer, Michael, Figaji, Anthony, Gao, Guoyi, Geocadin, Romer, Ghajar, Jamshid, Harris, Odette A, Hoffer, Alan, Hutchinson, Peter John, Joseph, Matthew, Kitagawa, Ryan Seiji, Manley, Geoffrey T, Mayer, Stephan, Menon, David, Meyfroidt, Geert, Michael, Daniel, Oddo, Mauro, Okonkwo, David O, Patel, Mayur B, Robertson, Claudia S, Rosenfeld, Jeffrey V, Rubiano, Andres M, Sahuquillo, Juan, Servadei, Franco, Shutter, Lori, Stein, Deborah, Stocchetti, Nino, Taccone, Fabio, Timmons, Shelly, Tsai, Eve, Ullman, Jamie S, Vespa, Paul M, Videtta, Walter, Wright, David, Zammit, Christopher, Hawryluk, Gregory, Sarigul, B, Bell, R, Chesnut, R, Aguilera, S, Buki, A, Citerio, G, Cooper, D, Diaz-Arrastia, R, Diringer, M, Figaji, A, Gao, G, Geocadin, R, Ghajar, J, Harris, O, Hoffer, A, Hutchinson, P, Joseph, M, Kitagawa, R, Manley, G, Mayer, S, Menon, D, Meyfroidt, G, Michael, D, Oddo, M, Okonkwo, D, Patel, M, Robertson, C, Rosenfeld, J, Rubiano, A, Sahuquillo, J, Servadei, F, Shutter, L, Stein, D, Stocchetti, N, Taccone, F, Timmons, S, Tsai, E, Ullman, J, Vespa, P, Videtta, W, Wright, D, Zammit, C, and Hawryluk, G

Subjects
withdrawal of care, survey, Neurology (clinical), SIBICC, brain injury, prognosi, nihilism
Abstract

Best practice guidelines have advanced severe traumatic brain injury (TBI) care; however, there is little that currently informs goals of care decisions and processes despite their importance and frequency. Panelists from the Seattle International severe traumatic Brain Injury Consensus Conference (SIBICC) participated in a survey consisting of 24 questions. Questions queried use of prognostic calculators, variability in and responsibility for goals of care decisions, and acceptability of neurological outcomes, as well as putative means of improving decisions that might limit care. A total of 97.6% of the 42 SIBICC panelists completed the survey. Responses to most questions were highly variable. Overall, panelists reported infrequent use of prognostic calculators, and observed variability in patient prognostication and goals of care decisions. They felt that it would be beneficial for physicians to improve consensus on what constitutes an acceptable neurological outcome as well as what chance of achieving that outcome is acceptable. Panelists felt that the public should help to define what constitutes a good outcome and expressed some support for a “nihilism guard.” More than 50% of panelists felt that if it was certain to be permanent, a vegetative state or lower severe disability would justify a withdrawal of care decision, whereas 15% felt that upper severe disability justified such a decision. Whether conceptualizing an ideal or existing prognostic calculator to predict death or an unacceptable outcome, on average a 64-69% chance of a poor outcome was felt to justify treatment withdrawal. These results demonstrate important variability in goals of care decision making and a desire to reduce this variability. Our panel of recognized TBI experts opined on the neurological outcomes and chances of those outcomes that might prompt consideration of care withdrawal; however, imprecision of prognostication and existing prognostication tools is a significant impediment to standardizing the approach to care-limiting decisions.

Published
2023

48. Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Author

Edoardo Picetti, Fausto Catena, Fikri Abu-Zidan, Luca Ansaloni, Rocco A. Armonda, Miklosh Bala, Zsolt J. Balogh, Alessandro Bertuccio, Walt L. Biffl, Pierre Bouzat, Andras Buki, Davide Cerasti, Randall M. Chesnut, Giuseppe Citerio, Federico Coccolini, Raul Coimbra, Carlo Coniglio, Enrico Fainardi, Deepak Gupta, Jennifer M. Gurney, Gregory W. J. Hawryluk, Raimund Helbok, Peter J. A. Hutchinson, Corrado Iaccarino, Angelos Kolias, Ronald W. Maier, Matthew J. Martin, Geert Meyfroidt, David O. Okonkwo, Frank Rasulo, Sandro Rizoli, Andres Rubiano, Juan Sahuquillo, Valerie G. Sams, Franco Servadei, Deepak Sharma, Lori Shutter, Philip F. Stahel, Fabio S. Taccone, Andrew Udy, Tommaso Zoerle, Vanni Agnoletti, Francesca Bravi, Belinda De Simone, Yoram Kluger, Costanza Martino, Ernest E. Moore, Massimo Sartelli, Dieter Weber, Chiara Robba, Apollo - University of Cambridge Repository, Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, R, Bala, M, Balogh, Z, Bertuccio, A, Biffl, W, Bouzat, P, Buki, A, Cerasti, D, Chesnut, R, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, J, Hawrylux, G, Helbok, R, Hutchinson, P, Iaccarino, C, Kolias, A, Maier, R, Martin, M, Meyfroidt, G, Okonkwo, D, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, V, Servadei, F, Sharma, D, Shutter, L, Stahel, P, Taccone, F, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, E, Sartelli, M, Weber, D, Robba, C, Institut Català de la Salut, [Picetti E] Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy. [Catena F] Department of General and Emergency Surgery, Bufalini Hospital, Cesena, Italy. [Abu-Zidan F] The Research Ofce, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. [Ansaloni L] Unit of General Surgery, San Matteo Hospital Pavia, University of Pavia, Pavia, Italy. [Armonda RA] Department of Neurosurgery, 71541MedStar Georgetown University Hospital, Washington, DC, USA. Department of Neurosurgery, 8405MedStar Washington Hospital Center, Washington, DC, USA. [Bala M] Acute Care Surgery and Trauma Unit, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem Kiriat Hadassah, Jerusalem, Israel. [Sahuquillo J] Servei de Neurocirurgia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain, Vall d'Hebron Barcelona Hospital Campus, and Citerio, Giuseppe [0000-0002-5374-3161]

Subjects
Hub, Health Occupations::Medicine::Specialties, Surgical::Neurosurgery [DISCIPLINES AND OCCUPATIONS], profesiones sanitarias::medicina::especialidades quirúrgicas::neurocirugía [DISCIPLINAS Y OCUPACIONES], Dany cerebral, Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus [PSYCHIATRY AND PSYCHOLOGY], conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso [PSIQUIATRÍA Y PSICOLOGÍA], Neurosurgical Procedures, Wounds and Injuries::Trauma, Nervous System::Craniocerebral Trauma::Brain Injuries::Brain Injuries, Traumatic [DISEASES], Traumatic brain injury, heridas y lesiones::traumatismos del sistema nervioso::traumatismos craneocerebrales::lesiones encefálicas::lesiones encefálicas traumáticas [ENFERMEDADES], Brain Injuries, Traumatic, Humans, Cervell - Ferides i lesions, Research, Presa de decisions, Brain, Otros calificadores::Otros calificadores::/cirugía [Otros calificadores], Management, Spoke, Transfer, Hospitals, Other subheadings::Other subheadings::/surgery [Other subheadings], Hospitalization, Emergency Medicine, Surgery, Sistema nerviós - Cirurgia
Abstract

Acknowledgements: We would like to thank WSES for the support., BACKGROUND: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. METHODS: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. RESULTS: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. CONCLUSIONS: This consensus provides practical recommendations to support clinician's decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.

Published
2023

49. A genome-wide association study of outcome from traumatic brain injury

Author

Mart Kals, Kevin Kunzmann, Livia Parodi, Farid Radmanesh, Lindsay Wilson, Saef Izzy, Christopher D. Anderson, Ava M. Puccio, David O. Okonkwo, Nancy Temkin, Ewout W. Steyerberg, Murray B. Stein, Geoff T. Manley, Andrew I.R. Maas, Sylvia Richardson, Ramon Diaz-Arrastia, Aarno Palotie, Samuli Ripatti, Jonathan Rosand, David K. Menon, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Coburn, Jonathan P. Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire DahyotFizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, GuyLoup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J.A. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Jiyao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, LarsOwe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Ana M. CastañoLeón, Marc Maegele, Marek Majdan, Alex Manara, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia F.J. Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Paul M. Parizel, JeanFrançois Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Isabel Retel Helmrich, Jonathan Rhodes, Sophie Richter, Saulius Rocka, Cecilie Roe, Olav Roise, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan SanchezPorras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Thijs Vande Vyvere, Roel P.J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Janek Frantzén, Ari Katila, Henna-Rikka Maanpää, Jussi Tallus, Opeolu Adeoye, Neeraj Badjatia, Kim Boase, Jason Barber, Yelena Bodien, Randall Chesnut, John D. Corrigan, Karen Crawford, Sureyya Dikmen, Ann-Christine Duhaime, Richard Ellenbogen, Ramana Feeser, Adam R. Ferguson, Brandon Foreman, Raquel Gardner, Etienne Gaudette, Joseph Giacino, Dana Goldman, Luis Gonzalez, Shankar Gopinath, Rao Gullapalli, Claude Hemphill, Gillian Hotz, Sonia Jain, Dirk Keene, Frederick K. Korley, Joel Kramer, Natalie Kreitzer, Harvey Levin, Chris Lindsell, Joan Machamer, Christopher Madden, Geoffrey T. Manley, Alastair Martin, Thomas McAllister, Michael McCrea, Randall Merchant, Pratik Mukherjee, Lindsay Nelson, Laura B Ngwenya, Florence Noel, Amber Nolan, David Okonkwo, Eva Palacios, Daniel Perl, Ava Puccio, Miri Rabinowitz, Claudia Robertson, Angelle Sander, Gabriella Satris, David Schnyer, Seth Seabury, Mark Sherer, Murray Stein, Sabrina Taylor, Arthur Toga, Alex Valadka, Mary Vassar, John K. Yue, Esther Yuh, Ross Zafonte, Public Health, Cell biology, Ragauskas, Arminas, Ročka, Saulius, Tamošuitis, Tomas, Vilcinis, Rimantas, Glocker, Ben, Golubovic, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J. A., Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Jiyao, Johnson, Faye, Jones, Kelly, Karan, Mladen, Kolias, Angelos G., Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, LarsOwe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, Maas, Andrew I. R., CastañoLeón, Ana M., Maegele, Marc, Majdan, Marek, Manara, Alex, Martino, Costanza, Maréchal, Hugues, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menon, David K., Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Negru, Ancuta, Nelson, David, Newcombe, Virginia F. J., Nieboer, Daan, Nyirádi, József, Olubukola, Otesile, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Parizel, Paul M., Payen, JeanFrançois, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Piippo-Karjalainen, Anna, Pirinen, Matti, Pisica, Dana, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Raj, Rahul, Rambadagalla, Malinka, Helmrich, Isabel Retel, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rueckert, Daniel, Rusnák, Martin, Sahuquillo, Juan, Sakowitz, Oliver, SanchezPorras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Sewalt, Charlie, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stevens, Robert, Stewart, William, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Taylor, Mark Steven, Ao, Braden Te, Tenovuo, Olli, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Timmers, Marjolein, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Unterberg, Andreas, Vajkoczy, Peter, Vallance, Shirley, Valeinis, Egils, Vámos, Zoltán, van der Jagt, Mathieu, van der Steen, Gregory, van der Naalt, Joukje, van Dijck, Jeroen T. J. M., van Essen, Thomas A., Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, van Veen, Ernest, Vyvere, Thijs Vande, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Volovici, Victor, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Petar, Wang, Kevin K. W., Åkerlund, Cecilia, Wiegers, Eveline, Williams, Guy, Wilson, Lindsay, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Younsi, Alexander, Zeiler, Frederick A., Zelinkova, Veronika, Amrein, Krisztina, Ziverte, Agate, Zoerle, Tommaso, Izzy, Saef, Radmanesh, Farid, Frantzén, Janek, Katila, Ari, Maanpää, Henna-Rikka, Tallus, Jussi, Adeoye, Opeolu, Badjatia, Neeraj, Andelic, Nada, Boase, Kim, Barber, Jason, Bodien, Yelena, Chesnut, Randall, Corrigan, John D., Crawford, Karen, Diaz-Arrastia, Ramon, Dikmen, Sureyya, Duhaime, Ann-Christine, Ellenbogen, Richard, Andreassen, Lasse, Feeser, Ramana, Ferguson, Adam R., Foreman, Brandon, Gardner, Raquel, Gaudette, Etienne, Giacino, Joseph, Goldman, Dana, Gonzalez, Luis, Gopinath, Shankar, Gullapalli, Rao, Anke, Audny, Hemphill, Claude, Hotz, Gillian, Jain, Sonia, Keene, Dirk, Korley, Frederick K., Kramer, Joel, Kreitzer, Natalie, Levin, Harvey, Lindsell, Chris, Machamer, Joan, Antoni, Anna, Madden, Christopher, Manley, Geoffrey T., Martin, Alastair, McAllister, Thomas, McCrea, Michael, Merchant, Randall, Mukherjee, Pratik, Nelson, Lindsay, Ngwenya, Laura B., Noel, Florence, Audibert, Gérard, Nolan, Amber, Okonkwo, David, Palacios, Eva, Perl, Daniel, Puccio, Ava, Rabinowitz, Miri, Robertson, Claudia, Rosand, Jonathan, Sander, Angelle, Satris, Gabriella, Azouvi, Philippe, Schnyer, David, Seabury, Seth, Sherer, Mark, Stein, Murray, Taylor, Sabrina, Temkin, Nancy, Toga, Arthur, Valadka, Alex, Vassar, Mary, Yue, John K., Azzolini, Maria Luisa, Yuh, Esther, Zafonte, Ross, Carroll, Ellen, Chatfield, Doris A., Coles, Jonathan P., Helmy, Adel, Manktelow, Anne, Outtrim, Joanne G., Bartels, Ronald, Takala, Rikka, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, DahyotFizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Corte, Francesco Della, Boogert, Hugo den, Depreitere, Bart, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, GuyLoup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Molecular Neuroscience and Ageing Research (MOLAR), Kals, M, Kunzmann, K, Parodi, L, Radmanesh, F, Wilson, L, Izzy, S, Anderson, C, Puccio, A, Okonkwo, D, Temkin, N, Steyerberg, E, Stein, M, Manley, G, Citerio, G, Genetic Associations In Neurotrauma (GAIN) Consortium, CENTER-TBI, CABI, MGB, TBIcare Studies, TRACK-TBI, „Elsevier Science' grupė, Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, Institute for Molecular Medicine Finland, Complex Disease Genetics, Research Programs Unit, Centre of Excellence in Complex Disease Genetics, Genomics of Neurological and Neuropsychiatric Disorders, Faculty Common Matters (Faculty of Social Sciences), Department of Public Health, and Biostatistics Helsinki

Subjects
Traumatic, Physical Injury - Accidents and Adverse Effects, Clinical Sciences, LOCI, SUSCEPTIBILITY, Traumatic Brain Injury (TBI), Mannose-Binding Lectin, DISEASE, General Biochemistry, Genetics and Molecular Biology, Traumatic brain injury, Consortia, Recovery, Brain Injuries, Traumatic, Genetics, 2.1 Biological and endogenous factors, Humans, Prospective Studies, Aetiology, Traumatic Head and Spine Injury, Outcome, Human Genome, 3112 Neurosciences, Neurosciences, General Medicine, LECTIN, Brain Disorders, Good Health and Well Being, consortia, genome-wide association study, outcome, recovery, traumatic brain injury, Brain Injuries, Genetic Associations In Neurotrauma (GAIN) Consortium, Public Health and Health Services, Human medicine, Transcriptome, Genome-Wide association study
Abstract

EBioMedicine 77, 103933 (2022). doi:10.1016/j.ebiom.2022.103933, Published by Elsevier, Amsterdam [u.a.]

Published
2022

50. Traumatic brain injury : progress and challenges in prevention, clinical care, and research

Author

Andrew I R Maas, David K Menon, Geoffrey T Manley, Mathew Abrams, Cecilia Åkerlund, Nada Andelic, Marcel Aries, Tom Bashford, Michael J Bell, Yelena G Bodien, Benjamin L Brett, András Büki, Randall M Chesnut, Giuseppe Citerio, David Clark, Betony Clasby, D Jamie Cooper, Endre Czeiter, Marek Czosnyka, Kristen Dams-O'Connor, Véronique De Keyser, Ramon Diaz-Arrastia, Ari Ercole, Thomas A van Essen, Éanna Falvey, Adam R Ferguson, Anthony Figaji, Melinda Fitzgerald, Brandon Foreman, Dashiell Gantner, Guoyi Gao, Joseph Giacino, Benjamin Gravesteijn, Fabian Guiza, Deepak Gupta, Mark Gurnell, Juanita A Haagsma, Flora M Hammond, Gregory Hawryluk, Peter Hutchinson, Mathieu van der Jagt, Sonia Jain, Swati Jain, Ji-yao Jiang, Hope Kent, Angelos Kolias, Erwin J O Kompanje, Fiona Lecky, Hester F Lingsma, Marc Maegele, Marek Majdan, Amy Markowitz, Michael McCrea, Geert Meyfroidt, Ana Mikolić, Stefania Mondello, Pratik Mukherjee, David Nelson, Lindsay D Nelson, Virginia Newcombe, David Okonkwo, Matej Orešič, Wilco Peul, Dana Pisică, Suzanne Polinder, Jennie Ponsford, Louis Puybasset, Rahul Raj, Chiara Robba, Cecilie Røe, Jonathan Rosand, Peter Schueler, David J Sharp, Peter Smielewski, Murray B Stein, Nicole von Steinbüchel, William Stewart, Ewout W Steyerberg, Nino Stocchetti, Nancy Temkin, Olli Tenovuo, Alice Theadom, Ilias Thomas, Abel Torres Espin, Alexis F Turgeon, Andreas Unterberg, Dominique Van Praag, Ernest van Veen, Jan Verheyden, Thijs Vande Vyvere, Kevin K W Wang, Eveline J A Wiegers, W Huw Williams, Lindsay Wilson, Stephen R Wisniewski, Alexander Younsi, John K Yue, Esther L Yuh, Frederick A Zeiler, Marina Zeldovich, Roger Zemek, InTBIR Participants and Investigators, Maas, A, Menon, D, Manley, G, Abrams, M, Åkerlund, C, Andelic, N, Aries, M, Bashford, T, Bell, M, Bodien, Y, Brett, B, Büki, A, Chesnut, R, Citerio, G, Clark, D, Clasby, B, Cooper, D, Czeiter, E, Czosnyka, M, Dams-O'Connor, K, De Keyser, V, Diaz-Arrastia, R, Ercole, A, van Essen, T, Falvey, É, Ferguson, A, Figaji, A, Fitzgerald, M, Foreman, B, Gantner, D, Gao, G, Giacino, J, Gravesteijn, B, Guiza, F, Gupta, D, Gurnell, M, Haagsma, J, Hammond, F, Hawryluk, G, Hutchinson, P, van der Jagt, M, Jain, S, Jiang, J, Kent, H, Kolias, A, Kompanje, E, Lecky, F, Lingsma, H, Maegele, M, Majdan, M, Markowitz, A, Mccrea, M, Meyfroidt, G, Mikolić, A, Mondello, S, Mukherjee, P, Nelson, D, Nelson, L, Newcombe, V, Okonkwo, D, Orešič, M, Peul, W, Pisică, D, Polinder, S, Ponsford, J, Puybasset, L, Raj, R, Robba, C, Røe, C, Rosand, J, Schueler, P, Sharp, D, Smielewski, P, Stein, M, von Steinbüchel, N, Stewart, W, Steyerberg, E, Stocchetti, N, Temkin, N, Tenovuo, O, Theadom, A, Thomas, I, Espin, A, Turgeon, A, Unterberg, A, Van Praag, D, van Veen, E, Verheyden, J, Vyvere, T, Wang, K, Wiegers, E, Williams, W, Wilson, L, Wisniewski, S, Younsi, A, Yue, J, Yuh, E, Zeiler, F, Zeldovich, M, Zemek, R, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Intensive Care, and MUMC+: MA Medische Staf IC (9)

Subjects
NEUROTRAUMA EFFECTIVENESS RESEARCH, OUTCOME PREDICTION, PREHOSPITAL TRIAGE TOOLS, COMMON DATA ELEMENTS, Violence, INTENSIVE-CARE, CEREBRAL PERFUSION-PRESSURE, POSTTRAUMATIC-STRESS-DISORDER, Cost of Illness, LIFE-SUSTAINING THERAPY, CT HEAD RULE, Brain Injuries, Traumatic, Humans, Neurology (clinical), MAJOR TRAUMA, Human medicine, Sports
Abstract

Traumatic brain injury (TBI) has the highest incidence of all common neurological disorders, and poses a substantial public health burden. TBI is increasingly documented not only as an acute condition but also as a chronic disease with long-term consequences, including an increased risk of late-onset neurodegeneration. The first Lancet Neurology Commission on TBI, published in 2017, called for a concerted effort to tackle the global health problem posed by TBI. Since then, funding agencies have supported research both in high-income countries (HICs) and in low-income and middle-income countries (LMICs). In November 2020, the World Health Assembly, the decision-making body of WHO, passed resolution WHA73.10 for global actions on epilepsy and other neurological disorders, and WHO launched the Decade for Action on Road Safety plan in 2021. New knowledge has been generated by large observational studies, including those conducted under the umbrella of the International Traumatic Brain Injury Research (InTBIR) initiative, established as a collaboration of funding agencies in 2011. InTBIR has also provided a huge stimulus to collaborative research in TBI and has facilitated participation of global partners. The return on investment has been high, but many needs of patients with TBI remain unaddressed. This update to the 2017 Commission presents advances and discusses persisting and new challenges in prevention, clinical care, and research.

Published
2022

Catalog

Books, media, physical & digital resources
See catalog results