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

Author: van Essen, T, Lingsma, H, Pisică, D, Singh, R, Volovici, V, den Boogert, H, Younsi, A, Peppel, L, Heijenbrok-Kal, M, Ribbers, G, Walchenbach, R, Citerio, G, van Essen TA, Lingsma HF, Pisică D, Singh RD, Volovici V, den Boogert HF, Younsi A, Peppel LD, Heijenbrok-Kal MH, Ribbers GM, Walchenbach R, Citerio G, van Essen, T, Lingsma, H, Pisică, D, Singh, R, Volovici, V, den Boogert, H, Younsi, A, Peppel, L, Heijenbrok-Kal, M, Ribbers, G, Walchenbach, R, Citerio, G, van Essen TA, Lingsma HF, Pisică D, Singh RD, Volovici V, den Boogert HF, Younsi A, Peppel LD, Heijenbrok-Kal MH, Ribbers GM, Walchenbach R, and Citerio G
Abstract: Background: Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma. Methods: We did a prospective, observational, comparative effectiveness study using data from participants enrolled in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We included patients with no pre-existing severe neurological disorders who presented with acute subdural haematoma within 24 h of traumatic brain injury. Using an instrumental variable analysis, we compared outcomes between centres according to treatment preference for acute subdural haematoma (acute surgical evacuation or initial conservative treatment), measured by the case-mix-adjusted percentage of acute surgery per centre. The primary endpoint was functional outcome at 6 months as rated with the Glasgow Outcome Scale Extended, which was estimated with ordinal regression as a common odds ratio (OR) and adjusted for prespecified confounders. Variation in centre preference was quantified with the median OR (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). Findings: Between Dec 19, 2014 and Dec 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI, of whom 1407 (31%) presented with acute subdural haematoma and were included in our study. Acute surgical evacuation was done in 336 (24%) patients, by craniotomy in 245 (73%) of those patients and by decompressive craniectomy in 91 (27%). Delayed decompressive craniectomy or craniotomy after initial conservative treatment (n=982) occurred in 107 (11%) patients. The percentage of patients who underwent acute surgery ranged from 5·6% to 51·5% (IQR 12·3–35·9) between centres
Published: 2022

2. Comparative effectiveness of decompressive craniectomy versus craniotomy for traumatic acute subdural hematoma (CENTER-TBI): an observational cohort study

Author: van Essen, T, van Erp, I, Lingsma, H, Pisică, D, Yue, J, Singh, R, van Dijck, J, Volovici, V, Younsi, A, Kolias, A, Peppel, L, Heijenbrok-Kal, M, Ribbers, G, Menon, D, Hutchinson, P, Manley, G, Depreitere, B, Steyerberg, E, Maas, A, de Ruiter, G, Peul, W, Åkerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Lozano, G, Carbonara, M, Castaño-León, A, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Čović, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, Boogert, H, Đilvesi, Đ, Dixit, A, Donoghue, E, Dreier, J, Dulière, 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, Golubović, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kompanje, E, Kondziella, D, Kornaropoulos, E, Koskinen, L, Kovács, N, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Maegele, M, Majdan, M, Manara, A, Maréchal, H, Martino, C, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Nair, N, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyirádi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Rădoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorčíková, V, Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnák, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schäfer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Kowark, A, Stevens, R, Stewart, W, Stocchetti, N, Sundström, N, Takala, R, Tamás, V, Tamosuitis, T, Taylor, M, 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, Vámos, Z, Van der Jagt, M, van der Naalt, J, Van der Steen, G, Van Hecke, W, van Heugten, C, Van Praag, D, Van Veen, E, van Wijk, R, Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, von Steinbüchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Winzeck, S, Wolf, S, Yang, Z, Ylén, P, Zeiler, F, Ziverte, A, Zoerle, T, van Essen, Thomas A., van Erp, Inge A. M., Lingsma, Hester F., Pisică, Dana, Yue, John K., Singh, Ranjit D., van Dijck, Jeroen T. J. M., Volovici, Victor, Younsi, Alexander, Kolias, Angelos, Peppel, Lianne D., Heijenbrok-Kal, Majanka, Ribbers, Gerard M., Menon, David K., Hutchinson, Peter J. A., Manley, Geoffrey T., Depreitere, Bart, Steyerberg, Ewout W., Maas, Andrew I. R., de Ruiter, Godard C. W., Peul, Wilco C., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark Steven, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, Boogert, Hugo den, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubović, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J., Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, Kolias, Angelos G., Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Maréchal, Hugues, Martino, Costanza, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menon, David, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Nair, Nandesh, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Oresic, Matej, Ortolano, Fabrizio, Otesile, Olubukola, Palotie, Aarno, Parizel, Paul M., Payen, Jean-François, 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, Rădoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Rehorčíková, Veronika, Helmrich, Isabel Retel, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rueckert, Daniel, Rusnák, Martin, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Sewalt, Charlie, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Kowark, Ana, Stevens, Robert, Stewart, William, 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, Marjolijn, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Unterberg, Andreas, Vajkoczy, Peter, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, Van der Jagt, Mathieu, van der Naalt, Joukje, Van der Steen, Gregory, Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, Van Veen, Ernest, van Wijk, Roel, Vyvere, Thijs Vande, Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Petar, Wang, Kevin K. W., Wiegers, Eveline, Williams, Guy, Wilson, Lindsay, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Zeiler, Frederick A., Ziverte, Agate, Zoerle, Tommaso, van Essen, T, van Erp, I, Lingsma, H, Pisică, D, Yue, J, Singh, R, van Dijck, J, Volovici, V, Younsi, A, Kolias, A, Peppel, L, Heijenbrok-Kal, M, Ribbers, G, Menon, D, Hutchinson, P, Manley, G, Depreitere, B, Steyerberg, E, Maas, A, de Ruiter, G, Peul, W, Åkerlund, C, Amrein, K, Andelic, N, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Barzó, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Lozano, G, Carbonara, M, Castaño-León, A, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Čović, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, Dawes, H, De Keyser, V, Degos, V, Della Corte, F, Boogert, H, Đilvesi, Đ, Dixit, A, Donoghue, E, Dreier, J, Dulière, 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, Golubović, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kompanje, E, Kondziella, D, Kornaropoulos, E, Koskinen, L, Kovács, N, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Maegele, M, Majdan, M, Manara, A, Maréchal, H, Martino, C, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Nair, N, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyirádi, J, Oresic, M, Ortolano, F, Otesile, O, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Piippo-Karjalainen, A, Pirinen, M, Pisica, D, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Rădoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorčíková, V, Helmrich, I, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roe, C, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnák, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schäfer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Kowark, A, Stevens, R, Stewart, W, Stocchetti, N, Sundström, N, Takala, R, Tamás, V, Tamosuitis, T, Taylor, M, 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, Vámos, Z, Van der Jagt, M, van der Naalt, J, Van der Steen, G, Van Hecke, W, van Heugten, C, Van Praag, D, Van Veen, E, van Wijk, R, Vyvere, T, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, von Steinbüchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Winzeck, S, Wolf, S, Yang, Z, Ylén, P, Zeiler, F, Ziverte, A, Zoerle, T, van Essen, Thomas A., van Erp, Inge A. M., Lingsma, Hester F., Pisică, Dana, Yue, John K., Singh, Ranjit D., van Dijck, Jeroen T. J. M., Volovici, Victor, Younsi, Alexander, Kolias, Angelos, Peppel, Lianne D., Heijenbrok-Kal, Majanka, Ribbers, Gerard M., Menon, David K., Hutchinson, Peter J. A., Manley, Geoffrey T., Depreitere, Bart, Steyerberg, Ewout W., Maas, Andrew I. R., de Ruiter, Godard C. W., Peul, Wilco C., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Barzó, Pál, Beauvais, Romuald, Beer, Ronny, Bellander, Bo-Michael, Belli, Antonio, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Blaabjerg, Morten, Bragge, Peter, Brazinova, Alexandra, Brinck, Vibeke, Brooker, Joanne, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Carbonara, Marco, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Clusmann, Hans, Coburn, Mark Steven, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Čović, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, Dawes, Helen, De Keyser, Véronique, Degos, Vincent, Della Corte, Francesco, Boogert, Hugo den, Đilvesi, Đula, Dixit, Abhishek, Donoghue, Emma, Dreier, Jens, Dulière, Guy-Loup, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gantner, Dashiell, Gao, Guoyi, George, Pradeep, Ghuysen, Alexandre, Giga, Lelde, Glocker, Ben, Golubović, Jagoš, Gomez, Pedro A., Gratz, Johannes, Gravesteijn, Benjamin, Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Haitsma, Iain, Helbok, Raimund, Helseth, Eirik, Horton, Lindsay, Huijben, Jilske, Hutchinson, Peter J., Jacobs, Bram, Jankowski, Stefan, Jarrett, Mike, Jiang, Ji-yao, Johnson, Faye, Jones, Kelly, Karan, Mladen, Kolias, Angelos G., Kompanje, Erwin, Kondziella, Daniel, Kornaropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Ledoux, Didier, Lefering, Rolf, Legrand, Valerie, Lejeune, Aurelie, Levi, Leon, Lightfoot, Roger, Lingsma, Hester, Maegele, Marc, Majdan, Marek, Manara, Alex, Manley, Geoffrey, Maréchal, Hugues, Martino, Costanza, Mattern, Julia, McMahon, Catherine, Melegh, Béla, Menon, David, Menovsky, Tomas, Mikolic, Ana, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Nair, Nandesh, Negru, Ancuta, Nelson, David, Newcombe, Virginia, Nieboer, Daan, Nyirádi, József, Oresic, Matej, Ortolano, Fabrizio, Otesile, Olubukola, Palotie, Aarno, Parizel, Paul M., Payen, Jean-François, 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, Rădoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Rehorčíková, Veronika, Helmrich, Isabel Retel, Rhodes, Jonathan, Richardson, Sylvia, Richter, Sophie, Ripatti, Samuli, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rueckert, Daniel, Rusnák, Martin, Sahuquillo, Juan, Sakowitz, Oliver, Sanchez-Porras, Renan, Sandor, Janos, Schäfer, Nadine, Schmidt, Silke, Schoechl, Herbert, Schoonman, Guus, Schou, Rico Frederik, Schwendenwein, Elisabeth, Sewalt, Charlie, Skandsen, Toril, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Kowark, Ana, Stevens, Robert, Stewart, William, 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, Marjolijn, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Unterberg, Andreas, Vajkoczy, Peter, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, Van der Jagt, Mathieu, van der Naalt, Joukje, Van der Steen, Gregory, Van Hecke, Wim, van Heugten, Caroline, Van Praag, Dominique, Van Veen, Ernest, van Wijk, Roel, Vyvere, Thijs Vande, Vargiolu, Alessia, Vega, Emmanuel, Velt, Kimberley, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, von Steinbüchel, Nicole, Voormolen, Daphne, Vulekovic, Petar, Wang, Kevin K. W., Wiegers, Eveline, Williams, Guy, Wilson, Lindsay, Winzeck, Stefan, Wolf, Stefan, Yang, Zhihui, Ylén, Peter, Zeiler, Frederick A., Ziverte, Agate, and Zoerle, Tommaso
Abstract: Background: Limited evidence existed on the comparative effectiveness of decompressive craniectomy (DC) versus craniotomy for evacuation of traumatic acute subdural hematoma (ASDH) until the recently published randomised clinical trial RESCUE-ASDH. In this study, that ran concurrently, we aimed to determine current practice patterns and compare outcomes of primary DC versus craniotomy. Methods: We conducted an analysis of centre treatment preference within the prospective, multicentre, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (known as CENTER-TBI) and NeuroTraumatology Quality Registry (known as Net-QuRe) studies, which enrolled patients throughout Europe and Israel (2014–2020). We included patients with an ASDH who underwent acute neurosurgical evacuation. Patients with severe pre-existing neurological disorders were excluded. In an instrumental variable analysis, we compared outcomes between centres according to treatment preference, measured by the case-mix adjusted proportion DC per centre. The primary outcome was functional outcome rated by the 6-months Glasgow Outcome Scale Extended, estimated with ordinal regression as a common odds ratio (OR), adjusted for prespecified confounders. Variation in centre preference was quantified with the median odds ratio (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). Findings: Between December 19, 2014 and December 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI of whom 336 (7%) underwent acute surgery for ASDH evacuation; 91 (27%) underwent DC and 245 (63%) craniotomy. The proportion primary DC within total acute surgery cases ranged from 6 to 67% with an interquartile range (IQR) of 12–26% among 46 centres; the odds of receiving a DC for prognostically similar patients in one centre versus another randomly selected centre were
Published: 2023

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

Author: Volovici, V, Pisică, D, Gravesteijn, B, Dirven, C, Steyerberg, E, Ercole, A, Stocchetti, N, Nelson, D, Menon, D, Citerio, G, van der Jagt, M, Maas, A, Haitsma, I, Lingsma, H, Åkerlund, C, Amrein, K, Andelic, N, Andreassen, L, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Beer, R, Bellander, B, Benali, H, Berardino, M, Beretta, L, Beqiri, E, Blaabjerg, M, Lund, S, Brorsson, C, Buki, A, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Lozano, G, Castaño-León, A, Cavallo, S, Chevallard, G, Chieregato, A, Coburn, M, Coles, J, Cooper, J, Correia, M, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, De Keyser, V, Degos, V, Corte, F, Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Dreier, J, Dulière, G, Ezer, E, Fabricius, M, Foks, K, Frisvold, S, Furmanov, A, Galanaud, D, Gantner, D, Ghuysen, A, Giga, L, Golubovic, J, Gomez, P, Grossi, F, Gupta, D, Helseth, E, Hutchinson, P, Jankowski, S, Johnson, F, Karan, M, Kolias, A, Kondziella, D, Koraropoulos, E, Koskinen, L, Kovács, N, Kowark, A, Lagares, A, Laureys, S, Ledoux, D, Lejeune, A, Lightfoot, R, Manara, A, Martino, C, Maréchal, H, Mattern, J, Mcmahon, C, Menovsky, T, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Newcombe, V, Nyirádi, J, Ortolano, F, Payen, J, Perlbarg, V, Persona, P, Piippo-Karjalainen, A, Ples, H, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rhodes, J, Richter, S, Rocka, S, Roe, C, Roise, O, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Sahuquillo, J, Sandrød, O, Sakowitz, O, Sanchez-Porras, R, Schirmer-Mikalsen, K, Schou, R, Smielewski, P, Sorinola, A, Stamatakis, E, Sundström, N, Takala, R, Tamás, V, Tamosuitis, T, Tenovuo, O, Thomas, M, Tibboel, D, Tolias, C, Trapani, T, Tudora, C, Vajkoczy, P, Vallance, S, Valeinis, E, Vámos, Z, Van der Steen, G, van Wijk, R, Vargiolu, A, Vega, E, Vik, A, Vilcinis, R, Vulekovic, P, Williams, G, Winzeck, S, Wolf, S, Younsi, A, Zeiler, F, Ziverte, A, Clusmann, H, Voormolen, D, van&nbsp, Dijck, J, van Essen, T, Volovici, Victor, Pisică, Dana, Gravesteijn, Benjamin Y., Dirven, Clemens M. F., Steyerberg, Ewout W., Ercole, Ari, Stocchetti, Nino, Nelson, David, Menon, David K., Citerio, Giuseppe, van der Jagt, Mathieu, Maas, Andrew I. R., Haitsma, Iain K., Lingsma, Hester F., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Beer, Ronny, Bellander, Bo-Michael, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Beqiri, Erta, Blaabjerg, Morten, Lund, Stine Borgen, Brorsson, Camilla, Buki, Andras, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, De Keyser, Véronique, Degos, Vincent, Corte, Francesco Della, Boogert, Hugo den, Depreitere, Bart, Dilvesi, Dula, Dixit, Abhishek, Dreier, Jens, Dulière, Guy-Loup, Ezer, Erzsébet, Fabricius, Martin, Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Galanaud, Damien, Gantner, Dashiell, Ghuysen, Alexandre, Giga, Lelde, Golubovic, Jagos, Gomez, Pedro A., Grossi, Francesca, Gupta, Deepak, Haitsma, Iain, Helseth, Eirik, Hutchinson, Peter J., Jankowski, Stefan, Johnson, Faye, Karan, Mladen, Kolias, Angelos G., Kondziella, Daniel, Koraropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Laureys, Steven, Ledoux, Didier, Lejeune, Aurelie, Lightfoot, Roger, Manara, Alex, Martino, Costanza, Maréchal, Hugues, Mattern, Julia, McMahon, Catherine, Menovsky, Tomas, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Negru, Ancuta, Newcombe, Virginia, Nyirádi, József, Ortolano, Fabrizio, Payen, Jean-François, Perlbarg, Vincent, Persona, Paolo, Piippo-Karjalainen, Anna, Ples, Horia, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rhodes, Jonathan, Richter, Sophie, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Sahuquillo, Juan, Sandrød, Oddrun, Sakowitz, Oliver, Sanchez-Porras, Renan, Schirmer-Mikalsen, Kari, Schou, Rico Frederik, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Tenovuo, Olli, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Vajkoczy, Peter, Vallance, Shirley, Valeinis, Egils, Vámos, Zoltán, Van der Steen, Gregory, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Vik, Anne, Vilcinis, Rimantas, Vulekovic, Petar, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Younsi, Alexander, Zeiler, Frederick A., Ziverte, Agate, Clusmann, Hans, Voormolen, Daphne, Dijck, Jeroen T. J. M., van Essen, Thomas A., Volovici, V, Pisică, D, Gravesteijn, B, Dirven, C, Steyerberg, E, Ercole, A, Stocchetti, N, Nelson, D, Menon, D, Citerio, G, van der Jagt, M, Maas, A, Haitsma, I, Lingsma, H, Åkerlund, C, Amrein, K, Andelic, N, Andreassen, L, Audibert, G, Azouvi, P, Azzolini, M, Bartels, R, Beer, R, Bellander, B, Benali, H, Berardino, M, Beretta, L, Beqiri, E, Blaabjerg, M, Lund, S, Brorsson, C, Buki, A, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Lozano, G, Castaño-León, A, Cavallo, S, Chevallard, G, Chieregato, A, Coburn, M, Coles, J, Cooper, J, Correia, M, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, De Keyser, V, Degos, V, Corte, F, Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Dreier, J, Dulière, G, Ezer, E, Fabricius, M, Foks, K, Frisvold, S, Furmanov, A, Galanaud, D, Gantner, D, Ghuysen, A, Giga, L, Golubovic, J, Gomez, P, Grossi, F, Gupta, D, Helseth, E, Hutchinson, P, Jankowski, S, Johnson, F, Karan, M, Kolias, A, Kondziella, D, Koraropoulos, E, Koskinen, L, Kovács, N, Kowark, A, Lagares, A, Laureys, S, Ledoux, D, Lejeune, A, Lightfoot, R, Manara, A, Martino, C, Maréchal, H, Mattern, J, Mcmahon, C, Menovsky, T, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Newcombe, V, Nyirádi, J, Ortolano, F, Payen, J, Perlbarg, V, Persona, P, Piippo-Karjalainen, A, Ples, H, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rhodes, J, Richter, S, Rocka, S, Roe, C, Roise, O, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Sahuquillo, J, Sandrød, O, Sakowitz, O, Sanchez-Porras, R, Schirmer-Mikalsen, K, Schou, R, Smielewski, P, Sorinola, A, Stamatakis, E, Sundström, N, Takala, R, Tamás, V, Tamosuitis, T, Tenovuo, O, Thomas, M, Tibboel, D, Tolias, C, Trapani, T, Tudora, C, Vajkoczy, P, Vallance, S, Valeinis, E, Vámos, Z, Van der Steen, G, van Wijk, R, Vargiolu, A, Vega, E, Vik, A, Vilcinis, R, Vulekovic, P, Williams, G, Winzeck, S, Wolf, S, Younsi, A, Zeiler, F, Ziverte, A, Clusmann, H, Voormolen, D, van&nbsp, Dijck, J, van Essen, T, Volovici, Victor, Pisică, Dana, Gravesteijn, Benjamin Y., Dirven, Clemens M. F., Steyerberg, Ewout W., Ercole, Ari, Stocchetti, Nino, Nelson, David, Menon, David K., Citerio, Giuseppe, van der Jagt, Mathieu, Maas, Andrew I. R., Haitsma, Iain K., Lingsma, Hester F., Åkerlund, Cecilia, Amrein, Krisztina, Andelic, Nada, Andreassen, Lasse, Audibert, Gérard, Azouvi, Philippe, Azzolini, Maria Luisa, Bartels, Ronald, Beer, Ronny, Bellander, Bo-Michael, Benali, Habib, Berardino, Maurizio, Beretta, Luigi, Beqiri, Erta, Blaabjerg, Morten, Lund, Stine Borgen, Brorsson, Camilla, Buki, Andras, Cabeleira, Manuel, Caccioppola, Alessio, Calappi, Emiliana, Calvi, Maria Rosa, Cameron, Peter, Lozano, Guillermo Carbayo, Castaño-León, Ana M., Cavallo, Simona, Chevallard, Giorgio, Chieregato, Arturo, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Dark, Paul, De Keyser, Véronique, Degos, Vincent, Corte, Francesco Della, Boogert, Hugo den, Depreitere, Bart, Dilvesi, Dula, Dixit, Abhishek, Dreier, Jens, Dulière, Guy-Loup, Ezer, Erzsébet, Fabricius, Martin, Foks, Kelly, Frisvold, Shirin, Furmanov, Alex, Galanaud, Damien, Gantner, Dashiell, Ghuysen, Alexandre, Giga, Lelde, Golubovic, Jagos, Gomez, Pedro A., Grossi, Francesca, Gupta, Deepak, Haitsma, Iain, Helseth, Eirik, Hutchinson, Peter J., Jankowski, Stefan, Johnson, Faye, Karan, Mladen, Kolias, Angelos G., Kondziella, Daniel, Koraropoulos, Evgenios, Koskinen, Lars-Owe, Kovács, Noémi, Kowark, Ana, Lagares, Alfonso, Laureys, Steven, Ledoux, Didier, Lejeune, Aurelie, Lightfoot, Roger, Manara, Alex, Martino, Costanza, Maréchal, Hugues, Mattern, Julia, McMahon, Catherine, Menovsky, Tomas, Misset, Benoit, Muraleedharan, Visakh, Murray, Lynnette, Negru, Ancuta, Newcombe, Virginia, Nyirádi, József, Ortolano, Fabrizio, Payen, Jean-François, Perlbarg, Vincent, Persona, Paolo, Piippo-Karjalainen, Anna, Ples, Horia, Pomposo, Inigo, Posti, Jussi P., Puybasset, Louis, Radoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Rhodes, Jonathan, Richter, Sophie, Rocka, Saulius, Roe, Cecilie, Roise, Olav, Rosenfeld, Jeffrey V., Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Sahuquillo, Juan, Sandrød, Oddrun, Sakowitz, Oliver, Sanchez-Porras, Renan, Schirmer-Mikalsen, Kari, Schou, Rico Frederik, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Sundström, Nina, Takala, Riikka, Tamás, Viktória, Tamosuitis, Tomas, Tenovuo, Olli, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Trapani, Tony, Tudora, Cristina Maria, Vajkoczy, Peter, Vallance, Shirley, Valeinis, Egils, Vámos, Zoltán, Van der Steen, Gregory, van Wijk, Roel P. J., Vargiolu, Alessia, Vega, Emmanuel, Vik, Anne, Vilcinis, Rimantas, Vulekovic, Petar, Williams, Guy, Winzeck, Stefan, Wolf, Stefan, Younsi, Alexander, Zeiler, Frederick A., Ziverte, Agate, Clusmann, Hans, Voormolen, Daphne, Dijck, Jeroen T. J. M., and van Essen, Thomas A.
Abstract: Objective: To compare outcomes between patients with primary external ventricular device (EVD)–driven treatment of intracranial hypertension and those with primary intraparenchymal monitor (IP)–driven treatment. Methods: The CENTER-TBI study is a prospective, multicenter, longitudinal observational cohort study that enrolled patients of all TBI severities from 62 participating centers (mainly level I trauma centers) across Europe between 2015 and 2017. Functional outcome was assessed at 6 months and a year. We used multivariable adjusted instrumental variable (IV) analysis with “center” as instrument and logistic regression with covariate adjustment to determine the effect estimate of EVD on 6-month functional outcome. Results: A total of 878 patients of all TBI severities with an indication for intracranial pressure (ICP) monitoring were included in the present study, of whom 739 (84%) patients had an IP monitor and 139 (16%) an EVD. Patients included were predominantly male (74% in the IP monitor and 76% in the EVD group), with a median age of 46 years in the IP group and 48 in the EVD group. Six-month GOS-E was similar between IP and EVD patients (adjusted odds ratio (aOR) and 95% confidence interval [CI] OR 0.74 and 95% CI [0.36–1.52], adjusted IV analysis). The length of intensive care unit stay was greater in the EVD group than in the IP group (adjusted rate ratio [95% CI] 1.70 [1.34–2.12], IV analysis). One hundred eighty-seven of the 739 patients in the IP group (25%) required an EVD due to refractory ICPs. Conclusion: We found no major differences in outcomes of patients with TBI when comparing EVD-guided and IP monitor–guided ICP management. In our cohort, a quarter of patients that initially received an IP monitor required an EVD later for ICP control. The prevalence of complications was higher in the EVD group. Protocol: The core study is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (RRID: SCR_015582).
Published: 2022

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

Author: Essen, T.A. van, Lingsma, H.F., Pisică, D., Singh, R.D., Volovici, V., Boogert, H.F. den, Younsi, A., Peppel, L.D., Heijenbrok-Kal, M.H., Ribbers, G.M., Walchenbach, R., Menon, D.K., Hutchinson, P., Depreitere, B., Steyerberg, Ewout W., Maas, A.I., Ruiter, G.C.W. de, Peul, W.C., Essen, T.A. van, Lingsma, H.F., Pisică, D., Singh, R.D., Volovici, V., Boogert, H.F. den, Younsi, A., Peppel, L.D., Heijenbrok-Kal, M.H., Ribbers, G.M., Walchenbach, R., Menon, D.K., Hutchinson, P., Depreitere, B., Steyerberg, Ewout W., Maas, A.I., Ruiter, G.C.W. de, and Peul, W.C.
Abstract: Item does not contain fulltext, BACKGROUND: Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma. METHODS: We did a prospective, observational, comparative effectiveness study using data from participants enrolled in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We included patients with no pre-existing severe neurological disorders who presented with acute subdural haematoma within 24 h of traumatic brain injury. Using an instrumental variable analysis, we compared outcomes between centres according to treatment preference for acute subdural haematoma (acute surgical evacuation or initial conservative treatment), measured by the case-mix-adjusted percentage of acute surgery per centre. The primary endpoint was functional outcome at 6 months as rated with the Glasgow Outcome Scale Extended, which was estimated with ordinal regression as a common odds ratio (OR) and adjusted for prespecified confounders. Variation in centre preference was quantified with the median OR (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). FINDINGS: Between Dec 19, 2014 and Dec 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI, of whom 1407 (31%) presented with acute subdural haematoma and were included in our study. Acute surgical evacuation was done in 336 (24%) patients, by craniotomy in 245 (73%) of those patients and by decompressive craniectomy in 91 (27%). Delayed decompressive craniectomy or craniotomy after initial conservative treatment (n=982) occurred in 107 (11%) patients. The percentage of patients who underwent acute surgery ranged from 5·6% to 51·5% (IQR 12·3-35·9) between centres
Published: 2022

5. 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

6. Surgery versus conservative treatment for traumatic acute subdural hematoma: a prospective, multicentre, comparative effectiveness study

Author: Van Essen, T.A., Lingsma, H.F., Pisică, D., Singh, R.D., Volovici, V., Boogert, H.F. den, Younsi, A., Peppel, L.D., Heijenbrok-Kal, M.H., Ribbers, G.M., Walchenbach, R., Menon, D.K., Hutchinson, P., Depreitere, B., Steyerberg, E.W., Maas, A.I.R., and Peul, W.C.
Published: 2022
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7. Early surgery versus conservative treatment in patients with traumatic intracerebral hematoma: a CENTER-TBI study

Author: van Erp, I.A.M., van Essen, T.A., Lingsma, H., Pisica, D., Singh, R.D., van Dijck, J.T.J.M., Volovici, V., Kolias, A., Peppel, L.D., Heijenbrok-Kal, M., Ribbers, G.M., Menon, D., Hutchinson, P., Depreitere, B., Steyerberg, E.W., Maas, A.I.R., de Ruiter, G.C.W., and Peul, W.C.
Published: 2022
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8. Surgery versus conservative treatment for traumatic acute subdural haematoma: a prospective, multicentre, observational, comparative effectiveness study

Author: Thomas A van Essen, Hester F Lingsma, Dana Pisică, Ranjit D Singh, Victor Volovici, Hugo F den Boogert, Alexander Younsi, Lianne D Peppel, Majanka H Heijenbrok-Kal, Gerard M Ribbers, Robert Walchenbach, David K Menon, Peter Hutchinson, Bart Depreitere, Ewout W Steyerberg, Andrew I R Maas, Godard C W de Ruiter, Wilco C Peul, 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, Ana M. Castaño-León, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Steven Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, 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 Golubović, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Hugues Maréchal, Costanza Martino, Julia Mattern, Catherine McMahon, Béla Melegh, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, 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, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Rădoi, 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, Jonathan Rosand, 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, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Ana Kowark, 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, 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, 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, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Frederick A. Zeiler, Agate Ziverte, Tommaso Zoerle, CENTER-TBI Collaboration Group, Molecular Neuroscience and Ageing Research (MOLAR), Public Health, Neurosurgery, Rehabilitation Medicine, van Essen, T, Lingsma, H, Pisică, D, Singh, R, Volovici, V, den Boogert, H, Younsi, A, Peppel, L, Heijenbrok-Kal, M, Ribbers, G, Walchenbach, R, and Citerio, G
Subjects: Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Brain Injuries, Traumatic, traumatic acute subdural haematoma, Glasgow Outcome Scale, Hematoma, Subdural, Acute, Humans, Surgery, Prospective Studies, Neurology (clinical), Human medicine, Conservative Treatment
Abstract: Contains fulltext : 251563.pdf (Publisher’s version ) (Closed access) BACKGROUND: Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma. METHODS: We did a prospective, observational, comparative effectiveness study using data from participants enrolled in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We included patients with no pre-existing severe neurological disorders who presented with acute subdural haematoma within 24 h of traumatic brain injury. Using an instrumental variable analysis, we compared outcomes between centres according to treatment preference for acute subdural haematoma (acute surgical evacuation or initial conservative treatment), measured by the case-mix-adjusted percentage of acute surgery per centre. The primary endpoint was functional outcome at 6 months as rated with the Glasgow Outcome Scale Extended, which was estimated with ordinal regression as a common odds ratio (OR) and adjusted for prespecified confounders. Variation in centre preference was quantified with the median OR (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). FINDINGS: Between Dec 19, 2014 and Dec 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI, of whom 1407 (31%) presented with acute subdural haematoma and were included in our study. Acute surgical evacuation was done in 336 (24%) patients, by craniotomy in 245 (73%) of those patients and by decompressive craniectomy in 91 (27%). Delayed decompressive craniectomy or craniotomy after initial conservative treatment (n=982) occurred in 107 (11%) patients. The percentage of patients who underwent acute surgery ranged from 5·6% to 51·5% (IQR 12·3-35·9) between centres, with a two-times higher probability of receiving acute surgery for an identical patient in one centre versus another centre at random (adjusted MOR for acute surgery 1·8; p
Published: 2022
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9. 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

10. Onco-functional outcome after resection for eloquent glioblastoma (OFO): A propensity-score matched analysis of an international, multicentre, cohort study.

Author: Gerritsen JKW, Mekary RA, Pisică D, Zwarthoed RH, Kilgallon JL, Nawabi NL, Jessurun CAC, Versyck G, Moussa A, Bouhaddou H, Pruijn KP, Fisher FL, Larivière E, Solie L, Kloet A, Tewarie RN, Schouten JW, Bos EM, Dirven CMF, Jacques van den Bent M, Chang SM, Smith TR, Broekman MLD, Vincent AJPE, and De Vleeschouwer PS
Subjects: Humans, Female, Male, Middle Aged, Aged, Propensity Score, Adult, Neurosurgical Procedures adverse effects, Neurosurgical Procedures methods, Retrospective Studies, Treatment Outcome, Glioblastoma surgery, Glioblastoma mortality, Brain Neoplasms surgery, Brain Neoplasms mortality, Brain Neoplasms pathology
Abstract: Background: The combined impact of complete resection (oncological goal) and no functional loss (functional goal) in glioblastoma subgroups is currently unknown. This study aimed to develop a novel onco-functional outcome (OFO) to merge these two goals into one outcome, resulting in four classes: complete without deficits (OFO1), incomplete without deficits (OFO2), complete with deficits (OFO3), or incomplete with deficits (OFO4)., Methods: Between 2010-2020, 858 patients with tumor resection for eloquent glioblastoma were included. We analyzed the impact of OFO class on postoperative surgical outcomes using Cox proportional-hazards models with hazard ratios (HR) or logistic regression with odds ratios (OR), followed by specific subgroup analyses. We developed a risk model to predict OFO class preoperatively using logistic regression., Results: The OFO classification stratified the four OFO classes for overall survival (OS:19.0 versus 14.0 versus 12.0 versus 9.0 months), progression-free survival (PFS), and adjuvant therapy. OFO1 was associated with improved OS [HR= 0.67, (0.55-0.81); p < 0.001], and PFS [HR = 0.68, (0.57-0.81); p < 0.001] in the overall cohort and all clinical and molecular subgroups, except for MGMT-unmethylated tumors; and higher rate of adjuvant therapy [OR= 2.81, (1.71-4.84);p < 0.001]. In patients≥ 70 years, only OFO1 improved their survival outcomes. Safe surgery was especially important in patients with a preoperative KPS ≤ 80 to qualify for adjuvant treatment. Awake craniotomy more often led to OFO1 compared to asleep resection [OR = 1.93, (1.19-3.14); p = 0.008]., Conclusions: OFO1 was associated with improved OS, PFS, and receipt of adjuvant therapy in all glioblastoma patients with IDH-wildtype and MGMT-methylated tumors. Awake craniotomy was associated with achieving this optimal OFO status. Preventing deficits was more important than complete surgery., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. MvdB has received honoraria for consultancy from Anheart Therapeutics, Boehringer Ingelheim, Fore Biotherapeutics, Genenta, Incyte, Mundipharm, Chimerix, Roche, and Servier. All remaining authors have declared no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Published: 2024
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11. Clinical profile of patients with acute traumatic brain injury undergoing cranial surgery in the United States: report from the 18-centre TRACK-TBI cohort study.

Author: Yue JK, Kanter JH, Barber JK, Huang MC, van Essen TA, Elguindy MM, Foreman B, Korley FK, Belton PJ, Pisică D, Lee YM, Kitagawa RS, Vassar MJ, Sun X, Satris GG, Wong JC, Ferguson AR, Huie JR, Wang KKW, Deng H, Wang VY, Bodien YG, Taylor SR, Madhok DY, McCrea MA, Ngwenya LB, DiGiorgio AM, Tarapore PE, Stein MB, Puccio AM, Giacino JT, Diaz-Arrastia R, Lingsma HF, Mukherjee P, Yuh EL, Robertson CS, Menon DK, Maas AIR, Markowitz AJ, Jain S, Okonkwo DO, Temkin NR, and Manley GT
Abstract: Background: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery., Methods: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014-2018; ClinicalTrials.gov #NCT02119182) enrolled subjects who presented to trauma centre and received head computed tomography within 24-h (h) post-TBI. We performed a secondary data analysis in subjects aged ≥17-years with hospitalisation. Clinical characteristics, surgery type/timing, hospital and six-month outcomes were reported., Findings: Of 2032 subjects (age: mean = 41.4-years, range = 17-89-years; male = 71% female = 29%), 260 underwent cranial surgery, comprising 65% decompressive craniectomy, 23% craniotomy, 12% other surgery. Subjects with surgery (vs. without surgery) presented with worse neurological injury (median Glasgow Coma Scale = 6 vs. 15; midline shift ≥5 mm: 48% vs. 2%; cisternal effacement: 61% vs. 4%; p < 0.0001). Median time-to-craniectomy/craniotomy was 1.8 h (interquartile range = 1.1-5.0 h), and 67% underwent intracranial pressure monitoring. Seventy-three percent of subjects with decompressive craniectomy and 58% of subjects with craniotomy had ≥3 intracranial lesion types. Decompressive craniectomy (vs. craniotomy) was associated with intracranial injury severity (median Rotterdam Score = 4 vs. 3, p < 0.0001), intensive care length of stay (median = 13 vs. 4-days, p = 0.0002), and six-month unfavourable outcome (62% vs. 30%; p = 0.0001). Earlier time-to-craniectomy was associated with intracranial injury severity., Interpretation: In a large representative cohort of patients hospitalised with TBI, surgical decision-making and time-to-surgery aligned with intracranial injury severity. Multifocal TBIs predominated in patients with cranial surgery. These findings summarise current TBI surgical practice across US trauma centres and provide the foundation for analyses in targeted subpopulations., Funding: National Institute of Neurological Disorders and Stroke; US Department of Defense; Neurosurgery Research and Education Foundation., Competing Interests: AMD declares: grant funding from the Mercatus Center at George Mason University (not related to the current work). DKM declares: grant funding from United Kingdom National Institute for Health Research (not related to the current work). KKWW declares: is a shareholder of Gryphon Bio, Inc. (not related to the current work). All other authors declare no conflict of interest., (© 2024 The Author(s).)
Published: 2024
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12. Imaging Findings in Acute Traumatic Brain Injury: a National Institute of Neurological Disorders and Stroke Common Data Element-Based Pictorial Review and Analysis of Over 4000 Admission Brain Computed Tomography Scans from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study.

Author: Vande Vyvere T, Pisică D, Wilms G, Claes L, Van Dyck P, Snoeckx A, van den Hauwe L, Pullens P, Verheyden J, Wintermark M, Dekeyzer S, Mac Donald CL, Maas AIR, and Parizel PM
Subjects: Humans, Adult, Male, Middle Aged, Female, Aged, United States epidemiology, Adolescent, Europe epidemiology, Young Adult, Neuroimaging methods, Neuroimaging standards, Child, Aged, 80 and over, Child, Preschool, Brain Injuries, Traumatic diagnostic imaging, Common Data Elements, Tomography, X-Ray Computed standards, Tomography, X-Ray Computed methods, National Institute of Neurological Disorders and Stroke (U.S.)
Abstract: In 2010, the National Institute of Neurological Disorders and Stroke (NINDS) created a set of common data elements (CDEs) to help standardize the assessment and reporting of imaging findings in traumatic brain injury (TBI). However, as opposed to other standardized radiology reporting systems, a visual overview and data to support the proposed standardized lexicon are lacking. We used over 4000 admission computed tomography (CT) scans of patients with TBI from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study to develop an extensive pictorial overview of the NINDS TBI CDEs, with visual examples and background information on individual pathoanatomical lesion types, up to the level of supplemental and emerging information (e.g., location and estimated volumes). We documented the frequency of lesion occurrence, aiming to quantify the relative importance of different CDEs for characterizing TBI, and performed a critical appraisal of our experience with the intent to inform updating of the CDEs. In addition, we investigated the co-occurrence and clustering of lesion types and the distribution of six CT classification systems. The median age of the 4087 patients in our dataset was 50 years (interquartile range, 29-66; range, 0-96), including 238 patients under 18 years old (5.8%). Traumatic subarachnoid hemorrhage (45.3%), skull fractures (37.4%), contusions (31.3%), and acute subdural hematoma (28.9%) were the most frequently occurring CT findings in acute TBI. The ranking of these lesions was the same in patients with mild TBI (baseline Glasgow Coma Scale [GCS] score 13-15) compared with those with moderate-severe TBI (baseline GCS score 3-12), but the frequency of occurrence was up to three times higher in moderate-severe TBI. In most TBI patients with CT abnormalities, there was co-occurrence and clustering of different lesion types, with significant differences between mild and moderate-severe TBI patients. More specifically, lesion patterns were more complex in moderate-severe TBI patients, with more co-existing lesions and more frequent signs of mass effect. These patients also had higher and more heterogeneous CT score distributions, associated with worse predicted outcomes. The critical appraisal of the NINDS CDEs was highly positive, but revealed that full assessment can be time consuming, that some CDEs had very low frequencies, and identified a few redundancies and ambiguity in some definitions. Whilst primarily developed for research, implementation of CDE templates for use in clinical practice is advocated, but this will require development of an abbreviated version. In conclusion, with this study, we provide an educational resource for clinicians and researchers to help assess, characterize, and report the vast and complex spectrum of imaging findings in patients with TBI. Our data provides a comprehensive overview of the contemporary landscape of TBI imaging pathology in Europe, and the findings can serve as empirical evidence for updating the current NINDS radiologic CDEs to version 3.0.
Published: 2024
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13. Association Between Early External Ventricular Drain Insertion and Functional Outcomes 6 Months Following Moderate-to-Severe Traumatic Brain Injury.

Author: Taylor JD, Bailey M, Cooper DJ, French C, Menon DK, Nichol AD, Pisică D, Udy A, Volovici V, and Higgins AM
Subjects: Humans, Male, Female, Adult, Middle Aged, Treatment Outcome, Recovery of Function physiology, Young Adult, Prospective Studies, Ventriculostomy methods, Glasgow Coma Scale, Intracranial Hypertension etiology, Time Factors, Brain Injuries, Traumatic surgery, Drainage methods
Abstract: Traumatic brain injury (TBI) is a leading global cause of morbidity and mortality. Intracranial hypertension following moderate-to-severe TBI (m-sTBI) is a potentially modifiable secondary cerebral insult and one of the central therapeutic targets of contemporary neurocritical care. External ventricular drain (EVD) insertion is a common therapeutic intervention used to control intracranial hypertension and attenuate secondary brain injury. However, the optimal timing of EVD insertion in the setting of m-sTBI is uncertain and practice variation is widespread. Therefore, we aimed to assess if there is an association between timing of EVD placement and functional neurological outcome at 6 months post m-sTBI. We pooled individual patient data for all relevant harmonizable variables from the Erythropoietin in Traumatic Brain Injury (EPO-TBI) and Prophylactic Hypothermia Trial to Lessen Traumatic Brain Injury (POLAR) randomized control trials, and the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) Core Study version 3.0 and Australia-Europe NeuroTrauma Effectiveness Research in TBI (Oz-ENTER) prospective observational studies to create a combined dataset. The Glasgow Coma Scale (GCS) score was used to define TBI severity and we included all patients admitted to an intensive care unit with a GCS ≤12, who were 15 years or older and underwent EVD placement within 7 days of injury. We used hierarchical multi-variable logistic regression models to study the association between EVD insertion within 24 h of injury (early) compared with EVD insertion more than 24 h after injury (late) and 6-month functional neurological outcome measured using the Glasgow Outcome Score Extended (GOSE). In total, 2536 patients were assessed. Of these, 502 (20%) underwent early EVD insertion and 145 (6%) underwent late EVD insertion. Following adjustment for the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in TBI) score extended (Core + CT), sex, injury severity score, study and treatment site, patients receiving a late EVD had higher odds of death or severe disability (GOSE 1-4) at 6 months follow-up than those receiving an early EVD adjusted odds ratio; 95% confidence interval, 2.14; 1.22-3.76; p = 0.008. Our study suggests that in patients with m-sTBI where an EVD is needed, early (≤ 24 h post-injury) insertion may result in better long-term functional outcomes. This finding supports future prospective investigation in this area.
Published: 2024
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14. Clinical and Imaging Characteristics, Care Pathways, and Outcomes of Traumatic Epidural Hematomas: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Study.

Author: Pisică D, Volovici V, Yue JK, van Essen TA, den Boogert HF, Vande Vyvere T, Haitsma I, Nieboer D, Markowitz AJ, Yuh EL, Steyerberg EW, Peul WC, Dirven CMF, Menon DK, Manley GT, Maas AIR, and Lingsma HF
Abstract: Background and Objectives: Guideline recommendations for surgical management of traumatic epidural hematomas (EDHs) do not directly address EDHs that co-occur with other intracranial hematomas; the relative rates of isolated vs nonisolated EDHs and guideline adherence are unknown. We describe characteristics of a contemporary cohort of patients with EDHs and identify factors influencing acute surgery., Methods: This research was conducted within the longitudinal, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury cohort study which prospectively enrolled patients with traumatic brain injury from 65 hospitals in 18 European countries from 2014 to 2017. All patients with EDH on the first scan were included. We describe clinical, imaging, management, and outcome characteristics and assess associations between site and baseline characteristics and acute EDH surgery, using regression modeling., Results: In 461 patients with EDH, median age was 41 years (IQR 24-56), 76% were male, and median EDH volume was 5 cm3 (IQR 2-20). Concomitant acute subdural hematomas (ASDHs) and/or intraparenchymal hemorrhages were present in 328/461 patients (71%). Acute surgery was performed in 99/461 patients (21%), including 70/86 with EDH volume ≥30 cm3 (81%). Larger EDH volumes (odds ratio [OR] 1.19 [95% CI 1.14-1.24] per cm3 below 30 cm3), smaller ASDH volumes (OR 0.93 [95% CI 0.88-0.97] per cm3), and midline shift (OR 6.63 [95% CI 1.99-22.15]) were associated with acute surgery; between-site variation was observed (median OR 2.08 [95% CI 1.01-3.48]). Six-month Glasgow Outcome Scale-Extended scores ≥5 occurred in 289/389 patients (74%); 41/389 (11%) died., Conclusion: Isolated EDHs are relatively infrequent, and two-thirds of patients harbor concomitant ASDHs and/or intraparenchymal hemorrhages. EDHs ≥30 cm3 are generally evacuated early, adhering to Brain Trauma Foundation guidelines. For heterogeneous intracranial pathology, surgical decision-making is related to clinical status and overall lesion burden. Further research should examine the optimal surgical management of EDH with concomitant lesions in traumatic brain injury, to inform updated guidelines., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Congress of Neurological Surgeons.)
Published: 2024
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15. Performance of the IMPACT and CRASH prognostic models for traumatic brain injury in a contemporary multicenter cohort: a TRACK-TBI study.

Author: Yue JK, Lee YM, Sun X, van Essen TA, Elguindy MM, Belton PJ, Pisică D, Mikolic A, Deng H, Kanter JH, McCrea MA, Bodien YG, Satris GG, Wong JC, Ambati VS, Grandhi R, Puccio AM, Mukherjee P, Valadka AB, Tarapore PE, Huang MC, DiGiorgio AM, Markowitz AJ, Yuh EL, Okonkwo DO, Steyerberg EW, Lingsma HF, Menon DK, Maas AIR, Jain S, and Manley GT
Subjects: Humans, Middle Aged, Female, Prognosis, Male, Adult, Prospective Studies, Aged, Cohort Studies, Young Adult, Adolescent, Brain Injuries, Traumatic mortality, Brain Injuries, Traumatic therapy, Glasgow Outcome Scale, Glasgow Coma Scale
Abstract: Objective: The International Mission on Prognosis and Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) and Corticosteroid Randomization After Significant Head Injury (CRASH) prognostic models for mortality and outcome after traumatic brain injury (TBI) were developed using data from 1984 to 2004. This study examined IMPACT and CRASH model performances in a contemporary cohort of US patients., Methods: The prospective 18-center Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study (enrollment years 2014-2018) enrolled subjects aged ≥ 17 years who presented to level I trauma centers and received head CT within 24 hours of TBI. Data were extracted from the subjects who met the model criteria (for IMPACT, Glasgow Coma Scale [GCS] score 3-12 with 6-month Glasgow Outcome Scale-Extended [GOSE] data [n = 441]; for CRASH, GCS score 3-14 with 2-week mortality data and 6-month GOSE data [n = 831]). Analyses were conducted in the overall cohort and stratified on the basis of TBI severity (severe/moderate/mild TBI defined as GCS score 3-8/9-12/13-14), age (17-64 years or ≥ 65 years), and the 5 top enrolling sites. Unfavorable outcome was defined as GOSE score 1-4. Original IMPACT and CRASH model coefficients were applied, and model performances were assessed by calibration (intercept [< 0 indicated overprediction; > 0 indicated underprediction] and slope) and discrimination (c-statistic)., Results: Overall, the IMPACT models overpredicted mortality (intercept -0.79 [95% CI -1.05 to -0.53], slope 1.37 [1.05-1.69]) and acceptably predicted unfavorable outcome (intercept 0.07 [-0.14 to 0.29], slope 1.19 [0.96-1.42]), with good discrimination (c-statistics 0.84 and 0.83, respectively). The CRASH models overpredicted mortality (intercept -1.06 [-1.36 to -0.75], slope 0.96 [0.79-1.14]) and unfavorable outcome (intercept -0.60 [-0.78 to -0.41], slope 1.20 [1.03-1.37]), with good discrimination (c-statistics 0.92 and 0.88, respectively). IMPACT overpredicted mortality and acceptably predicted unfavorable outcome in the severe and moderate TBI subgroups, with good discrimination (c-statistic ≥ 0.81). CRASH overpredicted mortality in the severe and moderate TBI subgroups and acceptably predicted mortality in the mild TBI subgroup, with good discrimination (c-statistic ≥ 0.86); unfavorable outcome was overpredicted in the severe and mild TBI subgroups with adequate discrimination (c-statistic ≥ 0.78), whereas calibration was nonlinear in the moderate TBI subgroup. In subjects ≥ 65 years of age, the models performed variably (IMPACT-mortality, intercept 0.28, slope 0.68, and c-statistic 0.68; CRASH-unfavorable outcome, intercept -0.97, slope 1.32, and c-statistic 0.88; nonlinear calibration for IMPACT-unfavorable outcome and CRASH-mortality). Model performance differences were observed across the top enrolling sites for mortality and unfavorable outcome., Conclusions: The IMPACT and CRASH models adequately discriminated mortality and unfavorable outcome. Observed overestimations of mortality and unfavorable outcome underscore the need to update prognostic models to incorporate contemporary changes in TBI management and case-mix. Investigations to elucidate the relationships between increased survival, outcome, treatment intensity, and site-specific practices will be relevant to improve models in specific TBI subpopulations (e.g., older adults), which may benefit from the inclusion of blood-based biomarkers, neuroimaging features, and treatment data.
Published: 2024
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16. Intramural Healthcare Consumption and Costs After Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study.

Author: Kaplan ZLR, van der Vlegel M, van Dijck JTJM, Pisică D, van Leeuwen N, Lingsma HF, Steyerberg EW, Haagsma JA, Majdan M, and Polinder S
Subjects: Humans, Male, Female, Hospitalization, Length of Stay, Prospective Studies, Glasgow Coma Scale, Brain Injuries, Traumatic epidemiology, Brain Injuries
Abstract: Traumatic brain injury (TBI) is a global public health problem and a leading cause of mortality, morbidity, and disability. The increasing incidence combined with the heterogeneity and complexity of TBI will inevitably place a substantial burden on health systems. These findings emphasize the importance of obtaining accurate and timely insights into healthcare consumption and costs on a multi-national scale. This study aimed to describe intramural healthcare consumption and costs across the full spectrum of TBI in Europe. The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) core study is a prospective observational study conducted in 18 countries across Europe and in Israel. The baseline Glasgow Coma Scale (GCS) was used to differentiate patients by brain injury severity in mild (GCS 13-15), moderate (GCS 9-12), or severe (GCS ≤8) TBI. We analyzed seven main cost categories: pre-hospital care, hospital admission, surgical interventions, imaging, laboratory, blood products, and rehabilitation. Costs were estimated based on Dutch reference prices and converted to country-specific unit prices using gross domestic product (GDP)-purchasing power parity (PPP) adjustment. Mixed linear regression was used to identify between-country differences in length of stay (LOS), as a parameter of healthcare consumption. Mixed generalized linear models with gamma distribution and log link function quantified associations of patient characteristics with higher total costs. We included 4349 patients, of whom 2854 (66%) had mild, 371 (9%) had moderate, and 962 (22%) had severe TBI. Hospitalization accounted for the largest part of the intramural consumption and costs (60%). In the total study population, the mean LOS was 5.1 days at the intensive care unit (ICU) and 6.3 days at the ward. For mild, moderate, and severe TBI, mean LOS was, respectively, 1.8, 8.9, and 13.5 days at the ICU and 4.5, 10.1, and 10.3 days at the ward. Other large contributors to the total costs were rehabilitation (19%) and intracranial surgeries (8%). Total costs increased with higher age and greater trauma severity (mild; €3,800 [IQR €1,400-14,000], moderate; €37,800 [IQR €14,900-€74,200], severe; €60,400 [IQR €24,400-€112,700]). The adjusted analysis showed that female patients had lower costs than male patients (odds ratio (OR) 0.80 [CI 0.75-1.85]). Increasing TBI severity was associated with higher costs, OR 1.46 (confidence interval [CI] 1.31-1.63) and OR 1.67 [CI 1.52-1.84] for moderate and severe patients, respectively. A worse pre-morbid overall health state, increasing age and more severe systemic trauma, expressed in the Injury Severity Score (ISS), were also significantly associated with higher costs. Intramural costs of TBI are significant and are profoundly driven by hospitalization. Costs increased with trauma severity and age, and male patients incurred higher costs. Reducing LOS could be targeted with advanced care planning, in order to provide cost-effective care.
Published: 2023
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17. Comparative effectiveness of decompressive craniectomy versus craniotomy for traumatic acute subdural hematoma (CENTER-TBI): an observational cohort study.

Author: van Essen TA, van Erp IAM, Lingsma HF, Pisică D, Yue JK, Singh RD, van Dijck JTJM, Volovici V, Younsi A, Kolias A, Peppel LD, Heijenbrok-Kal M, Ribbers GM, Menon DK, Hutchinson PJA, Manley GT, Depreitere B, Steyerberg EW, Maas AIR, de Ruiter GCW, and Peul WC
Abstract: Background: Limited evidence existed on the comparative effectiveness of decompressive craniectomy (DC) versus craniotomy for evacuation of traumatic acute subdural hematoma (ASDH) until the recently published randomised clinical trial RESCUE-ASDH. In this study, that ran concurrently, we aimed to determine current practice patterns and compare outcomes of primary DC versus craniotomy., Methods: We conducted an analysis of centre treatment preference within the prospective, multicentre, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (known as CENTER-TBI) and NeuroTraumatology Quality Registry (known as Net-QuRe) studies, which enrolled patients throughout Europe and Israel (2014-2020). We included patients with an ASDH who underwent acute neurosurgical evacuation. Patients with severe pre-existing neurological disorders were excluded. In an instrumental variable analysis, we compared outcomes between centres according to treatment preference, measured by the case-mix adjusted proportion DC per centre. The primary outcome was functional outcome rated by the 6-months Glasgow Outcome Scale Extended, estimated with ordinal regression as a common odds ratio (OR), adjusted for prespecified confounders. Variation in centre preference was quantified with the median odds ratio (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582)., Findings: Between December 19, 2014 and December 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI of whom 336 (7%) underwent acute surgery for ASDH evacuation; 91 (27%) underwent DC and 245 (63%) craniotomy. The proportion primary DC within total acute surgery cases ranged from 6 to 67% with an interquartile range (IQR) of 12-26% among 46 centres; the odds of receiving a DC for prognostically similar patients in one centre versus another randomly selected centre were trebled (adjusted median odds ratio 2.7, p < 0.0001). Higher centre preference for DC over craniotomy was not associated with better functional outcome (adjusted common odds ratio (OR) per 14% [IQR increase] more DC in a centre = 0.9 [95% CI 0.7-1.1], n = 200). Primary DC was associated with more follow-on surgeries and complications [secondary cranial surgery 27% vs. 18%; shunts 11 vs. 5%]; and similar odds of in-hospital mortality (adjusted OR per 14% IQR more primary DC 1.3 [95% CI (1.0-3.4), n = 200])., Interpretation: We found substantial practice variation in the employment of DC over craniotomy for ASDH. This variation in treatment strategy did not result in different functional outcome. These findings suggest that primary DC should be restricted to salvageable patients in whom immediate replacement of the bone flap is not possible due to intraoperative brain swelling., Funding: Hersenstichting Nederland for the Dutch NeuroTraumatology Quality Registry and the European Union Seventh Framework Program., Competing Interests: AIRM declares consulting fees from PresSura Neuro, Integra Life Sciences, and NeuroTrauma Sciences. DKM reports grants from the UK National Institute for Health Research, during the conduct of the study; grants, personal fees, and non-financial support from GlaxoSmithKline; and personal fees from Neurotrauma Sciences, Lantmaanen AB, Pressura, and Pfizer, outside of the submitted work. EWS reports personal fees from Springer during the conduct of the study. VV reports JAMA Statistical Reviewer Board membership. All other authors declare no competing interests., (© 2023 The Author(s).)
Published: 2023
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18. Traumatic brain injury: progress and challenges in prevention, clinical care, and research.

Author: Maas AIR, Menon DK, Manley GT, Abrams M, Åkerlund C, Andelic N, Aries M, Bashford T, Bell MJ, Bodien YG, Brett BL, Büki A, Chesnut RM, Citerio G, Clark D, Clasby B, Cooper DJ, Czeiter E, Czosnyka M, Dams-O'Connor K, De Keyser V, Diaz-Arrastia R, Ercole A, van Essen TA, Falvey É, Ferguson AR, Figaji A, Fitzgerald M, Foreman B, Gantner D, Gao G, Giacino J, Gravesteijn B, Guiza F, Gupta D, Gurnell M, Haagsma JA, Hammond FM, Hawryluk G, Hutchinson P, van der Jagt M, Jain S, Jain S, Jiang JY, Kent H, Kolias A, Kompanje EJO, Lecky F, Lingsma HF, Maegele M, Majdan M, Markowitz A, McCrea M, Meyfroidt G, Mikolić A, Mondello S, Mukherjee P, Nelson D, Nelson LD, 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 DJ, Smielewski P, Stein MB, von Steinbüchel N, Stewart W, Steyerberg EW, Stocchetti N, Temkin N, Tenovuo O, Theadom A, Thomas I, Espin AT, Turgeon AF, Unterberg A, Van Praag D, van Veen E, Verheyden J, Vyvere TV, Wang KKW, Wiegers EJA, Williams WH, Wilson L, Wisniewski SR, Younsi A, Yue JK, Yuh EL, Zeiler FA, Zeldovich M, and Zemek R
Subjects: Humans, Cost of Illness, Violence, Sports, Brain Injuries, Traumatic prevention & control, Brain Injuries, Traumatic drug therapy
Abstract: Competing Interests: Declaration of interests No funding was provided specifically for this Commission paper; however, most authors are involved in the International Initiative for Traumatic Brain Injury Research (InTBIR) as a scientific participant or an investigator. This Commission would not have been possible without the indirect facilitation provided by the InTBIR network. AIRM declares consulting fees from PresSura Neuro, Integra Life Sciences, and NeuroTrauma Sciences. DKM reports research support, and educational and consulting fees from Lantmannen AB, GlaxoSmithKline, Calico, PresSura Neuro, NeuroTrauma Sciences, and Integra Neurosciences. GTM declares grants from the US National Institutes of Health-National Institute of Neurological Disorders and Stroke (grant U01NS086090), the US Department of Defense (grant W81XWH-14-2-0176, grant W81XWH-18-2-0042, and contract W81XWH-15-9-0001). MC reports licensing fees for ICM+ software from Cambridge Enterprise and was an honorary (unpaid) director for Medicam. PS reports licensing fees for ICM+ software from Cambridge Enterprise. MBS has in the past 3 years received consulting income from Acadia Pharmaceuticals, Aptinyx, atai Life Sciences, Boehringer Ingelheim, Bionomics, BioXcel Therapeutics, Clexio, Eisai, EmpowerPharm, Engrail Therapeutics, Janssen, Jazz Pharmaceuticals, and Roche/Genentech. MBS also has stock options in Oxeia Biopharmaceuticals and EpiVario and is paid for editorial work on Depression and Anxiety (Editor-in-Chief), Biological Psychiatry (Deputy Editor), and UpToDate (Co-Editor-in-Chief for Psychiatry). KKWW holds stock options in Gryphon Bio. All other authors declare no competing interests.
Published: 2022
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19. Surgery versus conservative treatment for traumatic acute subdural haematoma: a prospective, multicentre, observational, comparative effectiveness study.

Author: van Essen TA, Lingsma HF, Pisică D, Singh RD, Volovici V, den Boogert HF, Younsi A, Peppel LD, Heijenbrok-Kal MH, Ribbers GM, Walchenbach R, Menon DK, Hutchinson P, Depreitere B, Steyerberg EW, Maas AIR, de Ruiter GCW, and Peul WC
Subjects: Conservative Treatment, Glasgow Outcome Scale, Humans, Prospective Studies, Brain Injuries, Traumatic, Hematoma, Subdural, Acute etiology, Hematoma, Subdural, Acute surgery
Abstract: Background: Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma., Methods: We did a prospective, observational, comparative effectiveness study using data from participants enrolled in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We included patients with no pre-existing severe neurological disorders who presented with acute subdural haematoma within 24 h of traumatic brain injury. Using an instrumental variable analysis, we compared outcomes between centres according to treatment preference for acute subdural haematoma (acute surgical evacuation or initial conservative treatment), measured by the case-mix-adjusted percentage of acute surgery per centre. The primary endpoint was functional outcome at 6 months as rated with the Glasgow Outcome Scale Extended, which was estimated with ordinal regression as a common odds ratio (OR) and adjusted for prespecified confounders. Variation in centre preference was quantified with the median OR (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582)., Findings: Between Dec 19, 2014 and Dec 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI, of whom 1407 (31%) presented with acute subdural haematoma and were included in our study. Acute surgical evacuation was done in 336 (24%) patients, by craniotomy in 245 (73%) of those patients and by decompressive craniectomy in 91 (27%). Delayed decompressive craniectomy or craniotomy after initial conservative treatment (n=982) occurred in 107 (11%) patients. The percentage of patients who underwent acute surgery ranged from 5·6% to 51·5% (IQR 12·3-35·9) between centres, with a two-times higher probability of receiving acute surgery for an identical patient in one centre versus another centre at random (adjusted MOR for acute surgery 1·8; p<0·0001]). Centre preference for acute surgery over initial conservative treatment was not associated with improvements in functional outcome (common OR per 23·6% [IQR increase] more acute surgery in a centre 0·92, 95% CI 0·77-1·09)., Interpretation: Our findings show that treatment for patients with acute subdural haematoma with similar characteristics differed depending on the treating centre, because of variation in the preferred approach. A treatment strategy preferring an aggressive approach of acute surgical evacuation over initial conservative treatment was not associated with better functional outcome. Therefore, in a patient with acute subdural haematoma for whom a neurosurgeon sees no clear superiority for acute surgery over conservative treatment, initial conservative treatment might be considered., Funding: The Hersenstichting Nederland (also known as the Dutch Brain Foundation), the European Commission Seventh Framework Programme, the Hannelore Kohl Stiftung (Germany), OneMind (USA), Integra LifeSciences Corporation (USA), and NeuroTrauma Sciences (USA)., Competing Interests: Declaration of interests AIRM declares consulting fees from PresSura Neuro, Integra Life Sciences, and NeuroTrauma Sciences. DKM reports grants from the UK National Institute for Health Research, during the conduct of the study; grants, personal fees, and non-financial support from GlaxoSmithKline; and personal fees from Neurotrauma Sciences, Lantmaanen AB, Pressura, and Pfizer, outside of the submitted work. EWS reports personal fees from Springer during the conduct of the study. All other authors declare no competing interests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)
Published: 2022
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20. Comparative effectiveness of intracranial hypertension management guided by ventricular versus intraparenchymal pressure monitoring: a CENTER-TBI study.

Author: Volovici V, Pisică D, Gravesteijn BY, Dirven CMF, Steyerberg EW, Ercole A, Stocchetti N, Nelson D, Menon DK, Citerio G, van der Jagt M, Maas AIR, Haitsma IK, and Lingsma HF
Subjects: Female, Humans, Male, Middle Aged, Intracranial Pressure, Monitoring, Physiologic, Prospective Studies, Brain Injuries, Traumatic complications, Brain Injuries, Traumatic diagnosis, Brain Injuries, Traumatic therapy, Intracranial Hypertension complications, Intracranial Hypertension diagnosis, Intracranial Hypertension therapy
Abstract: Objective: To compare outcomes between patients with primary external ventricular device (EVD)-driven treatment of intracranial hypertension and those with primary intraparenchymal monitor (IP)-driven treatment., Methods: The CENTER-TBI study is a prospective, multicenter, longitudinal observational cohort study that enrolled patients of all TBI severities from 62 participating centers (mainly level I trauma centers) across Europe between 2015 and 2017. Functional outcome was assessed at 6 months and a year. We used multivariable adjusted instrumental variable (IV) analysis with "center" as instrument and logistic regression with covariate adjustment to determine the effect estimate of EVD on 6-month functional outcome., Results: A total of 878 patients of all TBI severities with an indication for intracranial pressure (ICP) monitoring were included in the present study, of whom 739 (84%) patients had an IP monitor and 139 (16%) an EVD. Patients included were predominantly male (74% in the IP monitor and 76% in the EVD group), with a median age of 46 years in the IP group and 48 in the EVD group. Six-month GOS-E was similar between IP and EVD patients (adjusted odds ratio (aOR) and 95% confidence interval [CI] OR 0.74 and 95% CI [0.36-1.52], adjusted IV analysis). The length of intensive care unit stay was greater in the EVD group than in the IP group (adjusted rate ratio [95% CI] 1.70 [1.34-2.12], IV analysis). One hundred eighty-seven of the 739 patients in the IP group (25%) required an EVD due to refractory ICPs., Conclusion: We found no major differences in outcomes of patients with TBI when comparing EVD-guided and IP monitor-guided ICP management. In our cohort, a quarter of patients that initially received an IP monitor required an EVD later for ICP control. The prevalence of complications was higher in the EVD group., Protocol: The core study is registered with ClinicalTrials.gov , number NCT02210221, and the Resource Identification Portal (RRID: SCR_015582)., (© 2022. The Author(s).)
Published: 2022
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21. Tenets of Good Practice in Regression Analysis. A Brief Tutorial.

Author: Pisică D, Dammers R, Boersma E, and Volovici V
Subjects: Humans, Regression Analysis, Research Design, Biomedical Research
Abstract: Background: Regression analysis quantifies the relationships between one or more independent variables and a dependent variable and is one of the most frequently used types of analysis in medical research. The aim of this article is to provide a brief theoretical and practical tutorial for neurosurgeons wishing to conduct or interpret regression analyses., Methods and Results: Data preparation, univariable and multivariable analysis, choice of model, model requirements and assumptions are discussed, as essential prerequisites to any regression analysis. Four main types of regression techniques are presented: linear, logistic, multinomial logistic, and proportional odds logistic. To illustrate the applications of regression to real-world data and exemplify the concepts introduced, we used a previously reported data set of patients with intracranial aneurysms treated by microsurgical clip reconstruction at the Department of Neurosurgery of Erasmus MC University Medical Center Rotterdam, between January 2000 and January 2019., Conclusions: Regression analysis is a powerful and versatile instrument in data analysis. This material is intended as a starter for those wishing to critically interpret or perform regression analysis and we recommend multidisciplinary collaborations with trained methodologists, statisticians, or epidemiologists., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Published: 2022
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22. Letter: Assessing Frailty in Neurosurgical Patients: Less is not Always More. Is There Any Construct Validity Left in the Modified Frailty Index?

Author: Pisică D and Volovici V
Published: 2021
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22 results on '"Pisică D"'

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

2. Comparative effectiveness of decompressive craniectomy versus craniotomy for traumatic acute subdural hematoma (CENTER-TBI): an observational cohort study

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

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

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

6. Surgery versus conservative treatment for traumatic acute subdural hematoma: a prospective, multicentre, comparative effectiveness study

7. Early surgery versus conservative treatment in patients with traumatic intracerebral hematoma: a CENTER-TBI study

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

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

10. Onco-functional outcome after resection for eloquent glioblastoma (OFO): A propensity-score matched analysis of an international, multicentre, cohort study.

11. Clinical profile of patients with acute traumatic brain injury undergoing cranial surgery in the United States: report from the 18-centre TRACK-TBI cohort study.

13. Association Between Early External Ventricular Drain Insertion and Functional Outcomes 6 Months Following Moderate-to-Severe Traumatic Brain Injury.

14. Clinical and Imaging Characteristics, Care Pathways, and Outcomes of Traumatic Epidural Hematomas: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Study.

15. Performance of the IMPACT and CRASH prognostic models for traumatic brain injury in a contemporary multicenter cohort: a TRACK-TBI study.

16. Intramural Healthcare Consumption and Costs After Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study.

17. Comparative effectiveness of decompressive craniectomy versus craniotomy for traumatic acute subdural hematoma (CENTER-TBI): an observational cohort study.

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

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

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

21. Tenets of Good Practice in Regression Analysis. A Brief Tutorial.

22. Letter: Assessing Frailty in Neurosurgical Patients: Less is not Always More. Is There Any Construct Validity Left in the Modified Frailty Index?

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