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4. Effects of a Geriatric Education Program for Emergency Physicians: A Mixed-Methods Study

Author

Hesselink, Gijs, Sir, Özcan, Öztürk, Ekin, Heiwegen, Nikki, Olde Rikkert, Marcel, and Schoon, Yvonne

Abstract

Emergency physicians (EPs) often regard care for older adults as complex, while they lack sufficient geriatric skills. This study evaluates the effect of a geriatric education program on EPs' geriatric knowledge, attitude and medical practice when treating older adults. A mixed-methods study was performed on EPs from two Dutch hospitals. Effects were measured by pre-post tests of EPs' (n = 21) knowledge of geriatric syndromes and attitudes toward older adults, and by a retrospective pre-post analysis of 100 records of patients aged 70 years or more. Six EPs were purposively sampled and interviewed after completion of the education program. The program significantly improved EPs' geriatric knowledge. EPs indicated that the program improved their ability and attentiveness to recognize frailty and geriatric syndromes. The program also significantly improved EPs' attention for the older patient's social history and circumstances (P = 0.04) but did not have a significant effect on medical decision making. EPs valued especially the case-based teaching and indicated that the interactive setting helped them to better understand and retain knowledge. Combined quantitative and qualitative data suggest that EPs benefit from geriatric emergency teaching. Future enhancement and evaluation of the geriatric education program is needed to confirm benefits to clinical practice and patient outcomes.

Published
2020
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7. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research

Author

Adams, Hadie, Agnoletti, Vanni, Allanson, Judith, Amrein, Krisztina, Andaluz, Norberto, Anke, Audny, Antoni, Anna, van As, Arjan Bastiaan, Audibert, Gérard, Azaševac, Antun, Azouvi, Philippe, Azzolini, Maria Luisa, Baciu, Camelia, Badenes, Rafael, Barlow, Karen M, Bartels, Ronald, Bauerfeind, Ursula, Beauchamp, Miriam, Beer, Darcy, Beer, Ronny, Belda, Francisco Javier, Bellander, Bo-Michael, Bellier, Rémy, Benali, Habib, Benard, Thierry, Beqiri, Valzerda, Beretta, Luigi, Bernard, Francis, Bertolini, Guido, Bilotta, Federico, Blaabjerg, Morten, den Boogert, Hugo, Boutis, Kathy, Bouzat, Pierre, Brooks, Brian, Brorsson, Camilla, Bullinger, Monika, Burns, Emma, Calappi, Emiliana, Cameron, Peter, Carise, Elsa, Castaño-León, Ana M, Causin, Francesco, Chevallard, Giorgio, Chieregato, Arturo, Christie, Brian, Cnossen, Maryse, Coles, Jonathan, Collett, Johnny, Della Corte, Francesco, Craig, William, Csato, Gabor, Csomos, Akos, Curry, Nicola, Dahyot-Fizelier, Claire, Dawes, Helen, DeMatteo, Carol, Depreitere, Bart, Dewey, Deborah, van Dijck, Jeroen, Đilvesi, Đula, Dippel, Diederik, Dizdarevic, Kemal, Donoghue, Emma, Duek, Or, Dulière, Guy-Loup, Dzeko, Adelaida, Eapen, George, Emery, Carolyn A, English, Shane, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feng, Junfeng, Fergusson, Dean, Figaji, Anthony, Fleming, Joanne, Foks, Kelly, Francony, Gilles, Freedman, Stephen, Freo, Ulderico, Frisvold, Shirin K, Gagnon, Isabelle, Galanaud, Damien, Gantner, Dashiell, Giraud, Benoit, Glocker, Ben, Golubovic, Jagoš, Gómez López, Pedro A, Gordon, Wayne A, Gradisek, Primoz, Gravel, Jocelyn, Griesdale, Donald, Grossi, Francesca, Haagsma, Juanita A, Håberg, Asta Kristine, Haitsma, Iain, Van Hecke, Wim, Helbok, Raimund, Helseth, Eirik, van Heugten, Caroline, Hoedemaekers, Cornelia, Höfer, Stefan, Horton, Lindsay, Hui, Jiyuan, Huijben, Jilske Antonia, Hutchinson, Peter J, Jacobs, Bram, van der Jagt, Mathieu, Jankowski, Stefan, Janssens, Koen, Jelaca, Bojan, Jones, Kelly M, Kamnitsas, Konstantinos, Kaps, Rafael, Karan, Mladen, Katila, Ari, Kaukonen, Kirsi-Maija, De Keyser, Véronique, Kivisaari, Riku, Kolias, Angelos G, Kolumbán, Bálint, Kolundžija, Ksenija, Kondziella, Daniel, Koskinen, Lars-Owe, Kovács, Noémi, Kramer, Andreas, Kutsogiannis, Demitri, Kyprianou, Theodoros, Lagares, Alfonso, Lamontagne, François, Latini, Roberto, Lauzier, François, Lazar, Isaac, Ledig, Christian, Lefering, Rolf, Legrand, Valerie, Levi, Leon, Lightfoot, Roger, Lozano, Angels, MacDonald, Stephen, Major, Sebastian, Manara, Alex, Manhes, Pauline, Maréchal, Hugues, Martino, Costanza, Masala, Alessandro, Masson, Serge, Mattern, Julia, McFadyen, Bradford, McMahon, Catherine, Meade, Maureen, Melegh, Béla, Menovsky, Tomas, Moore, Lynne, Morgado Correia, Marta, Morganti-Kossmann, Maria Cristina, Muehlan, Holger, Mukherjee, Pratik, Murray, Lynnette, van der Naalt, Joukje, Negru, Ancuta, Nelson, David, Nieboer, Daan, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Okonkwo, David O, Oldenbeuving, Annemarie W, Ortolano, Fabrizio, Osmond, Martin, Payen, Jean-François, Perlbarg, Vincent, Persona, Paolo, Pichon, Nicolas, Piippo-Karjalainen, Anna, Pili-Floury, Sébastien, Pirinen, Matti, Ple, Horia, Poca, Maria Antonia, Posti, Jussi, Van Praag, Dominique, Ptito, Alain, Radoi, Andreea, Ragauskas, Arminas, Raj, Rahul, Real, Ruben G L, Reed, Nick, Rhodes, Jonathan, Robertson, Claudia, Rocka, Saulius, Røe, Cecilie, Røise, Olav, Roks, Gerwin, Rosand, Jonathan, Rosenfeld, Jeffrey V, Rosenlund, Christina, Rosenthal, Guy, Rossi, Sandra, Rueckert, Daniel, de Ruiter, Godard C W, Sacchi, Marco, Sahakian, Barbara J, Sahuquillo, Juan, Sakowitz, Oliver, Salvato, Gerardo, Sánchez-Porras, Renán, Sándor, János, Sangha, Grinder, Schäfer, Nadine, Schmidt, Silke, Schneider, Kathryn J, Schnyer, David, Schöhl, Herbert, Schoonman, Guus G, Schou, Rico Frederik, Sir, Özcan, Skandsen, Toril, Smeets, Dirk, Sorinola, Abayomi, Stamatakis, Emmanuel, Stevanovic, Ana, Stevens, Robert D, Sundström, Nina, Taccone, Fabio Silvio, Takala, Riikka, Tanskanen, Päivi, Taylor, Mark Steven, Telgmann, Ralph, Temkin, Nancy, Teodorani, Guido, Thomas, Matt, Tolias, Christos M, Trapani, Tony, Turgeon, Alexis, Vajkoczy, Peter, Valadka, Alex B, Valeinis, Egils, Vallance, Shirley, Vámos, Zoltán, Vargiolu, Alessia, Vega, Emmanuel, Verheyden, Jan, Vik, Anne, Vilcinis, Rimantas, Vleggeert-Lankamp, Carmen, Vogt, Lidia, Volovici, Victor, Voormolen, Daphne C, Vulekovic, Peter, Vande Vyvere, Thijs, Van Waesberghe, Julia, Wessels, Lars, Wildschut, Eno, Williams, Guy, Winkler, Maren K L, Wolf, Stefan, Wood, Gordon, Xirouchaki, Nektaria, Younsi, Alexander, Zaaroor, Menashe, Zelinkova, Veronika, Zemek, Roger, Zumbo, Fabrizio, Maas, Andrew I R, Menon, David K, Adelson, P David, Andelic, Nada, Bell, Michael J, Belli, Antonio, Bragge, Peter, Brazinova, Alexandra, Büki, András, Chesnut, Randall M, Citerio, Giuseppe, Coburn, Mark, Cooper, D Jamie, Crowder, A Tamara, Czeiter, Endre, Czosnyka, Marek, Diaz-Arrastia, Ramon, Dreier, Jens P, Duhaime, Ann-Christine, Ercole, Ari, van Essen, Thomas A, Feigin, Valery L, Gao, Guoyi, Giacino, Joseph, Gonzalez-Lara, Laura E, Gruen, Russell L, Gupta, Deepak, Hartings, Jed A, Hill, Sean, Jiang, Ji-yao, Ketharanathan, Naomi, Kompanje, Erwin J O, Lanyon, Linda, Laureys, Steven, Lecky, Fiona, Levin, Harvey, Lingsma, Hester F, Maegele, Marc, Majdan, Marek, Manley, Geoffrey, Marsteller, Jill, Mascia, Luciana, McFadyen, Charles, Mondello, Stefania, Newcombe, Virginia, Palotie, Aarno, Parizel, Paul M, Peul, Wilco, Piercy, James, Polinder, Suzanne, Puybasset, Louis, Rasmussen, Todd E, Rossaint, Rolf, Smielewski, Peter, Söderberg, Jeannette, Stanworth, Simon J, Stein, Murray B, von Steinbüchel, Nicole, Stewart, William, Steyerberg, Ewout W, Stocchetti, Nino, Synnot, Anneliese, Te Ao, Braden, Tenovuo, Olli, Theadom, Alice, Tibboel, Dick, Videtta, Walter, Wang, Kevin K W, Williams, W Huw, Wilson, Lindsay, and Yaffe, Kristine

Published
2017
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9. Update of the CHIP (CT in Head Injury Patients) decision rule for patients with minor head injury based on a multicenter consecutive case series

Author

van den Brand, Crispijn L, primary, Foks, Kelly A, additional, Lingsma, Hester F, additional, van der Naalt, Joukje, additional, Jacobs, Bram, additional, de Jong, Eline, additional, den Boogert, Hugo F, additional, Sir, Özcan, additional, Patka, Peter, additional, Polinder, Suzanne, additional, Gaakeer, Menno I, additional, Schutte, Charlotte E, additional, Jie, Kim E, additional, Visee, Huib F, additional, Hunink, Myriam GM, additional, Reijners, Eef, additional, Braaksma, Meriam, additional, Schoonman, Guus G, additional, Steyerberg, Ewout W, additional, Dippel, Diederik WJ, additional, and Jellema, Korné, additional

Published
2022
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12. Biomarkers for Traumatic Brain Injury: Data Standards and Statistical Considerations

Author

Huie, J. Russell, primary, Mondello, Stefania, additional, Lindsell, Christopher J., additional, Antiga, Luca, additional, Yuh, Esther L., additional, Zanier, Elisa R., additional, Masson, Serge, additional, Rosario, Bedda L., additional, Ferguson, Adam R., additional, Adeoye, Opeolu, additional, Badjatia, Neeraj, additional, Boase, Kim, additional, Bodien, Yelena, additional, Bullock, M. Ross, additional, Chesnut, Randall, additional, Corrigan, John D., additional, Crawford, Karen, additional, Diaz-Arrastia, Ramon, additional, Dikmen, Sureyya, additional, Duhaime, Ann-Christine, additional, Ellenbogen, Richard, additional, Feeser, V. Ramana, additional, Foreman, Brandon, additional, Gardner, Raquel, additional, Gaudette, Etienne, additional, Giacino, Joseph, additional, Goldman, Dana, additional, Gonzalez, Luis, additional, Gopinath, Shankar, additional, Gullapalli, Rao, additional, Hemphill, J. Claude, additional, Hotz, Gillian, additional, Jain, Sonia, additional, Korley, Frederick, additional, Kramer, Joel, additional, Kreitzer, Natalie, additional, Levin, Harvey, additional, Machamer, Joan, additional, Madden, Christopher, additional, Manley, Geoffrey T., additional, Martin, Alastair, additional, McAllister, Thomas, additional, McCrea, Michael, additional, Merchant, Randall, additional, Mukherjee, Pratik, additional, Nelson, Lindsay, additional, Ngwenya, Laura B., additional, Noel, Florence, additional, Okonkwo, David, additional, Perl, Daniel, additional, Puccio, Ava, additional, Rabinowitz, Miri, additional, Robertson, Claudia, additional, Rosand, Jonathan, additional, Sander, Angelle, additional, Schnyer, David, additional, Seabury, Seth, additional, Stein, Murray, additional, Taylor, Sabrina, additional, Temkin, Nancy, additional, Toga, Arthur, additional, Valadka, Alex, additional, Vassar, Mary, additional, Vespa, Paul, additional, Wang, Kevin, additional, Yue, John K., additional, Zafonte, Ross, additional, Ackerlund, Cecilia, additional, Adams, Hadie, additional, Agnoletti, Vanni, additional, Allanson, Judith, additional, Amrein, Krisztina, additional, Andaluz, Norberto, additional, Andelic, Nada, additional, Andreassen, Lasse, additional, Anke, Audny, additional, Antun, Azasevac, additional, Antoni, Anna, additional, Ardon, Hilko, additional, Auslands, Kaspars, additional, Azouvi, Philippe, additional, Luisa Azzolini, Maria, additional, Baciu, Camelia, additional, Badenes, Rafael, additional, Bartels, Ronald, additional, Barzó, Pál, additional, Bauerfeind, Ursula, additional, Beauvais, Romuald, additional, Beer, Ronny, additional, Belda, Francisco Javier, additional, Bellander, Bo Michael, additional, Belli, Antonio, additional, Bellier, Rémy, additional, Benali, Habib, additional, Benard, Thierry, additional, Berardino, Maurizio, additional, Beretta, Luigi, additional, Beynon, Christopher, additional, Bilotta, Federico, additional, Binder, Harald, additional, Biqiri, Erta, additional, Blaabjerg, Morten, additional, Boogert, Hugo den, additional, Bragge, Peter, additional, Brazinova, Alexandra, additional, Brinck, Vibeke, additional, Brooker, Joanne, additional, Brorsson, Camilla, additional, Buki, Andras, additional, Bullinger, Monika, additional, Cabeleira, Manuel, additional, Calappi, Emiliana, additional, Calvi, Maria Rosa, additional, Cameron, Peter, additional, Carbayo, Lozano Guillermo, additional, Carbonara, Marco, additional, Carise, Elsa, additional, Carpenter, K., additional, Castaño León, Ana M., additional, Causin, Francesco, additional, Chevallard, Giorgio, additional, Chieregato, Arturo, additional, Citerio, Giuseppe, additional, Cnossen, Maryse, additional, Coburn, Mark, additional, Coles, Jonathan, additional, Coles-Kemp, Lizzie, additional, Collett, Johnny, additional, Cooper, Jamie D., additional, Correia, Marta, additional, Covic, Amra, additional, Curry, Nicola, additional, Czeiter, Endre, additional, Czosnyka, Marek, additional, Fizelier, Claire Dahyot, additional, Damas, François, additional, Damas, Pierre, additional, Dawes, Helen, additional, De Keyser, Véronique, additional, Corte, Francesco Della, additional, Depreitere, Bart, additional, de Ruiter, Godard C.W., additional, Dilvesi, Dula, additional, Ding, Shenghao, additional, Dippel, Diederik, additional, Dixit, Abhishek, additional, Donoghue, Emma, additional, Dreier, Jens, additional, Dulière, Guy Loup, additional, Engemann, Heiko, additional, Ercole, Ari, additional, Esser, Patrick, additional, Ezer, Erzsébet, additional, Fabricius, Martin, additional, Feigin, Valery L., additional, Feng, Junfeng, additional, Foks, Kelly, additional, Fossi, Francesca, additional, Francony, Gilles, additional, Freo, Ulderico, additional, Frisvold, Shirin, additional, Furmanov, Alex, additional, Gagliardo, Pablo, additional, Galanaud, Damien, additional, Gantner, Dashiell, additional, Gao, Guoyi, additional, Geleijns, Karin, additional, George, Pradeep, additional, Ghuysen, Alexandre, additional, Giga, Lelde, additional, Giraud, Benoit, additional, Glocker, Ben, additional, Golubovic, Jagos, additional, Gomez, Pedro A., additional, Gravesteijn, Benjamin, additional, Grossi, Francesca, additional, Gruen, Russell L., additional, Gupta, Deepak, additional, Haagsma, Juanita A., additional, Håberg, Asta Kristine, additional, Jacobs, Bram, additional, Haitsma, Iain, additional, Hartings, Jed A., additional, Helbok, Raimund, additional, Helseth, Eirik, additional, Hertle, Daniel, additional, Hoedemaekers, Astrid, additional, Hoefer, Stefan, additional, Horton, Lindsay, additional, Huijben, Jilske, additional, Hutchinson, Peter J., additional, Jankowski, Stefan, additional, Jarrett, Mike, additional, Jelaca, Bojan, additional, Jiang, Ji yao, additional, Jones, Kelly, additional, Kamnitsas, Konstantinos, additional, Karan, Mladen, additional, Katila, Ari, additional, Kaukonen, Maija, additional, Kerforne, Thomas, additional, Kivisaari, Riku, additional, Kolias, Angelos G., additional, Kolumbán, Bálint, additional, Kompanje, Erwin, additional, Kolundzija, Ksenija, additional, Kondziella, Daniel, additional, Koskinen, Lars Owe, additional, Kovács, Noémi, additional, Lagares, Alfonso, additional, Lanyon, Linda, additional, Laureys, Steven, additional, Lecky, Fiona, additional, Ledig, Christian, additional, Lefering, Rolf, additional, Legrand, Valerie, additional, Lei, Jin, additional, Levi, Leon, additional, Lightfoot, Roger, additional, Lingsma, Hester, additional, Loeckx, Dirk, additional, Lozano, Angels, additional, Maas, Andrew I.R., additional, MacDonald, Stephen, additional, Maegele, Marc, additional, Marek, Majdan, additional, Major, Sebastian, additional, Manara, Alex, additional, Manley, Geoffrey, additional, Martin, Didier, additional, Martin, Leon Francisco, additional, Martino, Costanza, additional, Maréchal, Hugues, additional, Maruenda, Armando, additional, Masala, Alessandro, additional, Mattern, Julia, additional, McFadyen, Charles, additional, McMahon, Catherine, additional, Melegh, Béla, additional, Menon, David, additional, Menovsky, Tomas, additional, Kossmann, Cristina Morganti, additional, Mulazzi, Davide, additional, Mühlan, Holger, additional, Muraleedharan, Visakh, additional, Murray, Lynnette, additional, Nair, Nandesh, additional, Negru, Ancuta, additional, Nelson, David, additional, Newcombe, Virginia, additional, Nieboer, Daan, additional, Noirhomme, Quentin, additional, Nyirádi, József, additional, Oddo, Mauro, additional, Oldenbeuving, Annemarie, additional, Oresic, Matej, additional, Ortolano, Fabrizio, additional, Palotie, Aarno, additional, Parizel, Paul M., additional, Patruno, Adriana, additional, Payen, Jean François, additional, Perera, Natascha, additional, Perlbarg, Vincent, additional, Persona, Paolo, additional, Peul, Wilco, additional, Piippo-Karjalainen, Anna, additional, Pili, Floury Sébastien, additional, Pirinen, Matti, additional, Ples, Horia, additional, Poca, Maria Antonia, additional, Polinder, Suzanne, additional, Pomposo, Inigo, additional, Posti, Jussi, additional, Puybasset, Louis, additional, Radoi, Andreea, additional, Ragauskas, Arminas, additional, Raj, Rahul, additional, Rambadagalla, Malinka, additional, Real, Ruben, additional, Rehorčíková, Veronika, additional, Rhodes, Jonathan, additional, Ripatti, Samuli, additional, Rocka, Saulius, additional, Roe, Cecilie, additional, Roise, Olav, additional, Roks, Gerwin, additional, Rosenfeld, Jeffrey, additional, Rosenlund, Christina, additional, Rosenthal, Guy, additional, Rossaint, Rolf, additional, Rossi, Sandra, additional, Rueckert, Daniel, additional, Rusnák, Martin, additional, Sacchi, Marco, additional, Sahakian, Barbara, additional, Sahuquillo, Juan, additional, Sakowitz, Oliver, additional, Sala, Francesca, additional, Porras, Renan Sanchez, additional, Sandor, Janos, additional, Santos, Edgar, additional, Sasu, Luminita, additional, Savo, Davide, additional, Schäffer, Nadine, additional, Schipper, Inger, additional, Schlößer, Barbara, additional, Schmidt, Silke, additional, Schoechl, Herbert, additional, Schoonman, Guus, additional, Schou, Rico Frederik, additional, Schwendenwein, Elisabeth, additional, Schöll, Michael, additional, Sewalt, Charlie, additional, Sir, Özcan, additional, Skandsen, Toril, additional, Smakman, Lidwien, additional, Smeets, Dirk, additional, Smielewski, Peter, additional, Sorinola, Abayomi, additional, Stamatakis, Emmanuel, additional, Stanworth, Simon, additional, Steinbüchel, Nicole, additional, Stevanovic, Ana, additional, Stevens, Robert, additional, Stewart, William, additional, Steyerberg, Ewout W., additional, Stocchetti, Nino, additional, Sundström, Nina, additional, Synnot, Anneliese, additional, Taccone, Fabio Silvio, additional, Takala, Riikka, additional, Tamás, Viktória, additional, Tanskanen, Päivi, additional, Taylor, Mark Steven, additional, Te Ao, Braden, additional, Tenovuo, Olli, additional, Telgmann, Ralph, additional, Teodorani, Guido, additional, Theadom, Alice, additional, Thomas, Matt, additional, Tibboel, Dick, additional, Tolias, Christos, additional, Tshibanda, Jean Flory Luaba, additional, Trapani, Tony, additional, Tudora, Cristina Maria, additional, Vajkoczy, Peter, additional, Vallance, Shirley, additional, Valeinis, Egils, additional, der Steen, Gregory Van, additional, der Jagt, Mathieu van, additional, de Naalt, JV, additional, van Dijck, Jeroen T.J.M., additional, van Essen, Thomas A., additional, Hecke, Wim Van, additional, Heugten, Caroline van, additional, Praag, Dominique Van, additional, Vyvere, Thijs Vande, additional, Waesberghe, Julia Van, additional, Vanhaudenhuyse, Audrey, additional, Vargiolu, Alessia, additional, Vega, Emmanuel, additional, Velt, Kimberley, additional, Verheyden, Jan, additional, Vespa, Paul M., additional, Vik, Anne, additional, Vilcinis, Rimantas, additional, Vizzino, Giacinta, additional, Lankamp, Carmen Vleggeert, additional, Volovici, Victor, additional, Voormolen, Daphne, additional, Vulekovic, Peter, additional, Vámos, Zoltán, additional, Wade, Derick, additional, Wang, Kevin K.W., additional, Wang, Lei, additional, Wessels, Lars, additional, Wiegers, Eveline, additional, Wildschut, Eno, additional, Williams, Guy, additional, Wilson, Lindsay, additional, Winkler, Maren K.L., additional, Wolf, Stefan, additional, Ylén, Peter, additional, Younsi, Alexander, additional, Zaaroor, Menashe, additional, Zeiler, Frederik, additional, Zhihui, Yang, additional, Ziverte, Agate, additional, and Zumbo, Fabrizio, additional

Published
2021
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14. Teach-back of discharge instructions in the emergency department: a pre-post pilot evaluation.

Author

Hesselink, Gijs, Sir, Özcan, Koster, Nadia, Tolsma, Carolien, Munsterman, Maartje, Rikkert, Marcel Olde, Schoon, Yvonne, and Olde Rikkert, Marcel

Abstract

Objectives: With the 'teach-back' method, patients or carers repeat back what they understand, so that professionals can confirm comprehension and correct misunderstandings. The effectiveness of teach-back has been underexamined, particularly for older patients discharged from the emergency department (ED). We aimed to determine whether teach-back would reduce ED revisits and whether it would increase patients' retention of discharge instructions, improve self-management at home and increase satisfaction with the provision of instructions.Methods: A nonrandomised pre-post pilot evaluation in the ED of one Dutch academic hospital including patients discharged from the ED receiving standard discharge care (pre) and teach-back (post). Primary outcomes were ED-revisits within 7 days and within 8-30 days postdischarge. Secondary outcomes for a subsample of older adults were retention of instructions, self-management 72 hours after discharge and satisfaction with the provision of discharge instructions.Results: A total of 648 patients were included, 154 were older adults. ED revisits within 7 days and within 8-30 days were lower in the teach-back group compared with those receiving standard discharge care: adjusted odds ratios (AORs) of 0.23 (95% CI 0.05 to 1.07) and 0.42 (95% CI 0.14 to 1.33), respectively. Participants in the teach-back group had an increased likelihood of full knowledge retention on information related to their ED diagnosis and treatment (AOR 2.19; 95% CI 1.01 to 4.75; p=0.048), medication (AOR 14.89; 95% CI 4.12 to 53.85; p>0.001) and follow-up appointments (AOR 3.86; 95% CI 1.33 to 10.19; p=0.012). Use of teach-back was not significantly associated with improved self-management and higher satisfaction with discharge instructions. Discharge conversations were generally shorter for participants receiving teach-back.Conclusions: Discharging patients from the ED with a relatively simple and feasible teach-back method can contribute to safer and better transitional care from the ED to home. [ABSTRACT FROM AUTHOR]

Published
2022
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17. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury

Author

Cnossen, Maryse C., Huijben, Jilske A., van der Jagt, Mathieu, Volovici, Victor, van Essen, Thomas, Polinder, Suzanne, Nelson, David, Ercole, Ari, Stocchetti, Nino, Citerio, Giuseppe, Peul, Wilco C., Maas, Andrew I. R., Menon, David, Steyerberg, Ewout W., Lingsma, Hester F., Adams, Hadie, Alessandro, Masala, Allanson, Judith, Amrein, Krisztina, Andaluz, Norberto, Andelic, Nada, Andrea, Nanni, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Ardon, Hilko, Audibert, Gérard, Auslands, Kaspars, Azouvi, Philippe, Baciu, Camelia, Bacon, Andrew, Badenes, Rafael, Baglin, Trevor, Bartels, Ronald, Barzó, Pál, Bauerfeind, Ursula, Beer, Ronny, Belda, Francisco Javier, Bellander, Bo-Michael, Belli, Antonio, Bellier, Rémy, Benali, Habib, Benard, Thierry, Berardino, Maurizio, Beretta, Luigi, Beynon, Christopher, Bilotta, Federico, Binder, Harald, Biqiri, Erta, Blaabjerg, Morten, Lund, Stine Borgen, Bouzat, Pierre, Bragge, Peter, Brazinova, Alexandra, Brehar, Felix, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Bucková, Veronika, Calappi, Emiliana, Cameron, Peter, Carbayo, Lozano Guillermo, Carise, Elsa, Carpenter, Keri, Castaño-León, Ana M., Causin, Francesco, Chevallard, Giorgio, Chieregato, Arturo, Cooper, M., Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Covic, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Damas, François, Damas, Pierre, Dawes, Helen, De Keyser, Véronique, Corte, Francesco Della, Depreitere, Bart, Ding, Shenghao, Dippel, Diederik, Dizdarevic, Kemal, Dulière, Guy-Loup, Dzeko, Adelaida, Eapen, George, Engemann, Heiko, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Feng, Junfeng, Foks, Kelly, Fossi, Francesca, Francony, Gilles, Frantzén, Janek, Freo, Ulderico, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gao, Guoyi, Geleijns, Karin, Ghuysen, Alexandre, Giraud, Benoit, Glocker, Ben, Gomez, Pedro A., Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Hadzic, Ermin, Haitsma, Iain, Hartings, Jed A., Helbok, Raimund, Helseth, Eirik, Hertle, Daniel, Hill, Sean, Hoedemaekers, Astrid, Hoefer, Stefan, Hutchinson, Peter J., Håberg, Kristine Asta, Jacobs, Bram, Janciak, Ivan, Janssens, Koen, Jiang, Ji-Yao, Jones, Kelly, Kalala, Jean-Pierre, Kamnitsas, Konstantinos, Karan, Mladen, Karau, Jana, Katila, Ari, Kaukonen, Maija, Keeling, David, Kerforne, Thomas, Ketharanathan, Naomi, Kettunen, Johannes, Kivisaari, Riku, Kolias, Angelos G., Kolumbán, Bálint, Kompanje, Erwin, Kondziella, Daniel, Koskinen, Lars-Owe, Kovács, Noémi, Kálovits, Ferenc, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lauritzen, Martin, Lecky, Fiona, Ledig, Christian, Lefering, Rolf, Legrand, Valerie, Lei, Jin, Levi, Leon, Lightfoot, Roger, Loeckx, Dirk, Lozano, Angels, Luddington, Roger, Luijten-Arts, Chantal, Macdonald, Stephen, Macfayden, Charles, Maegele, Marc, Majdan, Marek, Major, Sebastian, Manara, Alex, Manhes, Pauline, Manley, Geoffrey, Martin, Didier, Martino, Costanza, Maruenda, Armando, Maréchal, Hugues, Mastelova, Dagmara, Mattern, Julia, Mcmahon, Catherine, Melegh, Béla, Menovsky, Tomas, Morganti-Kossmann, Cristina, Mulazzi, Davide, Mutschler, Manuel, Mühlan, Holger, Negru, Ancuta, Neugebauer, Eddy, Newcombe, Virginia, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Oldenbeuving, Annemarie, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Parizel, Paul M., Patruno, Adriana, Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Pichon, Nicolas, Piilgaard, Henning, Piippo, Anna, Floury, Sébastien Pili, Pirinen, Matti, Ples, Horia, Pomposo, Inigo, Psota, Marek, Pullens, Pim, Puybasset, Louis, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Rehorcíková, Veronika, Rhodes, Jonathan, Richardson, Sylvia, Ripatti, Samuli, Rocka, Saulius, Rodier, Nicolas, Roe, Cecilie, Roise, Olav, Roks, Gerwin, Romegoux, Pauline, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rostalski, Tim, Rueckert, Daniel, de Ruiz, Arcaute Felix, Rusnák, Martin, Sacchi, Marco, Sahakian, Barbara, Sahuquillo, Juan, Sakowitz, Oliver, Sala, Francesca, Sanchez-Pena, Paola, Sanchez-Porras, Renan, Sandor, Janos, Santos, Edgar, Sasse, Nadine, Sasu, Luminita, Savo, Davide, Schipper, Inger, Schlößer, Barbara, Schmidt, Silke, Schneider, Annette, Schoechl, Herbert, Schoonman, Guus, Rico, Frederik Schou, Schwendenwein, Elisabeth, Schöll, Michael, Sir, Özcan, Skandsen, Toril, Smakman, Lidwien, Smeets, Dirk, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stegemann, Katrin, Steinbüchel, Nicole, Stevens, Robert, Stewart, William, Sundström, Nina, Synnot, Anneliese, Szabó, József, Söderberg, Jeannette, Taccone, Fabio Silvio, Tamás, Viktória, Tanskanen, Päivi, Tascu, Alexandru, Taylor, Mark Steven, Ao Braden, Te, Tenovuo, Olli, Teodorani, Guido, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Tshibanda, Jean-Flory Luaba, Tudora, Cristina Maria, Vajkoczy, Peter, Valeinis, Egils, Hecke, Wim Van, Praag, Dominique Van, Dirk, Van Roost, Vlierberghe, Eline Van, Vyvere, Thijs vande, Vanhaudenhuyse, Audrey, Vargiolu, Alessia, Vega, Emmanuel, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, Vizzino, Giacinta, Vleggeert-Lankamp, Carmen, Vulekovic, Peter, Vámos, Zoltán, Wade, Derick, Wang, Kevin K. W., Wang, Lei, Wildschut, Eno, Williams, Guy, Willumsen, Lisette, Wilson, Adam, Wilson, Lindsay, Winkler, Maren K. L., Ylén, Peter, Younsi, Alexander, Zaaroor, Menashe, Zhang, Zhiqun, Zheng, Zelong, Zumbo, Fabrizio, de Lange, Stefanie, de Ruiter, Godard C. W., den Boogert, Hugo, van Dijck, Jeroen, van Heugten, Caroline, van der Naalt, Joukje, Cnossen, Maryse C., Huijben, Jilske A., Van der Jagt, Mathieu, Volovici, Victor, Van Essen, Thoma, Polinder, Suzanne, Nelson, David, Ercole, Ari, Stocchetti, Nino, Citerio, Giuseppe, Peul, Wilco C., Maas, Andrew I. R., Menon, David, Steyerberg, Ewout W., Lingsma, Hester F., on behalf of the CENTER-TBI, Investigator, Beretta, Luigi, Cnossen, M, Huijben, J, van der Jagt, M, Volovici, V, van Essen, T, Polinder, S, Nelson, D, Ercole, A, Stocchetti, N, Citerio, G, Peul, W, Maas, A, Menon, D, Steyerberg, E, Lingsma, H, Molecular Neuroscience and Ageing Research (MOLAR), Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Commission of the European Communities, CENTER-TBI Investigators, Medical Informatics, Public and occupational health, Ragauskas, Arminas, Ročka, Saulius, Vilcinis, Rimantas, Public Health, Intensive Care, Neurosurgery, CENTER-TBI investigators, Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzó, P., Bauerfeind, U., Beer, R., Belda, F.J., Bellander, B.M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Borgen, L.S., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Bučková, V., Calappi, E., Cameron, P., Lozano, G.C., Carise, E., Carpenter, K., Castaño-León, A.M., Causin, F., Chevallard, G., Chieregato, A., Citerio, G., Cnossen, M., Coburn, M., Coles, J., Cooper, J.D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Corte, F.D., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Dulière, G.L., Dzeko, A., Eapen, G., Engemann, H., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V.L., Feng, J., Foks, K., Fossi, F., Francony, G., Frantzén, J., Freo, U., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gao, G., Geleijns, K., Ghuysen, A., Giraud, B., Glocker, B., Gomez, P.A., Grossi, F., Gruen, R.L., Gupta, D., Haagsma, J.A., Hadzic, E., Haitsma, I., Hartings, J.A., Helbok, R., Helseth, E., Hertle, D., Hill, S., Hoedemaekers, A., Hoefer, S., Hutchinson, P.J., Håberg, A.K., Jacobs, B., Janciak, I., Janssens, K., Jiang, J.Y., Jones, K., Kalala, J.P., Kamnitsas, K., Karan, M., Karau, J., Katila, A., Kaukonen, M., Keeling, D., Kerforne, T., Ketharanathan, N., Kettunen, J., Kivisaari, R., Kolias, A.G., Kolumbán, B., Kompanje, E., Kondziella, D., Koskinen, L.O., Kovács, N., Kálovits, F., Lagares, A., Lanyon, L., Laureys, S., Lauritzen, M., Lecky, F., Ledig, C., Lefering, R., Legrand, V., Lei, J., Levi, L., Lightfoot, R., Lingsma, H., Loeckx, D., Lozano, A., Luddington, R., Luijten-Arts, C., Andrew, IRM, MacDonald, S., MacFayden, C., Maegele, M., Majdan, M., Major, S., Manara, A., Manhes, P., Manley, G., Martin, D., Martino, C., Maruenda, A., Maréchal, H., Mastelova, D., Mattern, J., McMahon, C., Melegh, B., Menon, D., Menovsky, T., Morganti-Kossmann, C., Mulazzi, D., Mutschler, M., Mühlan, H., Negru, A., Nelson, D., Neugebauer, E., Newcombe, V., Noirhomme, Q., Nyirádi, J., Oddo, M., Oldenbeuving, A., Oresic, M., Ortolano, F., Palotie, A., Parizel, P.M., Patruno, A., Payen, J.F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Pichon, N., Piilgaard, H., Piippo, A., Floury, S.P., Pirinen, M., Ples, H., Polinder, S., Pomposo, I., Psota, M., Pullens, P., Puybasset, L., Ragauskas, A., Raj, R., Rambadagalla, M., Rehorčíková, V., Rhodes, J., Richardson, S., Ripatti, S., Rocka, S., Rodier, N., Roe, C., Roise, O., Roks, G., Romegoux, P., Rosand, J., Rosenfeld, J., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rostalski, T., Rueckert, D., de Arcaute, F.R., Rusnák, M., Sacchi, M., Sahakian, B., Sahuquillo, J., Sakowitz, O., Sala, F., Sanchez-Pena, P., Sanchez-Porras, R., Sandor, J., Santos, E., Sasse, N., Sasu, L., Savo, D., Schipper, I., Schlößer, B., Schmidt, S., Schneider, A., Schoechl, H., Schoonman, G., Schou, R.F., Schwendenwein, E., Schöll, M., Sir, Ö., Skandsen, T., Smakman, L., Smeets, D., Smielewski, P., Sorinola, A., Stamatakis, E., Stanworth, S., Stegemann, K., Steinbüchel, N., Stevens, R., Stewart, W., Steyerberg, E.W., Stocchetti, N., Sundström, N., Synnot, A., Szabó, J., Söderberg, J., Taccone, F.S., Tamás, V., Tanskanen, P., Tascu, A., Taylor, M.S., Te Ao, B., Tenovuo, O., Teodorani, G., Theadom, A., Thomas, M., Tibboel, D., Tolias, C., Tshibanda, J.L., Tudora, C.M., Vajkoczy, P., Valeinis, E., Van Hecke, W., Van Praag, D., Van Roost, D., Van Vlierberghe, E., Vyvere, T.V., Vanhaudenhuyse, A., Vargiolu, A., Vega, E., Verheyden, J., Vespa, P.M., Vik, A., Vilcinis, R., Vizzino, G., Vleggeert-Lankamp, C., Volovici, V., Vulekovic, P., Vámos, Z., Wade, D., Wang, KKW, Wang, L., Wildschut, E., Williams, G., Willumsen, L., Wilson, A., Wilson, L., Winkler, MKL, Ylén, P., Younsi, A., Zaaroor, M., Zhang, Z., Zheng, Z., Zumbo, F., de Lange, S., de Ruiter, GCW, den Boogert, H., van Dijck, J., van Essen, T.A., van Heugten, C., van der Jagt, M., van der Naalt, J., Rocka, Saulius, „Springer' grupė, Apollo - University of Cambridge Repository, Centre of Excellence in Complex Disease Genetics, Department of Mathematics and Statistics, Institute for Molecular Medicine Finland, Biostatistics Helsinki, Aarno Palotie / Principal Investigator, University of Helsinki, Neurokirurgian yksikkö, Clinicum, Samuli Olli Ripatti / Principal Investigator, Complex Disease Genetics, Genomics of Neurological and Neuropsychiatric Disorders, and Statistical and population genetics

Subjects
Neurology, Letter, IMPACT, Critical Care and Intensive Care Medicine, Intracranial hypertension, 0302 clinical medicine, Traumatic brain injury, Clinical Protocols, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine and Health Sciences, Longitudinal Studies, Prospective Studies, Prospective cohort study, Comparative effectiveness research, Survey, Comparative, effectiveness research, Intracranial pressure, Response rate (survey), Medicine (all), Head injury, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 11 Medical And Health Sciences, Orvostudományok, 3. Good health, Europe, Neurosurgery, medicine.medical_specialty, Critical Care, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], PRESSURE, Klinikai orvostudományok, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, ICP, ICU, medicine, MANAGEMENT, Humans, Monitoring, Physiologic, business.industry, MORTALITY, Research, 3112 Neurosciences, HEAD-INJURY, 030208 emergency & critical care medicine, lcsh:RC86-88.9, CARE, medicine.disease, Emergency & Critical Care Medicine, nervous system diseases, traumatic brain injury, comparative effectiveness research, survey, Emergency medicine, Physical therapy, Dentistry (all), MODERATE, Human medicine, business, 030217 neurology & neurosurgery, EUROPEAN-BRAIN
Abstract

Background No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. Methods A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Results The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%). Conclusions Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research. Electronic supplementary material The online version of this article (doi:10.1186/s13054-017-1816-9) contains supplementary material, which is available to authorized users.

Published
2017

18. External validation of computed tomography decision rules for minor head injury: prospective, multicentre cohort study in the Netherlands

Author

Foks, Kelly A, primary, van den Brand, Crispijn L, additional, Lingsma, Hester F, additional, van der Naalt, Joukje, additional, Jacobs, Bram, additional, de Jong, Eline, additional, den Boogert, Hugo F, additional, Sir, Özcan, additional, Patka, Peter, additional, Polinder, Suzanne, additional, Gaakeer, Menno I, additional, Schutte, Charlotte E, additional, Jie, Kim E, additional, Visee, Huib F, additional, Hunink, Myriam G M, additional, Reijners, Eef, additional, Braaksma, Meriam, additional, Schoonman, Guus G, additional, Steyerberg, Ewout W, additional, Jellema, Korné, additional, and Dippel, Diederik W J, additional

Published
2018
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19. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research

Author

Maas, Andrew I R, primary, Menon, David K, additional, Adelson, P David, additional, Andelic, Nada, additional, Bell, Michael J, additional, Belli, Antonio, additional, Bragge, Peter, additional, Brazinova, Alexandra, additional, Büki, András, additional, Chesnut, Randall M, additional, Citerio, Giuseppe, additional, Coburn, Mark, additional, Cooper, D Jamie, additional, Crowder, A Tamara, additional, Czeiter, Endre, additional, Czosnyka, Marek, additional, Diaz-Arrastia, Ramon, additional, Dreier, Jens P, additional, Duhaime, Ann-Christine, additional, Ercole, Ari, additional, van Essen, Thomas A, additional, Feigin, Valery L, additional, Gao, Guoyi, additional, Giacino, Joseph, additional, Gonzalez-Lara, Laura E, additional, Gruen, Russell L, additional, Gupta, Deepak, additional, Hartings, Jed A, additional, Hill, Sean, additional, Jiang, Ji-yao, additional, Ketharanathan, Naomi, additional, Kompanje, Erwin J O, additional, Lanyon, Linda, additional, Laureys, Steven, additional, Lecky, Fiona, additional, Levin, Harvey, additional, Lingsma, Hester F, additional, Maegele, Marc, additional, Majdan, Marek, additional, Manley, Geoffrey, additional, Marsteller, Jill, additional, Mascia, Luciana, additional, McFadyen, Charles, additional, Mondello, Stefania, additional, Newcombe, Virginia, additional, Palotie, Aarno, additional, Parizel, Paul M, additional, Peul, Wilco, additional, Piercy, James, additional, Polinder, Suzanne, additional, Puybasset, Louis, additional, Rasmussen, Todd E, additional, Rossaint, Rolf, additional, Smielewski, Peter, additional, Söderberg, Jeannette, additional, Stanworth, Simon J, additional, Stein, Murray B, additional, von Steinbüchel, Nicole, additional, Stewart, William, additional, Steyerberg, Ewout W, additional, Stocchetti, Nino, additional, Synnot, Anneliese, additional, Te Ao, Braden, additional, Tenovuo, Olli, additional, Theadom, Alice, additional, Tibboel, Dick, additional, Videtta, Walter, additional, Wang, Kevin K W, additional, Williams, W Huw, additional, Wilson, Lindsay, additional, Yaffe, Kristine, additional, Adams, Hadie, additional, Agnoletti, Vanni, additional, Allanson, Judith, additional, Amrein, Krisztina, additional, Andaluz, Norberto, additional, Anke, Audny, additional, Antoni, Anna, additional, van As, Arjan Bastiaan, additional, Audibert, Gérard, additional, Azaševac, Antun, additional, Azouvi, Philippe, additional, Azzolini, Maria Luisa, additional, Baciu, Camelia, additional, Badenes, Rafael, additional, Barlow, Karen M, additional, Bartels, Ronald, additional, Bauerfeind, Ursula, additional, Beauchamp, Miriam, additional, Beer, Darcy, additional, Beer, Ronny, additional, Belda, Francisco Javier, additional, Bellander, Bo-Michael, additional, Bellier, Rémy, additional, Benali, Habib, additional, Benard, Thierry, additional, Beqiri, Valzerda, additional, Beretta, Luigi, additional, Bernard, Francis, additional, Bertolini, Guido, additional, Bilotta, Federico, additional, Blaabjerg, Morten, additional, den Boogert, Hugo, additional, Boutis, Kathy, additional, Bouzat, Pierre, additional, Brooks, Brian, additional, Brorsson, Camilla, additional, Bullinger, Monika, additional, Burns, Emma, additional, Calappi, Emiliana, additional, Cameron, Peter, additional, Carise, Elsa, additional, Castaño-León, Ana M, additional, Causin, Francesco, additional, Chevallard, Giorgio, additional, Chieregato, Arturo, additional, Christie, Brian, additional, Cnossen, Maryse, additional, Coles, Jonathan, additional, Collett, Johnny, additional, Della Corte, Francesco, additional, Craig, William, additional, Csato, Gabor, additional, Csomos, Akos, additional, Curry, Nicola, additional, Dahyot-Fizelier, Claire, additional, Dawes, Helen, additional, DeMatteo, Carol, additional, Depreitere, Bart, additional, Dewey, Deborah, additional, van Dijck, Jeroen, additional, Đilvesi, Đula, additional, Dippel, Diederik, additional, Dizdarevic, Kemal, additional, Donoghue, Emma, additional, Duek, Or, additional, Dulière, Guy-Loup, additional, Dzeko, Adelaida, additional, Eapen, George, additional, Emery, Carolyn A, additional, English, Shane, additional, Esser, Patrick, additional, Ezer, Erzsébet, additional, Fabricius, Martin, additional, Feng, Junfeng, additional, Fergusson, Dean, additional, Figaji, Anthony, additional, Fleming, Joanne, additional, Foks, Kelly, additional, Francony, Gilles, additional, Freedman, Stephen, additional, Freo, Ulderico, additional, Frisvold, Shirin K, additional, Gagnon, Isabelle, additional, Galanaud, Damien, additional, Gantner, Dashiell, additional, Giraud, Benoit, additional, Glocker, Ben, additional, Golubovic, Jagoš, additional, Gómez López, Pedro A, additional, Gordon, Wayne A, additional, Gradisek, Primoz, additional, Gravel, Jocelyn, additional, Griesdale, Donald, additional, Grossi, Francesca, additional, Haagsma, Juanita A, additional, Håberg, Asta Kristine, additional, Haitsma, Iain, additional, Van Hecke, Wim, additional, Helbok, Raimund, additional, Helseth, Eirik, additional, van Heugten, Caroline, additional, Hoedemaekers, Cornelia, additional, Höfer, Stefan, additional, Horton, Lindsay, additional, Hui, Jiyuan, additional, Huijben, Jilske Antonia, additional, Hutchinson, Peter J, additional, Jacobs, Bram, additional, van der Jagt, Mathieu, additional, Jankowski, Stefan, additional, Janssens, Koen, additional, Jelaca, Bojan, additional, Jones, Kelly M, additional, Kamnitsas, Konstantinos, additional, Kaps, Rafael, additional, Karan, Mladen, additional, Katila, Ari, additional, Kaukonen, Kirsi-Maija, additional, De Keyser, Véronique, additional, Kivisaari, Riku, additional, Kolias, Angelos G, additional, Kolumbán, Bálint, additional, Kolundžija, Ksenija, additional, Kondziella, Daniel, additional, Koskinen, Lars-Owe, additional, Kovács, Noémi, additional, Kramer, Andreas, additional, Kutsogiannis, Demitri, additional, Kyprianou, Theodoros, additional, Lagares, Alfonso, additional, Lamontagne, François, additional, Latini, Roberto, additional, Lauzier, François, additional, Lazar, Isaac, additional, Ledig, Christian, additional, Lefering, Rolf, additional, Legrand, Valerie, additional, Levi, Leon, additional, Lightfoot, Roger, additional, Lozano, Angels, additional, MacDonald, Stephen, additional, Major, Sebastian, additional, Manara, Alex, additional, Manhes, Pauline, additional, Maréchal, Hugues, additional, Martino, Costanza, additional, Masala, Alessandro, additional, Masson, Serge, additional, Mattern, Julia, additional, McFadyen, Bradford, additional, McMahon, Catherine, additional, Meade, Maureen, additional, Melegh, Béla, additional, Menovsky, Tomas, additional, Moore, Lynne, additional, Morgado Correia, Marta, additional, Morganti-Kossmann, Maria Cristina, additional, Muehlan, Holger, additional, Mukherjee, Pratik, additional, Murray, Lynnette, additional, van der Naalt, Joukje, additional, Negru, Ancuta, additional, Nelson, David, additional, Nieboer, Daan, additional, Noirhomme, Quentin, additional, Nyirádi, József, additional, Oddo, Mauro, additional, Okonkwo, David O, additional, Oldenbeuving, Annemarie W, additional, Ortolano, Fabrizio, additional, Osmond, Martin, additional, Payen, Jean-François, additional, Perlbarg, Vincent, additional, Persona, Paolo, additional, Pichon, Nicolas, additional, Piippo-Karjalainen, Anna, additional, Pili-Floury, Sébastien, additional, Pirinen, Matti, additional, Ple, Horia, additional, Poca, Maria Antonia, additional, Posti, Jussi, additional, Van Praag, Dominique, additional, Ptito, Alain, additional, Radoi, Andreea, additional, Ragauskas, Arminas, additional, Raj, Rahul, additional, Real, Ruben G L, additional, Reed, Nick, additional, Rhodes, Jonathan, additional, Robertson, Claudia, additional, Rocka, Saulius, additional, Røe, Cecilie, additional, Røise, Olav, additional, Roks, Gerwin, additional, Rosand, Jonathan, additional, Rosenfeld, Jeffrey V, additional, Rosenlund, Christina, additional, Rosenthal, Guy, additional, Rossi, Sandra, additional, Rueckert, Daniel, additional, de Ruiter, Godard C W, additional, Sacchi, Marco, additional, Sahakian, Barbara J, additional, Sahuquillo, Juan, additional, Sakowitz, Oliver, additional, Salvato, Gerardo, additional, Sánchez-Porras, Renán, additional, Sándor, János, additional, Sangha, Grinder, additional, Schäfer, Nadine, additional, Schmidt, Silke, additional, Schneider, Kathryn J, additional, Schnyer, David, additional, Schöhl, Herbert, additional, Schoonman, Guus G, additional, Schou, Rico Frederik, additional, Sir, Özcan, additional, Skandsen, Toril, additional, Smeets, Dirk, additional, Sorinola, Abayomi, additional, Stamatakis, Emmanuel, additional, Stevanovic, Ana, additional, Stevens, Robert D, additional, Sundström, Nina, additional, Taccone, Fabio Silvio, additional, Takala, Riikka, additional, Tanskanen, Päivi, additional, Taylor, Mark Steven, additional, Telgmann, Ralph, additional, Temkin, Nancy, additional, Teodorani, Guido, additional, Thomas, Matt, additional, Tolias, Christos M, additional, Trapani, Tony, additional, Turgeon, Alexis, additional, Vajkoczy, Peter, additional, Valadka, Alex B, additional, Valeinis, Egils, additional, Vallance, Shirley, additional, Vámos, Zoltán, additional, Vargiolu, Alessia, additional, Vega, Emmanuel, additional, Verheyden, Jan, additional, Vik, Anne, additional, Vilcinis, Rimantas, additional, Vleggeert-Lankamp, Carmen, additional, Vogt, Lidia, additional, Volovici, Victor, additional, Voormolen, Daphne C, additional, Vulekovic, Peter, additional, Vande Vyvere, Thijs, additional, Van Waesberghe, Julia, additional, Wessels, Lars, additional, Wildschut, Eno, additional, Williams, Guy, additional, Winkler, Maren K L, additional, Wolf, Stefan, additional, Wood, Gordon, additional, Xirouchaki, Nektaria, additional, Younsi, Alexander, additional, Zaaroor, Menashe, additional, Zelinkova, Veronika, additional, Zemek, Roger, additional, and Zumbo, Fabrizio, additional

Published
2017
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20. Risk of Intracranial Complications in Minor Head Injury: The Role of Loss of Consciousness and Post-Traumatic Amnesia in a Multi-Center Observational Study.

Author

Foks, Kelly A., Dijkland, Simone A., Lingsma, Hester F., Polinder, Suzanne, van den Brand, Crispijn L., Jellema, Korné, Jacobs, Bram, van der Naalt, Joukje, Sir, Özcan, Jie, Kim E., Schoonman, Guus G., Hunink, Myriam G.M., Steyerberg, Ewout W., Dippel, Diederik W.J., Gaakeer, Menno I, Schutte, Charlotte E, Visee, Huib F, den Boogert, Hugo, Reijners, Eef, and Braaksma, Meriam

Published
2019
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26. TGF ABROGATES TCRMEDIATED SIGNALING BY UPREGULATING TYROSINE PHOSPHATASES IN T CELLS

Author

Choudhry, Mashkoor A., Sir, Özcan, and Sayeed, Mohammed M.

Abstract

TGF is known to inhibit many of the immune cell functions including T cell proliferation and IL2 production. The mechanism of such TGFmediated inhibition of T cell functions is poorly understood. The present study examined the effects of TGF on the activation of protein tyrosine kinases PTK P56lck, P59fyn, and Zap70, and protein tyrosine phosphatases PTP SHP1 and SHP2. A balance between the actions of PTK and PTP is critical for appropriate T cell activation. These studies were carried out using nylon woolpurified splenic T cells from healthy SpragueDawley rats. Results from these studies showed that incubation of T cells with TGF inhibited the activation of P56lck, P59fyn, and Zap70. The decrease in these three protein tyrosine kinases was accompanied by an increase in the activation of the protein tyrosine phosphatase SHP1. There was no change in the phosphorylation of SHP2 with and without pretreatment of T cells with TGF. The decrease in P56lck, P59fynkinase activity, and Zap70 phosphorylation was prevented when T cells were stimulated with antiCD3 in the presence of pervanadate, an inhibitor of PTP. These results suggested that TGFmediated inhibition of P56lck, P59fyn, and Zap70 is likely due to an upregulation of protein tyrosine phosphatases such as SHP1.

Published
2001

27. ROLE OF NEUTROPHILS IN BURNINDUCED MICROVASCULAR INJURY IN THE INTESTINE

Author

Sir, Özcan, Fazal, Nadeem, Choudhry, Mashkoor A., Goris, R. Jan A., Gamelli, Richard L., and Sayeed, Mohammed M.

Abstract

The present study evaluated burninduced vascular permeability alterations of rat small intestine in vivoand assessed the effect of neutrophil depletion in burninjured rats on the altered intestinal microvascular permeability. 125IIabeled bovine serum albumin 125IBSA was injected intravenously, and its leakage from circulation into the intestinal tissue was determined by measuring tissue counts of 125IBSA. Compared with sham, vascular albumin permeability increased 1.7fold on day 1 postburn and 3.0fold on day 3 postburn in ileum. In the jejunum, albumin permeability increased 1.8 and 2.5fold on day 1 and day 3 postburn, respectively. Intestinal tissue edema, determined as increases in tissue water contents, was noted in both intestinal segments on day 1 postburn no further increase in edema was found on day 3 postburn. Neutrophil depletion before burn injury prevented the vascular leakage of albumin and edema in the ileum and jejunum on day 1 postburn. On day 3 postburn, the effect of prior neutrophil depletion on vascular permeability was less marked, and edema formation was not affected at all. These findings indicate that an absence of neutrophils prevents the loss of intestinal vascular barrier properties only in the initial periods after burns.

Published
2000

28. External validation of computed tomography decision rules for minor head injury : prospective, multicentre cohort study in the Netherlands

Author

Foks, Kelly A, van den Brand, Crispijn L, Lingsma, Hester F, van der Naalt, Joukje, Jacobs, Bram, de Jong, Eline, den Boogert, Hugo F, Sir, Özcan, Patka, Peter, Polinder, Suzanne, Gaakeer, Menno I, Schutte, Charlotte E, Jie, Kim E, Visee, Huib F, Hunink, Myriam G M, Reijners, Eef, Braaksma, Meriam, Schoonman, Guus G, Steyerberg, Ewout W, Jellema, Korné, and Dippel, Diederik W J

29. Imputation strategies for missing baseline neurological assessment covariates after traumatic brain injury: A CENTER-TBI study

Author

Ari Ercole, Fiona Lecky, Frederick A. Zeiler, Abhishek Dixit, Participants, Ewout W. Steyerberg, Omar Bouamra, Daan Nieboer, Andrew I R Maas, David K. Menon, David W. Nelson, Lindsay Wilson, Center-Tbi investigators, Hester F. Lingsma, Simone A. Dijkland, Shubhayu Bhattacharyay, Ercole, Ari [0000-0001-8350-8093], Bhattacharyay, Shubhayu [0000-0001-7428-5588], Maas, Andrew I. R. [0000-0003-1612-1264], Wilson, Lindsay [0000-0003-4113-2328], Apollo - University of Cambridge Repository, Freo, Ulderico, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gao, Guoyi, Geleijns, Karin, Ghuysen, Alexandre, Giraud, Benoit, Glocker, Ben, Gomez, Pedro A., Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Hadzic, Ermin, Haitsma, Iain, Hartings, Jed A., Helbok, Raimund, Helseth, Eirik, Hertle, Daniel, Hill, Sean, Hoedemaekers, Astrid, Hoefer, Stefan, Hutchinson, Peter J., Haberg, Asta Kristine, Jacobs, Bram, Janciak, Ivan, Janssens, Koen, Jiang, Ji-yao, Jones, Kelly, Kalala, Jean-Pierre, Kamnitsas, Konstantinos, Karan, Mladen, Karau, Jana, Katila, Ari, Kaukonen, Maija, Keeling, David, Kerforne, Thomas, Ketharanathan, Naomi, Kettunen, Johannes, Kivisaari, Riku, Kolias, Angelos G., Kolumbán, Bálint, Kompanje, Erwin, Kondziella, Daniel, Koskinen, Lars-Owe, Kovács, Noémi, Kálovits, Ferenc, Lagares, Alfonso, Adams, Hadie, Lanyon, Linda, Laureys, Steven, Lauritzen, Martin, Lecky, Fiona, Ledig, Christian, Lefering, Rolf, Legrand, Valerie, Lei, Jin, Levi, Leon, Lightfoot, Roger, Alessandro, Masala, Lingsma, Hester, Loeckx, Dirk, Lozano, Angels, Luddington, Roger, Luijten-Arts, Chantal, Maas, Andrew I. R., MacDonald, Stephen, MacFayden, Charles, Maegele, Marc, Majdan, Marek, Allanson, Judith, Major, Sebastian, Manara, Alex, Manhes, Pauline, Manley, Geoffrey, Martin, Didier, Martino, Costanza, Maruenda, Armando, Maréchal, Hugues, Mastelova, Dagmara, Mattern, Julia, Amrein, Krisztina, McMahon, Catherine, Melegh, Béla, Menon, David, Menovsky, Tomas, Morganti-Kossmann, Cristina, Mulazzi, Davide, Mutschler, Manuel, Mühlan, Holger, Negru, Ancuta, Nelson, David, Andaluz, Norberto, Neugebauer, Eddy, Newcombe, Virginia, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Oldenbeuving, Annemarie, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Parizel, Paul M., Andelic, Nada, Patruno, Adriana, Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Peul, Wilco, Pichon, Nicolas, Piilgaard, Henning, Piippo, Anna, Pili, Floury Sébastien, Andrea, Nanni, Pirinen, Matti, Ples, Horia, Polinder, Suzanne, Pomposo, Inigo, Psota, Marek, Pullens, Pim, Puybasset, Louis, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Andreassen, Lasse, Rehorc̆íková, Veronika, Rhodes, Jonathan, Richardson, Sylvia, Ripatti, Samuli, Rocka, Saulius, Rodier, Nicolas, Roe, Cecilie, Roise, Olav, Roks, Gerwin, Romegoux, Pauline, Anke, Audny, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rostalski, Tim, Rueckert, Daniel, Ruiz de Arcaute, Felix, Rusnák, Martin, Antoni, Anna, Sacchi, Marco, Sahakian, Barbara, Sahuquillo, Juan, Sakowitz, Oliver, Sala, Francesca, Sanchez-Pena, Paola, Sanchez-Porras, Renan, Sandor, Janos, Santos, Edgar, Sasse, Nadine, Audibert, Gérard, Sasu, Luminita, Savo, Davide, Schipper, Inger, Schlößer, Barbara, Schmidt, Silke, Schneider, Annette, Schoechl, Herbert, Schoonman, Guus, Ardon, Hilko, Schou, Rico Frederik, Auslands, Kaspars, Schwendenwein, Elisabeth, Schöll, Michael, Sir, özcan, Skandsen, Toril, Smakman, Lidwien, Smeets, Dirk, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Azouvi, Philippe, Stegemann, Katrin, Steinbüchel, Nicole, Stevens, Robert, Stewart, William, Steyerberg, Ewout W., Stocchetti, Nino, Sundström, Nina, Synnot, Anneliese, Szabó, József, Söderberg, Jeannette, Baciu, Camelia, Taccone, Fabio Silvio, Tamás, Viktória, Tanskanen, Päivi, Tascu, Alexandru, Taylor, Mark Steven, Te, Ao Braden, Tenovuo, Olli, Teodorani, Guido, Theadom, Alice, Thomas, Matt, Bacon, Andrew, Tibboel, Dick, Tolias, Christos, Tshibanda, Jean-Flory Luaba, Tudora, Cristina Maria, Vajkoczy, Peter, Valeinis, Egils, Van Hecke, Wim, Van Praag, Dominique, Van Roost, Dirk, Van Vlierberghe, Eline, Badenes, Rafael, Vande Vyvere, Thijs, Vanhaudenhuyse, Audrey, Vargiolu, Alessia, Vega, Emmanuel, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, Vizzino, Giacinta, Vleggeert-Lankamp, Carmen, Baglin, Trevor, Volovici, Victor, Vulekovic, Peter, Vámos, Zoltán, Wade, Derick, Wang, Kevin K. W., Wang, Lei, Wildschut, Eno, Williams, Guy, Willumsen, Lisette, Wilson, Adam, Bartels, Ronald, Wilson, Lindsay, Winkler, Maren K. L., Ylén, Peter, Younsi, Alexander, Zaaroor, Menashe, Zhang, Zhiqun, Zheng, Zelong, Zumbo, Fabrizio, de Lange, Stefanie, de Ruiter, Godard C. W., Barzó, Pál, den Boogert, Hugo, van Dijck, Jeroen, van Essen, Thomas A., van Heugten, Caroline, van der Jagt, Mathieu, van der Naalt, Joukje, Beqiri, Erta, Bauerfeind, Ursula, Beer, Ronny, Belda, Francisco Javier, Bellander, Bo-Michael, Belli, Antonio, Bellier, Rémy, Benali, Habib, Benard, Thierry, Berardino, Maurizio, Beretta, Luigi, Beynon, Christopher, Bilotta, Federico, Binder, Harald, Blaabjerg, Morten, Borgen, Lund Stine, Bouzat, Pierre, Bragge, Peter, Brazinova, Alexandra, Brehar, Felix, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Buc̆ková, Veronika, Calappi, Emiliana, Cameron, Peter, Carbayo, Lozano Guillermo, Carise, Elsa, Carpenter, K., Castaño-León, Ana M., Causin, Francesco, Chevallard, Giorgio, Chieregato, Arturo, Citerio, Giuseppe, Cnossen, Maryse, Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Covic, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Damas, François, Damas, Pierre, Dawes, Helen, De Keyser, Véronique, Della Corte, Francesco, Depreitere, Bart, Ding, Shenghao, Dippel, Diederik, Dizdarevic, Kemal, Dulière, Guy-Loup, Dzeko, Adelaida, Eapen, George, Engemann, Heiko, Ercole, Ari, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Feng, Junfeng, Foks, Kelly, Fossi, Francesca, Francony, Gilles, Frantzén, Janek, Public Health, Erasmus MC other, Zeiler, Frederick A [0000-0003-1737-0510], Maas, Andrew I R [0000-0003-1612-1264], Maas, Andrew IR [0000-0003-1612-1264], and CENTER-TBI Investigators

Subjects
Critical Care and Emergency Medicine, Traumatic Brain Injury, Pooling, Blood Pressure, Logistic regression, Vascular Medicine, Outcome (game theory), Mathematical and Statistical Techniques, Cognition, Statistics, Brain Injuries, Traumatic, Psychology, Imputation (statistics), Hypoxia, Trauma Medicine, Neurologic Examination, Multidisciplinary, FOS: Social sciences, Prognosis, Physical sciences, Medicine, Hypotension, Traumatic Injury, Research Article, medicine.medical_specialty, Critical Care, Traumatic brain injury, Cognitive Neuroscience, Resuscitation, Science, Decision Making, FOS: Physical sciences, Social sciences, Motor Reactions, Physical medicine and rehabilitation, Covariate, medicine, Humans, Glasgow Coma Scale, Statistical Methods, Baseline (configuration management), Medicine and health sciences, Models, Statistical, Biology and life sciences, business.industry, Cognitive Psychology, Cell Biology, Emergency department, medicine.disease, Missing data, Research and analysis methods, Logistic Models, Cognitive Science, Human medicine, business, Neurotrauma, Mathematics, Neuroscience, Forecasting
Abstract

Funder: One Mind for Research, Funder: bill and melinda gates foundation (us), Funder: University of Manitoba VPRI Research investment fund, Funder: Winniped Health Sciences Centre HSC Foundation, Funder: ZNS - Hannelore Kohl Stiftung (DE), Funder: Integra LifeSciences (US), Funder: Rudy Falk Professorship, Statistical models for outcome prediction are central to traumatic brain injury research and critical to baseline risk adjustment. Glasgow coma score (GCS) and pupil reactivity are crucial covariates in all such models but may be measured at multiple time points between the time of injury and hospital and are subject to a variable degree of unreliability and/or missingness. Imputation of missing data may be undertaken using full multiple imputation or by simple substitution of measurements from other time points. However, it is unknown which strategy is best or which time points are more predictive. We evaluated the pseudo-R2 of logistic regression models (dichotomous survival) and proportional odds models (Glasgow Outcome Score—extended) using different imputation strategies on the The Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study dataset. Substitution strategies were easy to implement, achieved low levels of missingness (<< 10%) and could outperform multiple imputation without the need for computationally costly calculations and pooling multiple final models. While model performance was sensitive to imputation strategy, this effect was small in absolute terms and clinical relevance. A strategy of using the emergency department discharge assessments and working back in time when these were missing generally performed well. Full multiple imputation had the advantage of preserving time-dependence in the models: the pre-hospital assessments were found to be relatively unreliable predictors of survival or outcome. The predictive performance of later assessments was model-dependent. In conclusion, simple substitution strategies for imputing baseline GCS and pupil response can perform well and may be a simple alternative to full multiple imputation in many cases.

Published
2021

30. Emergency Department Triage, Transfer Times, and Hospital Mortality of Patients Admitted to the ICU: A Retrospective Replication and Continuation Study.

Author

van Herwerden MC, Groenland CNL, Termorshuizen F, Rietdijk WJR, Blokzijl F, Cleffken BI, Dormans T, Epker JL, Feyz L, Gritters van den Oever N, van der Heiden P, de Jonge E, Latten GHP, Pruijsten RV, Sir Ö, Spronk PE, Vermeijden WJ, van Vliet P, de Keizer NF, and den Uil CA

Abstract

Objectives: This study aimed to provide new insights into the impact of emergency department (ED) to ICU time on hospital mortality, stratifying patients by academic and nonacademic teaching (NACT) hospitals, and considering Acute Physiology and Chronic Health Evaluation (APACHE)-IV probability and ED-triage scores., Design, Setting, and Patients: We conducted a retrospective cohort study (2009-2020) using data from the Dutch National Intensive Care Evaluation registry. Patients directly admitted from the ED to the ICU were included from four academic and eight NACT hospitals. Odds ratios (ORs) for mortality associated with ED-to-ICU time were estimated using multivariable regression, both crude and after adjusting for and stratifying by APACHE-IV probability and ED-triage scores., Interventions: None., Measurements and Main Results: A total of 28,455 patients were included. The median ED-to-ICU time was 1.9 hours (interquartile range, 1.2-3.1 hr). No overall association was observed between ED-to-ICU time and hospital mortality after adjusting for APACHE-IV probability (p = 0.36). For patients with an APACHE-IV probability greater than 55.4% (highest quintile) and an ED-to-ICU time greater than 3.4 hours the adjusted OR (ORsadjApache) was 1.24 (95% CI, 1.00-1.54; p < 0.05) as compared with the reference category (< 1.1 hr). In the academic hospitals, the ORsadjApache for ED-to-ICU times of 1.6-2.3, 2.3-3.4, and greater than 3.4 hours were 1.21 (1.01-1.46), 1.21 (1.00-1.46), and 1.34 (1.10-1.64), respectively. In NACT hospitals, no association was observed (p = 0.07). Subsequently, ORs were adjusted for ED-triage score (ORsadjED). In the academic hospitals the ORsadjED for ED-to-ICU times greater than 3.4 hours was 0.98 (0.81-1.19), no overall association was observed (p = 0.08). In NACT hospitals, all time-ascending quintiles had ORsadjED values of less than 1.0 (p < 0.01)., Conclusions: In patients with the highest APACHE-IV probability at academic hospitals, a prolonged ED-to-ICU time was associated with increased hospital mortality. We found no significant or consistent unfavorable association in lower APACHE-IV probability groups and NACT hospitals. The association between longer ED-to-ICU time and higher mortality was not found after adjustment and stratification for ED-triage score., Competing Interests: Dr. Termorshuizen’s and de Keizer’s institutions received funding from the National Intensive Care Evaluation foundation for processing and analyzing data submitted by the ICUs into the national database. Dr. Termorshuizen received funding from the Rivierduinen Mental Health Care Institute. The remaining authors have disclosed that they do not have any potential conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc.)

Published
2024
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31. Teach-back of discharge instructions in the emergency department: a pre-post pilot evaluation.

Author

Hesselink G, Sir Ö, Koster N, Tolsma C, Munsterman M, Olde Rikkert M, and Schoon Y

Subjects
Aged, Emergency Service, Hospital, Humans, Pilot Projects, Aftercare, Patient Discharge
Abstract

Objectives: With the 'teach-back' method, patients or carers repeat back what they understand, so that professionals can confirm comprehension and correct misunderstandings. The effectiveness of teach-back has been underexamined, particularly for older patients discharged from the emergency department (ED). We aimed to determine whether teach-back would reduce ED revisits and whether it would increase patients' retention of discharge instructions, improve self-management at home and increase satisfaction with the provision of instructions., Methods: A nonrandomised pre-post pilot evaluation in the ED of one Dutch academic hospital including patients discharged from the ED receiving standard discharge care (pre) and teach-back (post). Primary outcomes were ED-revisits within 7 days and within 8-30 days postdischarge. Secondary outcomes for a subsample of older adults were retention of instructions, self-management 72 hours after discharge and satisfaction with the provision of discharge instructions., Results: A total of 648 patients were included, 154 were older adults. ED revisits within 7 days and within 8-30 days were lower in the teach-back group compared with those receiving standard discharge care: adjusted odds ratios (AORs) of 0.23 (95% CI 0.05 to 1.07) and 0.42 (95% CI 0.14 to 1.33), respectively. Participants in the teach-back group had an increased likelihood of full knowledge retention on information related to their ED diagnosis and treatment (AOR 2.19; 95% CI 1.01 to 4.75; p=0.048), medication (AOR 14.89; 95% CI 4.12 to 53.85; p>0.001) and follow-up appointments (AOR 3.86; 95% CI 1.33 to 10.19; p=0.012). Use of teach-back was not significantly associated with improved self-management and higher satisfaction with discharge instructions. Discharge conversations were generally shorter for participants receiving teach-back., Conclusions: Discharging patients from the ED with a relatively simple and feasible teach-back method can contribute to safer and better transitional care from the ED to home., Competing Interests: Competing interests: None., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Published
2022
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32. [Herlyn-Werner-Wunderlich syndrome].

Author

van Leerdam LE, Beerendonk CC, Klein WM, and Sir Ö

Subjects
Abdominal Pain diagnosis, Abdominal Pain etiology, Adolescent, Anal Canal abnormalities, Appendicitis diagnosis, Diagnosis, Differential, Female, Humans, Laparoscopy, Magnetic Resonance Imaging, Syndrome, Abnormalities, Multiple diagnosis, Kidney abnormalities, Urogenital Abnormalities, Uterus abnormalities, Vagina abnormalities
Abstract

Background: Many patients are admitted to accident and emergency departments with acute abdominal pain. Herlyn-Werner-Wunderlich syndrome (HWWS) is one of the less well-known causes of this. It is characterised by uterine didelphys with an obstructed hemivagina and ipsilateral renal agenesis or dysplasia., Case Description: A 16-year-old girl presented to the emergency department with progressive abdominal pain and a previous history of renal and anal abnormalities. Acute appendicitis was suspected because of both tenderness on pressure and rebound tenderness, and a raised C-reactive protein level. Abdominal ultrasonography revealed a cystic structure, probably of ovarian or tubal origin. An emergency laparoscopy was performed as ovarian torsion was suspected. This revealed uterine didelphys with an abnormal right horn. Additional abdominal MRI scan diagnostic revealed abnormalities consistent with HWWS., Conclusion: Congenital urogenital abnormalities should be included in the differential diagnosis of patients with a previous history of renal or anal abnormalities who present with progressive abdominal pain or dysmenorrhoea.

Published
2014

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