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4. Early Neurologic Recovery, Practice Pattern Variation, and the Risk of Endotracheal Intubation Following Established Status Epilepticus.

Author

Rosenthal, Eric S, Elm, Jordan J, Ingles, James, Rogers, Alexander J, Terndrup, Thomas E, Holsti, Maija, Thomas, Danny G, Babcock, Lynn, Okada, Pamela J, Lipsky, Robert H, Miller, Joseph B, Hickey, Robert W, Barra, Megan E, Bleck, Thomas P, Cloyd, James C, Silbergleit, Robert, Lowenstein, Daniel H, Coles, Lisa D, Kapur, Jaideep, Shinnar, Shlomo, Chamberlain, James M, and Established Status Epilepticus Treatment Trial Study Group

Subjects
Established Status Epilepticus Treatment Trial Study Group, Humans, Nervous System Diseases, Status Epilepticus, Anticonvulsants, Risk Factors, Cohort Studies, Intubation, Intratracheal, Recovery of Function, Adolescent, Adult, Aged, Middle Aged, Child, Female, Male, Young Adult, Brain Disorders, Clinical Research, Neurosciences, Clinical Sciences, Cognitive Sciences, Neurology & Neurosurgery
Abstract

ObjectiveTo quantify the association between early neurologic recovery, practice pattern variation, and endotracheal intubation during established status epilepticus, we performed a secondary analysis within the cohort of patients enrolled in the Established Status Epilepticus Treatment Trial (ESETT).MethodsWe evaluated factors associated with the endpoint of endotracheal intubation occurring within 120 minutes of ESETT study drug initiation. We defined a blocked, stepwise multivariate regression, examining 4 phases during status epilepticus management: (1) baseline characteristics, (2) acute treatment, (3) 20-minute neurologic recovery, and (4) 60-minute recovery, including seizure cessation and improving responsiveness.ResultsOf 478 patients, 117 (24.5%) were intubated within 120 minutes. Among high-enrolling sites, intubation rates ranged from 4% to 32% at pediatric sites and 19% to 39% at adult sites. Baseline characteristics, including seizure precipitant, benzodiazepine dosing, and admission vital signs, provided limited discrimination for predicting intubation (area under the curve [AUC] 0.63). However, treatment at sites with an intubation rate in the highest (vs lowest) quartile strongly predicted endotracheal intubation independently of other treatment variables (adjusted odds ratio [aOR] 8.12, 95% confidence interval [CI] 3.08-21.4, model AUC 0.70). Site-specific variation was the factor most strongly associated with endotracheal intubation after adjustment for 20-minute (aOR 23.4, 95% CI 6.99-78.3, model AUC 0.88) and 60-minute (aOR 14.7, 95% CI 3.20-67.5, model AUC 0.98) neurologic recovery.ConclusionsEndotracheal intubation after established status epilepticus is strongly associated with site-specific practice pattern variation, independently of baseline characteristics, and early neurologic recovery and should not alone serve as a clinical trial endpoint in established status epilepticus.Trial registration informationClinicalTrials.gov Identifier: NCT01960075.

Published
2021

10. Stratification of risk for emergent intracranial abnormalities in children with headaches: a Pediatric Emergency Care Applied Research Network (PECARN) study protocol

Author

Tsze, Daniel S, primary, Kuppermann, Nathan, additional, Casper, T Charles, additional, Barney, Bradley J, additional, Richer, Lawrence P, additional, Liberman, Danica B, additional, Okada, Pamela J, additional, Morris, Claudia R, additional, Myers, Sage R, additional, Soung, Jane K, additional, Mistry, Rakesh D, additional, Babcock, Lynn, additional, Spencer, Sandra P, additional, Johnson, Michael D, additional, Klein, Eileen J, additional, Quayle, Kimberly S, additional, Steele, Dale W, additional, Cruz, Andrea T, additional, Rogers, Alexander J, additional, Thomas, Danny G, additional, Grupp-Phelan, Jacqueline M, additional, Johnson, Tiffani J, additional, and Dayan, Peter S, additional

Published
2023
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12. The Effects of Rest on Concussion Symptom Resolution and Recovery Time: A Meta-analytic Review and Subgroup Analysis of 4329 Patients.

Author

Kontos, Anthony P., Eagle, Shawn R., Braithwaite, Rock, Preszler, Jonathan, Manderino, Lisa, Turner, Rose L., Jennings, Sabrina, Trbovich, Alicia, Hickey, Robert W., Collins, Michael W., McCrea, Michael, Nelson, Lindsay D., Root, Jeremy, and Thomas, Danny G.

Subjects
BRAIN concussion prevention, MEDICAL databases, PSYCHOLOGY information storage & retrieval systems, META-analysis, MEDICAL information storage & retrieval systems, CONVALESCENCE, TIME, SYSTEMATIC reviews, AGE distribution, SPORTS, SPORTS injuries, CONTINUING education units, RELAXATION for health, TREATMENT effectiveness, PHYSICAL activity, SYMPTOMS, RESEARCH funding, MEDLINE, INFORMATION storage & retrieval systems, DISEASE complications
Abstract

Background: Numerous individual studies suggest that rest may have a negative effect on outcomes following concussion. Purpose: To perform a systematic meta-analysis of the effects of prescribed rest compared with active interventions after concussion. Study Design: Meta-analysis; Level of evidence, 4. Methods: A meta-analysis (using the Hedges g) of randomized controlled trials and cohort studies was conducted to evaluate the effects of prescribed rest on symptoms and recovery time after concussion. Subgroup analyses were performed for methodological, study, and sample characteristics. Data sources were obtained from systematic search of key terms using Ovid Medline, Embase, Cochrane Database of Systematic Reviews, APA PsycINFO, Web of Science, SPORTDiscus, and ProQuest dissertations and theses through May 28, 2021. Eligible studies were those that (1) assessed concussion or mild traumatic brain injury; (2) included symptoms or days to recovery for ≥2 time points; (3) included 2 groups with 1 group assigned to rest; and (4) were written in the English language. Results: In total, 19 studies involving 4239 participants met criteria. Prescribed rest had a significant negative effect on symptoms (k = 15; g = −0.27; SE = 0.11; 95% CI, −0.48 to −0.05; P =.04) but not on recovery time (k = 8; g = −0.16; SE = 0.21; 95% CI, −0.57 to 0.26; P =.03). Subgroup analyses suggested that studies with shorter duration (<28 days) (g = −0.46; k = 5), studies involving youth (g = −0.33; k = 12), and studies focused on sport-related concussion (g = −0.38; k = 8) reported higher effect sizes. Conclusion: The findings support a small negative effect for prescribed rest on symptoms after concussion. Younger age and sport-related mechanisms of injury were associated with a greater negative effect size. However, the lack of support for an effect for recovery time and the relatively small overall numbers of eligible studies highlight ongoing concerns regarding the quantity and rigor of clinical trials in concussion. Registration: CRD42021253060 (PROSPERO). [ABSTRACT FROM AUTHOR]

Published
2023
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15. sj-docx-1-ajs-10.1177_03635465221150214 – Supplemental material for The Effects of Rest on Concussion Symptom Resolution and Recovery Time: A Meta-analytic Review and Subgroup Analysis of 4329 Patients

Author

Kontos, Anthony P., Eagle, Shawn R., Braithwaite, Rock, Preszler, Jonathan, Manderino, Lisa, Turner, Rose L., Jennings, Sabrina, Trbovich, Alicia, Hickey, Robert W., Collins, Michael W., McCrea, Michael, Nelson, Lindsay D., Root, Jeremy, and Thomas, Danny G.

Subjects
FOS: Clinical medicine, 110323 Surgery, 110604 Sports Medicine, FOS: Health sciences, 110314 Orthopaedics
Abstract

Supplemental material, sj-docx-1-ajs-10.1177_03635465221150214 for The Effects of Rest on Concussion Symptom Resolution and Recovery Time: A Meta-analytic Review and Subgroup Analysis of 4329 Patients by Anthony P. Kontos, Shawn R. Eagle, Rock Braithwaite, Jonathan Preszler, Lisa Manderino, Rose L. Turner, Sabrina Jennings, Alicia Trbovich, Robert W. Hickey, Michael W. Collins, Michael McCrea, Lindsay D. Nelson, Jeremy Root and Danny G. Thomas in The American Journal of Sports Medicine

Published
2023
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25. Contributors

Author

Abraham, Michael K., primary, Abrahamian, Fredrick M., additional, Abu Aish, Mohammed A., additional, Adams, Bruce D., additional, Adams, James G., additional, Afshar, Nima, additional, Ahn, James, additional, Aldeen, Amer Z., additional, Allegretti, Paul J., additional, Anders, Jennifer F., additional, Anderson, Jana L., additional, Andrus, Phillip, additional, Arbelaez, Christian, additional, Arbogast, Charles B., additional, Aubin, Chandra D., additional, Avegno, Jennifer, additional, Bailitz, John, additional, Baines, Patricia, additional, Bair, Aaron E., additional, Bakes, Katherine, additional, Barksdale, Aaron N., additional, Barsan, William G., additional, Barton, Erik D., additional, Bassin, Benjamin S., additional, Bates, Craig G., additional, Bayram, Jamil D., additional, Begaz, Tomer, additional, Benko, Kip, additional, Bhanot, Kavita, additional, Bhatia, Kriti, additional, Biddinger, Paul D., additional, Blomkalns, Andra L., additional, Boe, John M., additional, Bohan, J. Stephen, additional, Boniface, Keith, additional, Bontempo, Laura J., additional, Borczuk, Pierre, additional, Borg, Keith, additional, Borm, Nicholas A., additional, Bossart, Philip, additional, Osborn, Megan Boysen, additional, Brady, William J., additional, Branzetti, Jeremy B., additional, Brown, Bart S., additional, Brown, David F.M., additional, Bryant, Sean M., additional, Burton, John H., additional, Butts, Christine, additional, Byrne, Mark W., additional, Cabrera, Daniel, additional, Cannon, Robert D., additional, Caro, David A., additional, Carpenter, Christopher R., additional, Carter, Wallace A., additional, Chan, Cindy W., additional, Chan, Gar Ming, additional, Chang, Andrew K., additional, Char, Douglas M., additional, Cheema, Navneet, additional, Chng, Yi-Mei, additional, Christian, Michael R., additional, Clark, Richard F., additional, Clem, Kathleen J., additional, Colletti, James E., additional, Collings, Jamie L., additional, Colwell, Christopher B., additional, Cook, Justin, additional, Cooke, Jeremy L., additional, Cooper, Julie J., additional, Courtney, D. Mark, additional, Cumpston, Kirk L., additional, Cydulka, Rita K., additional, Daniel-Underwood, Lynda, additional, Datner, Elizabeth M., additional, Davis, Jonathan E., additional, Davis, Virgil, additional, De La Calzada-Jeanlouie, Mae F., additional, de Ramirez, Sarah Steward, additional, DeBlieux, Peter M.C., additional, Decker, Wyatt W., additional, del Castillo, Jorge, additional, Deledda, John, additional, Delgado, Eva M., additional, Delgado, M. Kit, additional, DiGeronimo, Margaret M., additional, D’Onofrio, Gail, additional, Doyle, Gerard S., additional, Dreifuss, Bradley A., additional, Druck, Jeffrey, additional, Edlow, Jonathan A., additional, Elder, Jeffrey M., additional, Engel, Kirsten G., additional, Ezenkwele, Ugo A., additional, Fulton, Jessica A., additional, Gallahue, Fiona E., additional, Garg, Manish, additional, Garmel, Gus M., additional, Geers, Ryan T., additional, Germann, Carl A., additional, Ghaemmaghami, Chris A., additional, Gibbs, Michael A., additional, Gilbert, Gregory H., additional, Gisondi, Michael A., additional, Godwin, Steven A., additional, Goldstein, Joshua N., additional, Goralnick, Eric, additional, Goyal, Deepi G., additional, Graber, Matthew N., additional, Gummin, David D., additional, Gupta, Geetika, additional, Guth, Todd A., additional, Hamedani, Azita G., additional, Hankin, Abigail D., additional, Harrison, Benjamin P., additional, Hartsell, Stephen C., additional, Hedayati, Tarlan, additional, Heffner, Alan C., additional, Heller, Diane B., additional, Hemphill, Robin R., additional, Henry, Gregory L., additional, Hern, H. Gene, additional, Heron, Sheryl L., additional, Hobgood, Cherri D., additional, Hoffmann, Beatrice, additional, Hoffman, Lance H., additional, Hopkins, Christy, additional, Horowitz, Russ, additional, Houry, Debra E., additional, Howes, David S., additional, Huff, J. Stephen, additional, Hwang, James Q., additional, Isaacs, Eric, additional, Jackson, Benjamin F., additional, Jagoda, Andy, additional, Jauch, Edward C., additional, Jones, Kerin A., additional, Jotte, Randall S., additional, Kang, Christopher S., additional, Khorasanee, Jacqueline, additional, Kiefer, Christopher S., additional, Kim, Tae Eung, additional, Kimberly, Heidi H., additional, Kippenhan, Matthew, additional, Kissoon, Niranjan, additional, Klauer, Kevin, additional, Korley, Frederick, additional, Kosowsky, Joshua M., additional, Kuehl, Karen Nolan, additional, Kunisaki, Thomas, additional, Kusin, Shana, additional, Lambert, Michael, additional, Lank, Patrick M., additional, Lareau, Erin M., additional, Lary, Sara, additional, Laurin, Erik G., additional, Ledyard, Holly K., additional, Legome, Eric L., additional, LeGros, Tracy Leigh, additional, Leone, Katrina A., additional, Levine, Matthew R., additional, Levine, Michael, additional, Liebzeit, Jason E., additional, Lin, Michelle, additional, Linscott, M. Scott, additional, Lippert, Suzanne, additional, Lissoway, John B., additional, Lockwood, Robert, additional, Long, Heather, additional, Lu, Dave W., additional, Ly, Binh T., additional, Lynch, Catherine A., additional, Madsen, Troy E., additional, Mahadevan, Swaminatha V., additional, Malik, Mamta, additional, Mallemat, Haney A., additional, Mallin, Michael P., additional, Maloney, Gerald, additional, Malouf, Nicole, additional, Manfredi, Rita A., additional, Manthey, David E., additional, Marill, Keith A., additional, Marinelli, Melissa, additional, Martinez, Joseph P., additional, Mattu, Amal, additional, McFarlin, Anna K., additional, McIntosh, Mark, additional, McNaughton, Candace D., additional, Medzon, Ron, additional, Menckhoff, Carl R., additional, Michael, Glen E., additional, Mick, Nathan W., additional, Mills, Lisa D., additional, Mills, Trevor J., additional, Monteleone, Peter P., additional, Morchi, Raveendra S., additional, Moreno-Walton, Lisa, additional, Mort, Elizabeth A., additional, Morrissey, Thomas, additional, Murphy-Lavoie, Heather, additional, Mycyk, Mark B., additional, Nadel, Eric S., additional, Nadindla, Swathi, additional, Nelson, Brian K., additional, Nelson, Lewis S., additional, Nelson, Sara W., additional, Newman, David H., additional, Nicks, Bret A., additional, Noble, Vicki E., additional, Nogar, Joshua N., additional, Norris, Robert L., additional, Norse, Ashley Booth, additional, O’Connor, Robert E., additional, O’Keefe, Kelly P., additional, Okuda, Haru, additional, Patterson, Brian W., additional, Patterson, Leigh A., additional, Paula, Richard, additional, Peabody, Joseph F., additional, Peak, David A., additional, Perret, John Nelson, additional, Perron, Andrew D., additional, Piazza, Vanessa Maria, additional, Poirier, Robert F., additional, Powell, Emilie S., additional, Promes, Susan B., additional, Quest, Tammie E., additional, Quinn, James, additional, Ranniger, Claudia, additional, Rathlev, Niels K., additional, Rhee, James W., additional, Robertson, Keri, additional, Robinson, Matthew T., additional, Rogers, Robert L., additional, Rosen, Carlo L., additional, Ross, Christopher, additional, Rudkin, Scott E., additional, Ruha, Anne-Michelle, additional, Runyon, Michael S., additional, Sadosty, Annie T., additional, Sanson, Tracy G., additional, Santanilla, Jairo I., additional, Santen, Sally A., additional, Sayan, Osman R., additional, Schmidt, Michael J., additional, Schrank, Kathleen S., additional, Schuur, Jeremiah D., additional, Schwab, Theresa, additional, Self, Wesley H., additional, Sellas, Monique I., additional, Shannon, Andrew W., additional, Sharieff, Ghazala Q., additional, Sharma, Rahul, additional, Shayne, Philip, additional, Shreves, Ashley, additional, Singh, Amandeep, additional, Slaven, Ellen M., additional, Sochor, Mark, additional, Sokolosky, Mitchell C., additional, Sperling, Jeremy D., additional, Stahmer, Sarah A., additional, Stephen, Robert L., additional, Stettler, Brian A., additional, Strehlow, Matthew, additional, Su, Mark, additional, Sudhir, Amita, additional, Sullivan, D. Matthew, additional, Tabas, Jeffrey, additional, Taira, Taku, additional, Takayesu, James K., additional, Tarabar, Asim F., additional, Thomas, Danny G., additional, Thompson, Kristine M., additional, Thompson, Trevonne M., additional, Thornton, Stephen, additional, Tran, T. Paul, additional, Ufberg, Jacob, additional, Ulrich, Andrew S., additional, Wadman, Michael C., additional, Wang, Ernest E., additional, Wang, N. Ewen, additional, Ware-McGee, Danielle M., additional, Wedmore, Ian S., additional, Wheaton, Natasha, additional, Whisenant, Beranton, additional, Wintermark, Max, additional, Winters, Michael E., additional, Wolf, Stephen J., additional, Wolfe, Richard E., additional, Wylie, Todd, additional, Yang-Kauh, Christine, additional, Young, Timothy P., additional, Zahn, Steven M., additional, Zeretzke, Cristina M., additional, Zich, David K., additional, and Zosel, Amy E., additional

Published
2013
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32. Episodic pain in a school-aged child

Author

Thomas, Danny G. and Hickey, Robert W.

Subjects
Epilepsy in children -- Diagnosis, Epilepsy in children -- Case studies, Abdominal pain in children -- Causes of, Abdominal pain in children -- Care and treatment, Abdominal pain in children -- Case studies
Published
2007

34. Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015

Author

Iverson, Grant L., Elbin, McAllister, Thomas, Shetty, Teena, Maroon, Joseph, Cardenas, Javier, Collins, Michael W., Clugston, Jay, Pombo, Matthew, Thomas, Danny G., Cohen, Randall, Yates, Tony, Okonkwo, David O., Gioia, Gerard, Echemendia, Ruben, Kontos, Anthony P., Heyer, Robert, Fonseca, Janna, Mucha, Anne, Valovich McLeod, Tamara C., Barisa, Mark, Manley, Geoffrey, Hotz, Gillian, Bloom, O. Josh, Solomon, Gary, Zafonte, Ross, Pieroth, Elizabeth, Ellenbogen, Richard, Brody, David L., McCrea, Michael, Bailes, Julian, Podell, Kenneth, Almquist, Jon, Sills, Allen, Bazarian, Jeffrey, Cantu, Robert, Guskiewicz, Kevin, and Jordan, Barry

Abstract

Conventional management for concussion involves prescribed rest and progressive return to activity. Recent evidence challenges this notion and suggests that active approaches may be effective for some patients. Previous concussion consensus statements provide limited guidance regarding active treatment.

Published
2016
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35. Statements of Agreement From the Targeted Evaluation and Active Management (TEAM) Approaches to Treating Concussion Meeting Held in Pittsburgh, October 15-16, 2015

Author

Collins, Michael W., primary, Kontos, Anthony P., additional, Okonkwo, David O., additional, Almquist, Jon, additional, Bailes, Julian, additional, Barisa, Mark, additional, Bazarian, Jeffrey, additional, Bloom, O. Josh, additional, Brody, David L., additional, Cantu, Robert, additional, Cardenas, Javier, additional, Clugston, Jay, additional, Cohen, Randall, additional, Echemendia, Ruben, additional, Elbin, R.J., additional, Ellenbogen, Richard, additional, Fonseca, Janna, additional, Gioia, Gerard, additional, Guskiewicz, Kevin, additional, Heyer, Robert, additional, Hotz, Gillian, additional, Iverson, Grant L., additional, Jordan, Barry, additional, Manley, Geoffrey, additional, Maroon, Joseph, additional, McAllister, Thomas, additional, McCrea, Michael, additional, Mucha, Anne, additional, Pieroth, Elizabeth, additional, Podell, Kenneth, additional, Pombo, Matthew, additional, Shetty, Teena, additional, Sills, Allen, additional, Solomon, Gary, additional, Thomas, Danny G., additional, Valovich McLeod, Tamara C., additional, Yates, Tony, additional, and Zafonte, Ross, additional

Published
2016
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