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001-es BibID:	BIBFORM107423
035-os BibID:	(scopus)85110576459 (wos)000677684700016
Első szerző:	Wiegers, Eveline Janine Anna
Cím:	Fluid balance and outcome in critically ill patients with traumatic brain injury (CENTER-TBI and OzENTER-TBI) : a prospective, multicentre, comparative effectiveness study / Wiegers Eveline Janine Anna, Lingsma Hester Floor, Huijben Jilske Antonia, Cooper David James, Citerio Giuseppe, Frisvold Shirin, Helbok Raimund, Maas Andrew Ian Ramsay, Menon David Krishna, Moore Elizabeth Madeleine, Stocchetti Nino, Dippel Diederik Willem, Steyerberg Ewout Willem, van der Jagt Mathieu, CENTER-TBI Collaboration Groups, OzENTER-TBI Collaboration Groups
Dátum:	2021
ISSN:	1474-4422 1474-4465
Megjegyzések:	Background Fluid therapy?the administration of fluids to maintain adequate organ tissue perfusion and oxygenation?is essential in patients admitted to the intensive care unit (ICU) with traumatic brain injury. We aimed to quantify the variability in fluid management policies in patients with traumatic brain injury and to study the effect of this variability on patients' outcomes. Methods We did a prospective, multicentre, comparative effectiveness study of two observational cohorts: CENTER-TBI in Europe and OzENTER-TBI in Australia. Patients from 55 hospitals in 18 countries, aged 16 years or older with traumatic brain injury requiring a head CT, and admitted to the ICU were included in this analysis. We extracted data on demographics, injury, and clinical and treatment characteristics, and calculated the mean daily fluid balance (difference between fluid input and loss) and mean daily fluid input during ICU stay per patient. We analysed the association of fluid balance and input with ICU mortality and functional outcome at 6 months, measured by the Glasgow Outcome Scale Extended (GOSE). Patient-level analyses relied on adjustment for key characteristics per patient, whereas centre-level analyses used the centre as the instrumental variable. Findings 2125 patients enrolled in CENTER-TBI and OzENTER-TBI between Dec 19, 2014, and Dec 17, 2017, were eligible for inclusion in this analysis. The median age was 50 years (IQR 31 to 66) and 1566 (74%) of patients were male. The median of the mean daily fluid input ranged from 1?48 L (IQR 1?12 to 2?09) to 4?23 L (3?78 to 4?94) across centres. The median of the mean daily fluid balance ranged from ?0?85 L (IQR ?1?51 to ?0?49) to 1?13 L (0?99 to 1?37) across centres. In patient-level analyses, a mean positive daily fluid balance was associated with higher ICU mortality (odds ratio [OR] 1?10 [95% CI 1?07 to 1?12] per 0?1 L increase) and worse functional outcome (1?04 [1?02 to 1?05] per 0?1 L increase); higher mean daily fluid input was also associated with higher ICU mortality (1?05 [1?03 to 1?06] per 0?1 L increase) and worse functional outcome (1?04 [1?03 to 1?04] per 1-point decrease of the GOSE per 0?1?L increase). Centre-level analyses showed similar associations of higher fluid balance with ICU mortality (OR 1?17 [95% CI 1?05 to 1?29]) and worse functional outcome (1?07 [1?02 to 1?13]), but higher fluid input was not associated with ICU mortality (OR 0?95 [0?90 to 1?00]) or worse functional outcome (1?01 [0?98 to 1?03]).
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk traumatic brain injury
Megjelenés:	Lancet Neurology. - 20 : 8 (2021), p. 627-638. -
További szerzők:	Lingsma, Hester Huijben, Jilske A. Cooper, David James Citerio, Giuseppe Frisvold, Shirin Helbok, Raimund Maas, Andrew I. R. Menon, David Krishna Moore, Elizabeth Madeleine Stocchetti, Nino Dippel, Diederik W. Steyerberg, Ewout W. van der Jagt, Mathieu Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI collaborators OzENTER-TBI Collaboration Groups
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