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001-es BibID:BIBFORM072262
Első szerző:Maas, Andrew I. R.
Cím:Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research / Andrew I. R. Maas, TBIR Participants and Investigators
Dátum:2017
Megjegyzések:Executive summaryA concerted effort to tackle the global health problemposed by traumatic brain injury (TBI) is long overdue.TBI is a public health challenge of vast, but insufficientlyrecognised, proportions. Worldwide, more than50 million people have a TBI each year, and it is estimatedthat about half the world's population will have one ormore TBIs over their lifetime. TBI is the leading cause ofmortality in young adults and a major cause of death anddisability across all ages in all countries, with adisproportionate burden of disability and death occurringin low-income and middle-income countries (LMICs). Ithas been estimated that TBI costs the global economyapproximately
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Lancet Neurology. - 16 : 12 (2017), p. 987-1048. -
További szerzők:Sándor János (1966-) (orvos-epidemiológus) TBIR Participants and Investigators
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001-es BibID:BIBFORM107489
035-os BibID:(Scopus)85071987996 (WOS)000485784000017
Első szerző:Steyerberg, Ewout W.
Cím:Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI : a European prospective, multicentre, longitudinal, cohort study / Ewout W. Steyerberg, Eveline Wiegers, Charlie Sewalt, Andras Buki, Giuseppe Citerio, Véronique De Keyser, Ari Ercole, Kevin Kunzmann, Linda Lanyon, Fiona Lecky, Hester Lingsma, Geoffrey Manley, David Nelson, Wilco Peul, Nino Stocchetti, Nicole von Steinbüchel, Thijs Vande Vyvere, Jan Verheyden, Lindsay Wilson, Andrew I. R. Maas, David K. Menon, CENTER-TBI Participants and Investigators
Dátum:2019
ISSN:1474-4422 1474-4465
Megjegyzések:Background The burden of traumatic brain injury (TBI) poses a large public health and societal problem, but the characteristics of patients and their care pathways in Europe are poorly understood. We aimed to characterise patient case-mix, care pathways, and outcomes of TBI. Methods CENTER-TBI is a Europe-based, observational cohort study, consisting of a core study and a registry. Inclusion criteria for the core study were a clinical diagnosis of TBI, presentation fewer than 24 h after injury, and an indication for CT. Patients were differentiated by care pathway and assigned to the emergency room (ER) stratum (patients who were discharged from an emergency room), admission stratum (patients who were admitted to a hospital ward), or intensive care unit (ICU) stratum (patients who were admitted to the ICU). Neuroimages and biospecimens were stored in repositories and outcome was assessed at 6 months after injury. We used the IMPACT core model for estimating the expected mortality and proportion with unfavourable Glasgow Outcome Scale Extended (GOSE) outcomes in patients with moderate or severe TBI (Glasgow Coma Scale [GCS] score ?12). The core study was registered with ClinicalTrials.gov, number NCT02210221, and with Resource Identification Portal (RRID: SCR_015582). Findings Data from 4509 patients from 18 countries, collected between Dec 9, 2014, and Dec 17, 2017, were analysed in the core study and from 22 782 patients in the registry. In the core study, 848 (19%) patients were in the ER stratum, 1523 (34%) in the admission stratum, and 2138 (47%) in the ICU stratum. In the ICU stratum, 720(36%) patients had mild TBI (GCS score 13?15). Compared with the core cohort, the registry had a higher proportion of patients in the ER (9839 [43%]) and admission (8571 [38%]) strata, with more than 95% of patients classified as having mild TBI. Patients in the core study were older than those in previous studies (median age 50 years [IQR 30?66], 1254 [28%] aged >65 years), 462 (11%) had serious comorbidities, 772 (18%) were taking anticoagulant or antiplatelet medication, and alcohol was contributory in 1054 (25%) TBIs. MRI and blood biomarker measurement enhanced characterisation of injury severity and type. Substantial inter-country differences existed in care pathways and practice. Incomplete recovery at 6 months (GOSE <8) was found in 207 (30%) patients in the ER stratum, 665 (53%) in the admission stratum, and 1547 (84%) in the ICU stratum. Among patients with moderate-to-severe TBI in the ICU stratum, 623 (55%) patients had unfavourable outcome at 6 months (GOSE <5), similar to the proportion predicted by the IMPACT prognostic model (observed to expected ratio 1?06 [95% CI 0?97?1?14]), but mortality was lower than expected (0?70 [0?62?0?76])
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
traumatic brain injury
Megjelenés:Lancet Neurology. - 18 : 10 (2019), p. 923-934. -
További szerzők:Wiegers, Eveline Janine Anna Sewalt, Charlie Aletta Buki András Citerio, Giuseppe Keyser, Véronique de Ercole, Ari Kunzmann, Kevin Lanyon, Linda Lecky, Fiona Lingsma, Hester Manley, Geoffrey T. Nelson, David Peul, Wilco C. Stocchetti, Nino von Steinbuechel, Nicole Vande Vyvere, Thijs Verheyden, Jan Wilson, Lindsay Maas, Andrew I. R. Menon, David Krishna Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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