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001-es BibID:	BIBFORM016240
Első szerző:	Csomós Ákos (aneszteziológus)
Cím:	Intensive care reimbursement practices : results from the ICUFUND survey / Csomos Akos, Varga Szilard, Bertolini Guido, Hibbert Clare, Sandor Janos, Capuzzo Maurizia, Guidet Bertrand R.
Dátum:	2010
ISSN:	0342-4642
Tárgyszavak:	Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban ICU expenditure ICU reimbursement Health insurance funding Health economics and organization
Megjelenés:	Intensive Care Medicine. - 36 : 10 (2010), p. 1759-1764. -
További szerzők:	Varga Szilárd Bertolini, Guido Hibbert, Clare Sándor János (1966-) (orvos-epidemiológus) Capuzzo, Maurizia Guidet, Bertrand R.
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM107421
035-os BibID:	(scopus)85117210103 (wos)000681565200001
Első szerző:	van Veen, Ernest
Cím:	Occurrence and timing of withdrawal of life-sustaining measures in traumatic brain injury patients : a CENTER-TBI study / van Veen Ernest, van der Jagt Mathieu, Citerio Giuseppe, Stocchetti Nino, Gommers Diederik, Burdorf Alex, Menon David K., Maas Andrew I. R., Kompanje Erwin J. O., Lingsma Hester F., CENTER-TBI investigators and participants
Dátum:	2021
ISSN:	0342-4642
Megjegyzések:	Background: In patients with severe brain injury, withdrawal of life-sustaining measures (WLSM) is common in inten sive care units (ICU). WLSM constitutes a dilemma: instituting WLSM too early could result in death despite the pos sibility of an acceptable functional outcome, whereas delaying WLSM could unnecessarily burden patients, families, clinicians, and hospital resources. We aimed to describe the occurrence and timing of WLSM, and factors associated with timing of WLSM in European ICUs in patients with traumatic brain injury (TBI). Methods: The CENTER-TBI Study is a prospective multi-center cohort study. For the current study, patients with traumatic brain injury (TBI) admitted to the ICU and aged 16 or older were included. Occurrence and timing of WLSM were documented. For the analyses, we dichotomized timing of WLSM in early (<72 h after injury) versus later (?72 h after injury) based on recent guideline recommendations. We assessed factors associated with initiating WLSM early versus later, including geographic region, center, patient, injury, and treatment characteristics with univariable and multivariable (mixed efects) logistic regression. Results: A total of 2022 patients aged 16 or older were admitted to the ICU. ICU mortality was 13% (n=267). Of these, 229 (86%) patients died after WLSM, and were included in the analyses. The occurrence of WLSM varied between regions ranging from 0% in Eastern Europe to 96% in Northern Europe. In 51% of the patients, WLSM was early. Patients in the early WLSM group had a lower maximum therapy intensity level (TIL) score than patients in the later WLSM group (median of 5 versus 10) The strongest independent variables associated with early WLSM were one unreactive pupil (odds ratio (OR) 4.0, 95% confdence interval (CI) 1.3?12.4) or two unreactive pupils (OR 5.8, CI 2.6?13.1) compared to two reactive pupils, and an Injury Severity Score (ISS) if over 41 (OR per point above 41=1.1, CI 1.0?1.1). Timing of WLSM was not signifcantly associated with region or center. Conclusion: WLSM occurs early in half of the patients, mostly in patients with severe TBI afecting brainstem refexes who were severely injured. We found no regional or center infuences in timing of WLSM. Whether WLSM is always appropriate or may contribute to a self-fulflling prophecy requires further research and argues for reluctance to insti tute WLSM early in case of any doubt on prognosis.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk traumatic brain injury
Megjelenés:	Intensive Care Medicine. - 47 : 10 (2021), p. 1115-1129. -
További szerzők:	van der Jagt, Mathieu Citerio, Giuseppe Stocchetti, Nino Gommers, Diederik Burdorf, Alex Menon, David Krishna Maas, Andrew I. R. Kompanje, Erwin J. O. Lingsma, Hester Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
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