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001-es BibID:BIBFORM107420
035-os BibID:(scopus)85122939948 (wos)000769111800016
Első szerző:Galimberti, Stefania
Cím:Effect of frailty on 6-month outcome after traumatic brain injury : a multicentre cohort study with external validation / Galimberti Stefania, Graziano Francesca, Maas Andrew I. R., Isernia Giulia, Lecky Fiona, Jain Sonia, Sun Xiaoying, Gardner Raquel C., Taylor Sabrina R., Markowitz Amy J., Manley Geoffrey T., Valsecchi Maria Grazia, Bellelli Giuseppe, Citerio Giuseppe, CENTER-TBI participants and investigators, TRACK-TBI participants and investigators
Dátum:2022
ISSN:1474-4422 1474-4465
Megjegyzések:Summary Background Frailty is known to be associated with poorer outcomes in individuals admitted to hospital for medical conditions requiring intensive care. However, little evidence is available for the effect of frailty on patients' outcomes after traumatic brain injury. Many frailty indices have been validated for clinical practice and show good performance to predict clinical outcomes. However, each is specific to a particular clinical context. We aimed to develop a frailty index to predict 6-month outcomes in patients after a traumatic brain injury. Methods A cumulative deficit approach was used to create a novel frailty index based on 30 items dealing with disease states, current medications, and laboratory values derived from data available from CENTER-TBI, a prospective, longitudinal observational study of patients with traumatic brain injury presenting within 24 h of injury and admitted to a ward or an intensive care unit at 65 centres in Europe between Dec 19, 2014, and Dec 17, 2017. From the individual cumulative CENTER-TBI frailty index (range 0?30), we obtained a standardised value (range 0?1), with high scores indicating higher levels of frailty. The effect of frailty on 6-month outcome evaluated with the extended Glasgow Outcome Scale (GOSE) was assessed through a proportional odds logistic model adjusted for known outcome predictors. An unfavourable outcome was defined as death or severe disability (GOSE score ?4). External validation was performed on data from TRACK-TBI, a prospective observational study co-designed with CENTER-TBI, which enrolled patients with traumatic brain injury at 18 level I trauma centres in the USA from Feb 26, 2014, to July 27, 2018. CENTER-TBI is registered with ClinicalTrials.gov, NCT02210221; TRACK-TBI is registered at ClinicalTrials.gov, NCT02119182. Findings 2993 participants (median age was 51 years [IQR 30?67], 2058 [69%] were men) were included in this analysis. The overall median CENTER-TBI frailty index score was 0?07 (IQR 0?03?0?15), with a median score of 0?17 (0?08?0?27) in older adults (aged ?65 years). The CENTER-TBI frailty index score was significantly associated with the probability of an increasingly unfavourable outcome (cumulative odds ratio [OR] 1?03, 95% CI 1?02?1?04; p<0?0001), and the association was stronger for participants admitted to hospital wards (1? 04, 1?03?1?06, p<0?0001) compared with those admitted to the intensive care unit (1 ?02, 1?01?1?03 p<0?0001). External validation of the CENTER-TBI frailty index in data from the TRACK-TBI (n=1667) cohort supported the robustness and reliability of these findings. The overall median TRACK-TBI frailty index score was 0?03 (IQR 0?0?10), with the frailty index score significantly associated with the risk of an increasingly unfavourable outcome in patients admitted to hospital wards (cumulative OR 1?05, 95% CI 1?03?1?08; p<0?0001), but not in those admitted to the intensive care unit (1?01, 0?99?1?03; p=0?43)
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
traumatic brain injury
Megjelenés:Lancet Neurology. - 21 : 2 (2022), p. 153-162. -
További szerzők:Graziano, Francesca Maas, Andrew I. R. Isernia, Giulia Lecky, Fiona Jain, Sonia Sun, Xiaoying Gardner, Raquel C. Taylor, Sabrina R. Markowitz, Amy J. Manley, Geoffrey T. Valsecchi, Maria Grazia Bellelli, Giuseppe Citerio, Giuseppe Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators TRACK-TBI Investigators
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2.

001-es BibID:BIBFORM104837
035-os BibID:(Scopus)85088991849 (WOS)000572673400042
Első szerző:Gravesteijn, Benjamin Yaël
Cím:Tracheal intubation in traumatic brain injury : a multicentre prospective observational study / Benjamin Yael Gravesteijn, Charlie Aletta Sewalt, Daan Nieboer, David Krishna Menon, Andrew Maas, Fiona Lecky, Markus Klimek, Hester Floor Lingsma, CENTERTBI collaboratorsy
Dátum:2020
ISSN:0007-0912
Megjegyzések:Abstract Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n?4509). For prehospital intubation, we excluded self- presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. Results: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio?1.01; 95% confidence interval, 0.79e1.28; P?0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio?0.86; 95% confidence interval, 0.65e1.13; P?0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P?0.009 and P?0.02, respectively), whereas in- hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P?0.01): in- hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. Conclusion: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that extracranial injury should influence the decision in the prehospital setting, and level of consciousness in the in-hospital setting. Clinical trial registration: NCT02210221
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
effectiveness
Europe neurological outcome
prehospital tracheal intubation
traumatic brain injury
Megjelenés:British Journal Of Anaesthesia. - 125 : 4 (2020), p. 505-517. -
További szerzők:Sewalt, Charlie Aletta Nieboer, Daan Menon, David Krishna Maas, Andrew I. R. Lecky, Fiona Klimek, Markus Lingsma, Hester Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI collaborators
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3.

001-es BibID:BIBFORM107422
035-os BibID:(cikkazonosító)e1003761 (scopus)85114922058 (wos)000724338300003
Első szerző:Lecky, Fiona
Cím:The burden of traumatic brain injury from low-energy falls among patients from 18 countries in the CENTER-TBI Registry : a comparative cohort study / Lecky Fiona E., Otesile Olubukola, Marincowitz Carl, Majdan Marek, Nieboer Daan, Lingsma Hester F., Maegele Marc, Citerio Giuseppe, Stocchetti Nino, Steyerberg Ewout W., Menon David K., Maas Andrew I. R., CENTER-TBI Participants and Investigators
Dátum:2021
ISSN:1549-1676
Megjegyzések:Background Traumatic brain injury (TBI) is an important global public health burden, where those injured by high-energy transfer (e.g., road traffic collisions) are assumed to have more severe injury and are prioritised by emergency medical service trauma triage tools. However recent studies suggest an increasing TBI disease burden in older people injured through low-energy falls. We aimed to assess the prevalence of low-energy falls among patients presenting to hospital with TBI, and to compare their characteristics, care pathways, and outcomes to TBI caused by high-energy trauma. Methods and findings We conducted a comparative cohort study utilising the CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) Registry, which recorded patient demographics, injury, care pathway, and acute care outcome data in 56 acute trauma receiving hospitals across 18 countries (17 countries in Europe and Israel). Patients presenting with TBI and indications for computed tomography (CT) brain scan between 2014 to 2018 were purposively sampled. The main study outcomes were (i) the prevalence of low-energy falls causing TBI within the overall cohort and (ii) comparisons of TBI patients injured by low-energy falls to TBI patients injured by high-energy transfer?in terms of demographic and injury characteristics, care pathways, and hospital mortality. In total, 22,782 eligible patients were enrolled, and study outcomes were analysed for 21,681 TBI patients with known injury mechanism; 40% (95% CI 39% to 41%) (8,622/21,681) of patients with TBI were injured by low-energy falls. Compared to 13,059 patients injured by high-energy transfer (HE cohort), the those injured through low-energy falls (LE cohort) were older (LE cohort, median 74 [IQR 56 to 84] years, versus HE cohort, median 42 [IQR 25 to 60] years; p < 0.001), more often female (LE cohort, 50% [95% CI 48% to 51%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001), more frequently taking pre-injury anticoagulants or/and platelet aggregation inhibitors (LE cohort, 44% [95% CI 42% to 45%], versus HE cohort, 13% [95% CI 11% to 14%]; p < 0.001), and less often presenting with moderately or severely impaired conscious level (LE cohort, 7.8% [95% CI 5.6% to 9.8%], versus HE cohort, 10% [95% CI 8.7% to 12%]; p < 0.001), but had similar in-hospital mortality (LE cohort, 6.3% [95% CI 4.2% to 8.3%], versus HE cohort, 7.0% [95% CI 5.3% to 8.6%]; p = 0.83). The CT brain scan traumatic abnormality rate was 3% lower in the LE cohort (LE cohort, 29% [95% CI 27% to 31%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001); individuals in the LE cohort were 50% less likely to receive critical care (LE cohort, 12% [95% CI 9.5% to 13%], versus HE cohort, 24% [95% CI 23% to 26%]; p < 0.001) or emergency interventions (LE cohort, 7.5% [95% CI 5.4% to 9.5%], versus HE cohort, 13% [95% CI 12% to 15%]; p < 0.001) than patients injured by high-energy transfer. The purposive sampling strategy and censorship of patient outcomes beyond hospital discharge are the main study limitations. Conclusions We observed that patients sustaining TBI from low-energy falls are an important component of the TBI disease burden and a distinct demographic cohort; further, our findings suggest that energy transfer may not predict intracranial injury or acute care mortality in patients with TBI presenting to hospital. This suggests that factors beyond energy transfer level may be more relevant to prehospital and emergency department TBI triage in older people. A specific focus to improve prevention and care for patients sustaining TBI from low-energy falls is required.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
traumatic brain injury
Megjelenés:PLOS Medicine. - 18 : 9 (2021), p. 1-22. -
További szerzők:Otesile, Olubukola Marincowitz, Carl Majdan, Marek Nieboer, Daan Lingsma, Hester Maegele, Marc Citerio, Giuseppe Stocchetti, Nino Steyerberg, Ewout W. Menon, David Krishna Maas, Andrew I. R. Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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4.

001-es BibID:BIBFORM066054
Első szerző:Maas, Andrew I. R.
Cím:Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) : a Prospective Longitudinal Observational Study / Andrew I. R. Maas, David K. Menon, Ewout W. Steyerberg, Giuseppe Citerio, Fiona Lecky, Geoffrey T. Manley, Sean Hill, Valerie Legrand, Annina Sorgner, CENTER-TBI Participants and Investigators
Dátum:2015
ISSN:0148-396X
Tárgyszavak:Orvostudományok Egészségtudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:Neurosurgery. - 76 : 1 (2015), p. 67-80. -
További szerzők:Menon, David Krishna Steyerberg, Ewout W. Citerio, Giuseppe Lecky, Fiona Manley, Geoffrey T. Hill, Sean Legrand, Valerie Sorgner, Annina Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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5.

001-es BibID:BIBFORM100333
035-os BibID:(cikkazonosító)113
Első szerző:Sewalt, Charlie Aletta
Cím:Primary versus early secondary referral to a specialized neurotrauma center in patients with moderate/severe traumatic brain injury : a CENTER TBI study / Sewalt Charlie Aletta, Gravesteijn Benjamin Yaël, Menon David, Lingsma Hester Floor, Maas Andrew I. R., Stocchetti Nino, Venema Esmee, Lecky Fiona E., CENTER-TBI Participants and Investigators
Dátum:2021
ISSN:1757-7241
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. - 29 : 1 (2021), p. 1-11. -
További szerzők:Gravesteijn, Benjamin Yaël Menon, David Krishna Lingsma, Hester Maas, Andrew I. R. Stocchetti, Nino Venema, Esmee Lecky, Fiona Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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6.

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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Intézményi repozitóriumban (DEA) tárolt változat
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