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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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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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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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