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001-es BibID:BIBFORM105073
035-os BibID:(WOS)000382876700016 (Scopus)84991063666 (cikkazonosító)e0161367
Első szerző:Cnossen, Maryse C.
Cím:Variation in Structure and Process of Care in Traumatic Brain Injury : provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study / Maryse C. Cnossen, Suzanne Polinder, Hester F. Lingsma, Andrew I. R. Maas, David Menon, Ewout W. Steyerberg, CENTER-TBI Investigators and Participants
Dátum:2016
ISSN:1932-6203
Megjegyzések:Abstract Introduction The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general struc tural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, ques tionnaires were disseminated to 71 centers from 20 countries participating in the CENTER TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), desig nated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabili tation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addi tion, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers.Conclusion Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effec tiveness of specific aspects of TBI care and to identify best practices with CER approaches.
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Plos One. - 11 : 8 (2016), p. 1-21. -
További szerzők:Polinder, Suzanne Lingsma, Hester Maas, Andrew I. R. Menon, David Krishna Steyerberg, Ewout W. Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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2.

001-es BibID:BIBFORM070421
Első szerző:Cnossen, Maryse C.
Cím:Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury : a survey in 66 neurotrauma centers participating in the CENTER-TBI study / Maryse C. Cnossen, Jilske A. Huijben, Mathieu van der Jagt, Victor Volovici, Thomas van Essen, Suzanne Polinder, David Nelson, Ari Ercole, Nino Stocchetti, Giuseppe Citerio, Wilco C. Peul, Andrew I. R. Maas, David Menon, Ewout W. Steyerberg, Hester F. Lingsma, CENTER-TBI Investigators and Participants
Dátum:2017
ISSN:1364-8535 1466-609X
Megjegyzések:Background: No definitive evidence exists on how intracranial hypertension should be treated in patients withtraumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefitsand risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim ofthis study was to examine variation in monitoring and treatment policies for intracranial hypertension in patientswith TBI.Methods: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expertopinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participatingin the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study.Results: The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals(n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines wereused in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor inpatients with severe TBI and computed tomographic abnormalities. There was no consensus on other indicationsor on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevatedICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring andtreatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%).Conclusions: Substantial variation was found regarding monitoring and treatment policies in patients with TBI andintracranial hypertension. The results of this survey indicate a lack of consensus between European neurotraumacenters and provide an opportunity and necessity for comparative effectiveness research.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Traumatic brain injury
Intracranial hypertension
ICP
ICU
Comparative effectiveness research
Survey
Megjelenés:Critical Care. - 21/2017 (2017), p. 233-245. -
További szerzők:Huijben, Jilske A. van der Jagt, Mathieu Volovici, Victor van Essen, Thomas Polinder, Suzanne Nelson, David Ercole, Ari Stocchetti, Nino Citerio, Giuseppe Peul, Wilco C. Maas, Andrew I. R. Menon, David Krishna Steyerberg, Ewout W. Lingsma, Hester Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
Pályázati támogatás:CENTER-TBI
Egyéb
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3.

001-es BibID:BIBFORM104926
035-os BibID:(Scopus)85058948585 (WOS)000460607500002
Első szerző:Essen, Thomas A. van
Cím:Variation in neurosurgical management of traumatic brain injury : a survey in 68 centers participating in the CENTER-TBI study / Thomas A. van Essen, Hugo F. den Boogert, Maryse C. Cnossen, Godard C. W. de Ruiter, Iain Haitsma, Suzanne Polinder, Ewout W. Steyerberg, David Menon, Andrew I. R. Maas, Hester F. Lingsma, Wilco C. Peul, CENTER-TBI Investigators and Participants
Dátum:2019
ISSN:0001-6268
Megjegyzések:Abstract Background Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decom pressive craniectomy (DC) in raised intracranial pressure (ICP). Results The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Acta Neurochirurgica. - 161 : 3 (2019), p. 435-449. -
További szerzők:Boogert, Hugo F. den Cnossen, Maryse C. Ruiter, Godard C. W. de Haitsma, Iain Polinder, Suzanne Steyerberg, Ewout W. Menon, David Krishna Maas, Andrew I. R. Lingsma, Hester Peul, Wilco C. Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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4.

001-es BibID:BIBFORM104936
035-os BibID:(Scopus)85045401878 (WOS)000429979700001 (cikkazonosító)90
Első szerző:Huijben, Jilske A.
Cím:Variation in general supportive and preventive intensive care management of traumatic brain injury : a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study / Jilske A. Huijben, Victor Volovici, Maryse C. Cnossen, Iain K. Haitsma, Nino Stocchetti, Andrew I. R. Maas, David K. Menon, Ari Ercole, Giuseppe Citerio, David Nelson, Suzanne Polinder, Ewout W. Steyerberg, Hester F. Lingsma, Mathieu van der Jagt, CENTER-TBI Investigators and Participants
Dátum:2018
ISSN:1364-8535
Megjegyzések:Abstract Background: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. Methods: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. We analyzed 23 questions focused on: 1) circulatory and respiratory management; 2) fever control; 3) use of corticosteroids; 4) nutrition and glucose management; and 5) seizure prophylaxis and treatment. Results: The survey was completed predominantly by intensivists (n = 33, 50%) and neurosurgeons (n = 23, 35%) from 66 centers (97% response rate). The most common cerebral perfusion pressure (CPP) target was > 60 mmHg (n = 39, 60%) and/or an individualized target (n = 25, 38%). To support CPP, crystalloid fluid loading (n = 60, 91%) was generally preferred over albumin (n = 15, 23%), and vasopressors (n = 63, 96%) over inotropes (n = 29, 44%). The most commonly reported target of partial pressure of carbon dioxide in arterial blood (PaCO2) was 36?40 mmHg (4.8?5.3 kPa) in case of controlled intracranial pressure (ICP) < 20 mmHg (n = 45, 69%) and PaCO2 target of 30-35 mmHg (4?4.7 kPa) in case of raised ICP (n = 40, 62%). Almost all respondents indicated to generally treat fever (n = 65, 98%) with paracetamol (n = 61, 92%) and/or external cooling (n = 49, 74%). Conventional glucose management (n = 43, 66%) was preferred over tight glycemic control (n = 18, 28%). More than half of the respondents indicated to aim for full caloric replacement within 7 days (n = 43, 66%) using enteral nutrition (n = 60, 92%). Indications for and duration of seizure prophylaxis varied, and levetiracetam wasmostly reported as the agent of choice for both seizure prophylaxis (n = 32, 49%) and treatment (n = 40, 61%). Conclusions: Practice preferences vary substantially regarding general supportive and preventive measures in TBI patients at ICUs of European neurotrauma centers. These results provide an opportunity for future comparative effectiveness research, since a more evidence-based uniformity in good practices in general ICU management could have a major impact on TBI outcome.
Tárgyszavak:Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Megjelenés:Critical Care. - 22 : 1 (2018), p. 1-9. -
További szerzők:Volovici, Victor Cnossen, Maryse C. Haitsma, Iain Stocchetti, Nino Maas, Andrew I. R. Menon, David Krishna Ercole, Ari Citerio, Giuseppe Nelson, David Polinder, Suzanne Steyerberg, Ewout W. Lingsma, Hester Jagt, Mathieu van der Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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5.

001-es BibID:BIBFORM107505
035-os BibID:(WOS)000450478400002 (Scopus)85056714365 (cikkazonosító)306
Első szerző:Veen, Ernest van
Cím:Brain death and postmortem organ donation : report of a questionnaire from the CENTER-TBI study / Ernest van Veen, Mathieu van der Jagt, Maryse C. Cnossen, Andrew I. R. Maas, Inez D. de Beaufort, David K. Menon, Giuseppe Citerio, Nino Stocchetti, Wim J. R. Rietdijk, Jeroen T. J. M. van Dijck, Erwin J. O. Kompanje, CENTER-TBI investigators and participants
Dátum:2018
ISSN:1364-8535
Megjegyzések:Abstract Background: We aimed to investigate the extent of the agreement on practices around brain death and postmortem organ donation. Methods: Investigators from 67 Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study centers completed several questionnaires (response rate: 99%). Results: Regarding practices around brain death, we found agreement on the clinical evaluation (prerequisites and neurological assessment) for brain death determination (BDD) in 100% of the centers. However, ancillary tests were required for BDD in 64% of the centers. BDD for nondonor patients was deemed mandatory in 18% of the centers before withdrawing life-sustaining measures (LSM). Also, practices around postmortem organ donation varied. Organ donation after circulatory arrest was forbidden in 45% of the centers. When withdrawal of LSM was contemplated, in 67% of centers the patients with a ventricular drain in situ had this removed, either sometimes or all of the time. Conclusions: This study showed both agreement and some regional differences regarding practices around brain death and postmortem organ donation. We hope our results help quantify and understand potential differences, and provide impetus for current dialogs toward further harmonization of practices around brain death and postmortem organ donation
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
folyóiratcikk
Traumatic brain injury
Brain death
Ethics
Postmortem organ donation
Withdrawing life-sustaining measures
Ventricular drainage
Megjelenés:Critical Care. - 22 : 1 (2018), p. 1-11. -
További szerzők:Jagt, Mathieu van der Cnossen, Maryse C. Maas, Andrew I. R. Beaufort, Inez D. de Menon, David Krishna Citerio, Giuseppe Stocchetti, Nino Rietdijk, Wim J. R. Dijck, Jeroen T. J. M. van Kompanje, Erwin J. O. Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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