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001-es BibID:	BIBFORM116192
035-os BibID:	(Scopus)85168315877 (WOS)000993931100001
Első szerző:	Mikolić, Ana
Cím:	Prognostic Models for Global Functional Outcome and Post-Concussion Symptoms Following Mild Traumatic Brain Injury : A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study / Ana Mikolic, Ewout W. Steyerberg, Suzanne Polinder, Lindsay Wilson, Marina Zeldovich, Nicole von Steinbuechel, Virginia F. J. Newcombe, David K. Menon, Joukjevander Naalt, Hester F. Lingsma, Andrew I. R. Maas, David van Klaveren, CENTER-TBI Participants and Investigators
Dátum:	2023
ISSN:	0897-7151
Megjegyzések:	After mild traumatic brain injury (mTBI), a substantial proportion of individuals do not fully recover on the Glasgow Outcome Scale Extended (GOSE) or experience persistent post-concussion symptoms (PPCS). We aimed to develop prognostic models for the GOSE and PPCS at 6 months after mTBI and to assess the prognostic value of different categories of predictors (clinical variables; questionnaires; computed tomography [CT]; blood biomarkers). From the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we included participants aged 16 or older with Glasgow Coma Score (GCS) 13-15. We used ordinal logistic regression to model the relationship between predictors and the GOSE, and linear regression to model the relationship between predictors and the Rivermead Post-concussion Symptoms Questionnaire (RPQ) total score. First, we studied a pre-specified Core model. Next, we extended the Core model with other clinical and sociodemographic variables available at presentation (Clinical model). The Clinical model was then extended with variables assessed before discharge from hospital: early post-concussion symptoms, CT variables, biomarkers, or all three categories (extended models). In a subset of patients mostly discharged home from the emergency department, the Clinical model was extended with 2-3-week post-concussion and mental health symptoms. Predictors were selected based on Akaike's Information Criterion. Performance of ordinal models was expressed as a concordance index (C) and performance of linear models as proportion of variance explained (R2). Bootstrap validation was used to correct for optimism. We included 2376 mTBI patients with 6-month GOSE and 1605 patients with 6-month RPQ. The Core and Clinical models for GOSE showed moderate discrimination (C = 0.68 95% confidence interval 0.68 to 0.70 and C = 0.70[0.69 to 0.71], respectively) and injury severity was the strongest predictor. The extended models had better discriminative ability (C = 0.71[0.69 to 0.72] with early symptoms; 0.71[0.70 to 0.72] with CT variables or with blood biomarkers; 0.72[0.71 to 0.73] with all three categories). The performance of models for RPQ was modest (R2 = 4% Core; R2 = 9% Clinical), and extensions with early symptoms increased the R2 to 12%. The 2-3-week models had better performance for both outcomes in the subset of participants with these symptoms measured (C = 0.74 [0.71 to 0.78] vs. C = 0.63[0.61 to 0.67] for GOSE; R2 = 37% vs. 6% for RPQ). In conclusion, the models based on variables available before discharge have moderate performance for the prediction of GOSE and poor performance for the prediction of PPCS. Symptoms assessed at 2-3 weeks are required for better predictive ability of both outcomes. The performance of the proposed models should be examined in independent cohorts.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk biomarkers Glasgow Outcome Scale Extended mild traumatic brain injury post-concussion symptoms predictors prognostic model
Megjelenés:	Journal Of Neurotrauma. - 40 : 15-16 (2023), p. 1651-1670. -
További szerzők:	Steyerberg, Ewout W. Polinder, Suzanne Wilson, Lindsay Zeldovich, Marina von Steinbuechel, Nicole Newcombe, Virginia F. J. Menon, David Krishna Naalt, Joukjevander Lingsma, Hester Maas, Andrew I. R. van Klaveren, David Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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001-es BibID:	BIBFORM107355
035-os BibID:	(scopus)85132842261 (wos)000834619400012
Első szerző:	van der Vlegel, Marjolein
Cím:	Health care utilization and outcomes in older adults after Traumatic Brain Injury : a CENTER-TBI study / van der Vlegel Marjolein, Mikolic Ana, Lee Hee Quentin, Kaplan Z. L. Rana, Retel Helmrich Isabel R. A., van Veen Ernest, Andelic Nada, Steinbuechel Nicole v., Plass Anne Marie, Zeldovich Marina, Wilson Lindsay, Maas Andrew I. R., Haagsma Juanita A., Polinder Suzanne, CENTER-TBI Participants and Investigators
Dátum:	2022
ISSN:	0020-1383
Megjegyzések:	Introduction: The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ?65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month out- comes after TBI and their determinants in older adults who sustained a TBI. Methods: We used data from the prospective multi-center Collaborative European NeuroTrauma Effective- ness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care uti- lization and outcomes were described for patients aged ?65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. Results: Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six- month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with func- tional impairment, lower generic and disease-specific HRQoL and mental health symptoms. Conclusion: The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Traumatic Brain Injury Older adults Outcomes Health care utilization Health-related quality of life Mental health
Megjelenés:	Injury-International Journal Of The Care Of The Injured. - 53 : 8 (2022), p. 2774-2782. -
További szerzők:	Mikolić, Ana Lee Hee, Quentin Kaplan, Z. L. Rana Retel Helmrich, Isabel R. A. van Veen, Ernest Andelic, Nada von Steinbuechel, Nicole Plass, Anne Marie Zeldovich, Marina Wilson, Lindsay Maas, Andrew I. R. Haagsma, Juanita A. Polinder, Suzanne Sándor János (1966-) (orvos-epidemiológus) CENTER-TBI Participants and Investigators
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