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dc.contributor.authorHuijbers, Jilske
dc.contributor.authorWiegers, E
dc.contributor.authorLingsma, Hester F
dc.contributor.authorCiterio, Giuseppe
dc.contributor.authorMaas, Andrew I.R.
dc.contributor.authorMenon, David K
dc.contributor.authorErcole, Ari
dc.contributor.authorNelson, David
dc.contributor.authorvan der Jagt, Mathieu
dc.contributor.authorSteyerberg, Ewout
dc.contributor.authorHelbok, Raimund
dc.contributor.authorLecky, Fiona
dc.contributor.authorPeul, Wilco
dc.contributor.authorBirg, Tatiana
dc.contributor.authorZoerle, Tomaso
dc.contributor.authorCarbonara, Marco
dc.contributor.authorStocchetti, Nino
dc.contributor.authorAndelic, Nada
dc.contributor.authorAndreassen, Lasse
dc.contributor.authorLund, Stine Borgen
dc.contributor.authorFrisvold, Shirin
dc.contributor.authorHelseth, Eirik
dc.contributor.authorRøe, Cecilie
dc.contributor.authorRøise, Olav
dc.contributor.authorSandrød, Oddrun
dc.contributor.authorSchirmer-Mikalsen, Kari
dc.contributor.authorVik, Anne
dc.contributor.authorÅkerlund, Cecilia
dc.contributor.authorAmrein, Krisztina
dc.contributor.authorBrorsson, Camilla
dc.contributor.authorAzzolini, Maria Luisa
dc.contributor.authorBartels, Ronald
dc.contributor.authorBeer, Ronny
dc.contributor.authorBellander, Bo-Michael
dc.contributor.authorBenali, Habib
dc.contributor.authorBerardino, Maurizio
dc.contributor.authorBeretta, Luigi
dc.contributor.authorBeqiri, Erta
dc.contributor.authorBlaabjerg, Morten
dc.contributor.authorBuki, Andras
dc.contributor.authorCabeleira, Manuel
dc.contributor.authorCaccioppola, Alessio
dc.contributor.authorCalappi, Emaliana
dc.contributor.authorCalvi, Maria Rosa
dc.contributor.authorCameron, Peter
dc.contributor.authorGuillermo, Carbayo Lozano
dc.contributor.authorSundström, Nina
dc.contributor.authorTibboel, Dick
dc.contributor.authorPles, Horia
dc.contributor.authorSakowitz, Oliver
dc.contributor.authorZiverte, Agate
dc.identifier.citationIntensive Care Medicine. 2020, 46 (5), 995-1004.en_US
dc.description.abstractPurpose: To describe ICU stay, selected management aspects, and outcome of Intensive Care Unit (ICU) patients with traumatic brain injury (TBI) in Europe, and to quantify variation across centers. Methods: This is a prospective observational multicenter study conducted across 18 countries in Europe and Israel. Admission characteristics, clinical data, and outcome were described at patient- and center levels. Between-center variation in the total ICU population was quantified with the median odds ratio (MOR), with correction for case-mix and random variation between centers. Results: A total of 2138 patients were admitted to the ICU, with median age of 49 years; 36% of which were mild TBI (Glasgow Coma Scale; GCS 13–15). Within, 72 h 636 (30%) were discharged and 128 (6%) died. Early deaths and long-stay patients (> 72 h) had more severe injuries based on the GCS and neuroimaging characteristics, compared with short-stay patients. Long-stay patients received more monitoring and were treated at higher intensity, and experienced worse 6-month outcome compared to short-stay patients. Between-center variations were prominent in the proportion of short-stay patients (MOR = 2.3, p < 0.001), use of intracranial pressure (ICP) monitoring (MOR = 2.5, p < 0.001) and aggressive treatments (MOR = 2.9, p < 0.001); and smaller in 6-month outcome (MOR = 1.2, p = 0.01). Conclusions: Half of contemporary TBI patients at the ICU have mild to moderate head injury. Substantial between-center variations exist in ICU stay and treatment policies, and less so in outcome. It remains unclear whether admission of short-stay patients represents appropriate prudence or inappropriate use of clinical resources.en_US
dc.rightsNavngivelse-Ikkekommersiell 4.0 Internasjonal*
dc.titleChanging care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysisen_US
dc.typePeer revieweden_US
dc.typeJournal articleen_US
dc.source.journalIntensive Care Medicineen_US
dc.description.localcodeThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.To view a copy of this licence, visit ses/by-nc/4.0/.en_US

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Navngivelse-Ikkekommersiell 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Navngivelse-Ikkekommersiell 4.0 Internasjonal