| 1. |
- Mondello, Stefania, et al.
(författare)
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Blood-based protein biomarkers for the management of traumatic brain injuries in adults presenting to emergency departments with mild brain injury : A living systematic review and meta-analysis
- 2021
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Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert. - 0897-7151 .- 1557-9042. ; 38:8, s. 1086-1106
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Forskningsöversikt (refereegranskat)abstract
- Accurate diagnosis of traumatic brain injury (TBI) is critical to effective management and intervention, but can be challenging in patients with mild TBI. A substantial number of studies have reported the use of circulating biomarkers as signatures for TBI, capable of improving diagnostic accuracy and clinical decision making beyond current practice standards. We performed a systematic review and meta-analysis to comprehensively and critically evaluate the existing body of evidence for the use of blood protein biomarkers (S100 calcium binding protein B [S100B], glial fibrillary acidic protein [GFAP], neuron specific enolase [NSE], ubiquitin C-terminal hydrolase-L1 [UCH-L1]. tau, and neurofilament proteins) for diagnosis of intracranial lesions on CT following mild TBI. Effects of potential confounding factors and differential diagnostic performance of the included markers were explored. Further, appropriateness of study design, analysis, quality, and demonstration of clinical utility were assessed. Studies published up to October 2016 were identified through searches of MEDLINE®, Embase, EBM Reviews, the Cochrane Library, World Health Organization (WHO), International Clinical Trials Registry Platform (ICTRP), and clinicaltrials.gov. Following screening of the identified articles, 26 were selected as relevant. We found that measurement of S100B can help informed decision making in the emergency department, possibly reducing resource use; however, there is insufficient evidence that any of the other markers is ready for clinical application. Our work pointed out serious problems in the design, analysis, and reporting of many of the studies, and identified substantial heterogeneity and research gaps. These findings emphasize the importance of methodologically rigorous studies focused on a biomarker's intended use, and defining standardized, validated, and reproducible approaches. The living nature of this systematic review, which will summarize key updated information as it becomes available, can inform and guide future implementation of biomarkers in the clinical arena.
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| 2. |
- Sorinola, Abayomi, et al.
(författare)
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Effectiveness of Traumatic Brain Injury Management Guideline Introduction in Hungary
- 2018
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Ingår i: Turkish Neurosurgery. - : Turkish Neurosurgi[c]al Society. - 1019-5149. ; 28:3, s. 410-415
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe the impact of the Traumatic Brain Injury management guideline introduction in Hungary. MATERIAL and METHODS: Hospital discharge records (HDR) including age, gender, codes of interventions applied, ICD codes of diagnosed disorders of patients admitted between 01/01/2004 and 31/12/2010 with the diagnosis of intracranial injury (S06 by ICD10) from every inpatient institution in Hungary were collected from the database of National Health Insurance Fund (NHIF). The Case Fatality Ratios (CFR) for one week, one month and six months were calculated for the periods before and after the guideline introduction. The change of CFRs was applied as indicators for change of clinical quality elicited by the guideline.RESULTS: The centers together at one week, one month and six months had pre-guideline introduction CFRs of 23.4%, 37.7% and 47.5% and post-guideline introduction CFRs of 22.1%, 39.1%, and 50.0% respectively. The secondary institutions together at one week, one month and six months had pre-guideline introduction CFRs of 21.5%, 34.8% and 46.3% and post-guideline introduction CFRs of 21.9%, 37.0%, and 48.9% respectively. None of the CFRs showed significant change.CONCLUSION: The effectiveness of TBI management guideline adaptation in Hungary is poor. Without supportive financing and external auditing system, guideline introduction alone cannot achieve standard clinical practice and a reduction in CFR.
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| 3. |
- Sorinola, Abayomi, et al.
(författare)
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Risk Factors of External Ventricular Drain Infection : Proposing a Model for Future Studies
- 2019
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Ingår i: Frontiers in Neurology. - : Frontiers Media S.A.. - 1664-2295. ; 10
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Forskningsöversikt (refereegranskat)abstract
- Background: External ventricular drain (EVD) has a major role in the management and monitoring of intracranial pressure (ICP) and its major complication is EVD infection. The risk factors for EVD infection are still a major topic of controversy, hence the need for further research.Objective: The objective of this review was to identify risk factors that affect the incidence of EVD infection and create a model, which can be used in future studies in order to contribute to elaborations on guideline for EVD.Methods: A PubMed and Google Scholar literature search was performed and data were extracted from studies published from 1966 through 2017. The search of the databases generated 604 articles and 28 articles of these were found to be relevant. A manual search of the 28 relevant papers generated 4 new articles. Of the 32 relevant articles, 20 articles that performed a multivariate analysis of the suspected risk factors of EVD infection and had a positive culture as a mandatory component in diagnosis were selected for data collection and analysis.Results: Because reviewed papers investigated only a few influencing factors, and could not determine convincingly the real risk factors of EVD infection and their real strengths. A total of 15 supposed influencing factors which includes: age, age & sex interactions, coinfection, catheter insertion outside the hospital, catheter type, CSF leakage, CSF sampling frequency, diagnosis, duration of catheterization, ICP > 20 mmHg, irrigation, multiple catheter, neurosurgical operation, reduced CSF glucose at catheter insertion and sex were identified.Conclusion: This review summarizes a set of variables which have to be covered by future clinical epidemiological investigations in order to describe the etiological background of EVD infection.
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