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Prognostication and...
Prognostication and Goals of Care Decisions in Severe Traumatic Brain Injury : A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference Working Group
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- Sarigul, Buse (author)
- Tuzla Public Hospital, Tuzla, Istanbul, Turkey
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- Bell, Randy S. (author)
- Uniformed Services University of Health Sciences, Avera Brain and Spine Institute, Sioux Falls, South Dakota, USA
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- Chesnut, Randall (author)
- Departments of Neurological Surgery and Orthopaedic Surgery, School of Global Health, Harborview Medical Center, University of Washington, Seattle, Washington, USA
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- Aguilera, Sergio (author)
- Almirante Nef Naval Hospital, Viña del Mar, Chile
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- Büki, Andras, 1966- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Department of Neurosurgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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- Citerio, Giuseppe (author)
- School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; NeuroIntensive Care, Department of Neuroscience, IRCCS Fondazione San Gerardo dei Tintori, Monza, Italy
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- Cooper, D. Jamie (author)
- Intensive Care Medicine, Australian and New Zealand Intensive Care Research Centre, Alfred Hospital, Melbourne, Victoria, Australia
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- Diaz-Arrastia, Ramon (author)
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
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- Diringer, Michael (author)
- Department of Neurology, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri, USA
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- Figaji, Anthony (author)
- Department of Neurosurgery, Division of Neurosurgery and Neuroscience Institute, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
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- Gao, Guoyi (author)
- Division of Neurotrauma, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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- Geocadin, Romergryko G. (author)
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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- Ghajar, Jamshid (author)
- Department of Neurosurgery, Stanford Neuroscience Health Center, Palo Alto, California, USA
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- Harris, Odette (author)
- Brain Trauma Foundation, Palo Alto, California, USA
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- Hoffer, Alan (author)
- University Hospitals of Cleveland, Cleveland, Ohio, USA
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- Hutchinson, Peter (author)
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
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- Joseph, Mathew (author)
- Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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- Kitagawa, Ryan (author)
- Vivian L Smith Department of Neurosurgery, McGovern Medical School at UTHealth, Houston, Texas, USA
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- Manley, Geoffrey (author)
- Department of Neurosurgery, University of California San Francisco, San Francisco General Hospital & Trauma Center, San Francisco, California, USA
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- Mayer, Stephan A. (author)
- Westchester Medical Center, New York Medical College, Valhalla, New York, USA
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- Menon, David K. (author)
- Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
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- Meyfroidt, Geert (author)
- Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven and KU Leuven, Leuven, Belgium
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- Michael, Daniel B. (author)
- Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Beaumont Health, Michigan Head & Spine Institute, Southfield, Michigan, USA
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- Oddo, Mauro (author)
- Directorate of Innovation and Clinical Research, CHUV-Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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- Okonkwo, David O. (author)
- Departments of Neurological Surgery, Neurology and Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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- Patel, Mayur B. (author)
- Critical Illness, Brain Dysfunction, and Survivorship Center; Center for Health Services Research; Tennessee Valley Healthcare System, Veterans Affairs Medical Center; Section of Surgical Sciences, Department of Surgery, Division of Acute Care Surgery Vanderbilt University Medical Center, Nashville, Tennessee, USA
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- Robertson, Claudia (author)
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
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- Rosenfeld, Jeffrey V. (author)
- Department of Neurosurgery, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia
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- Rubiano, Andres M. (author)
- INUB/MEDITECH Research Group, Neurosciences Institute, El Bosque University, Bogotá, Colombia; MEDITECH Foundation, Clinical Research, Cali, Colombia
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- Sahuquillo, Juan (author)
- Department of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
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- Servadei, Franco (author)
- Department of Neurosurgery, IRCCS Humanitas Research Hospital and Humanitas University, Milano, Italy
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- Shutter, Lori (author)
- Critical Care Medicine, Neurology and Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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- Stein, Deborah D. (author)
- Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland, USA
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- Stocchetti, Nino (author)
- Department of Pathophysiology and Transplantation, Dipartimento Fisiopatologia e Trapianti Universita di Milano, Scuola di Specializzazione Anestesia, Rianimazione, Terapia Intensiva e del Dolore, Neurorianimazione, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico Milano, Milano, Italy
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- Taccone, Fabio Silvio (author)
- Department of Intensive Care, Hospital Erasme, Université Libre de Bruxelles (ULB) Brussels, Belgium
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- Timmons, Shelly D. (author)
- Department of Neurological Surgery, Indiana University School of Medicine, Indiana, USA
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- Tsai, Eve (author)
- Division of Neurosurgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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- Ullman, Jamie S. (author)
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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- Vespa, Paul (author)
- Department of Neurosurgery and Neurology, UCLA School of Medicine, Neurocritical Care, Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica, California, USA
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- Videtta, Walter (author)
- Intensive Care Medicine, Posadas Hospital, Buenos Aires, Argentina
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- Wright, David W. (author)
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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- Zammit, Christopher (author)
- Department of Emergency Medicine, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
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- Hawryluk, Gregory W. J. (author)
- Neurological Institute, Akron General Hospital, Fairlawn, Ohio, USA
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(creator_code:org_t)
- 2023-03-18
- 2023
- English.
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In: Journal of Neurotrauma. - : Mary Ann Liebert. - 0897-7151 .- 1557-9042. ; 40:15-16, s. 1707-1717
- Related links:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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Abstract
Subject headings
Close
- Best practice guidelines have advanced severe traumatic brain injury (TBI) care; however, there is little that currently informs goals of care decisions and processes despite their importance and frequency. Panelists from the Seattle International severe traumatic Brain Injury Consensus Conference (SIBICC) participated in a survey consisting of 24 questions. Questions queried use of prognostic calculators, variability in and responsibility for goals of care decisions, and acceptability of neurological outcomes, as well as putative means of improving decisions that might limit care. A total of 97.6% of the 42 SIBICC panelists completed the survey. Responses to most questions were highly variable. Overall, panelists reported infrequent use of prognostic calculators, and observed variability in patient prognostication and goals of care decisions. They felt that it would be beneficial for physicians to improve consensus on what constitutes an acceptable neurological outcome as well as what chance of achieving that outcome is acceptable. Panelists felt that the public should help to define what constitutes a good outcome and expressed some support for a "nihilism guard." More than 50% of panelists felt that if it was certain to be permanent, a vegetative state or lower severe disability would justify a withdrawal of care decision, whereas 15% felt that upper severe disability justified such a decision. Whether conceptualizing an ideal or existing prognostic calculator to predict death or an unacceptable outcome, on average a 64-69% chance of a poor outcome was felt to justify treatment withdrawal. These results demonstrate important variability in goals of care decision making and a desire to reduce this variability. Our panel of recognized TBI experts opined on the neurological outcomes and chances of those outcomes that might prompt consideration of care withdrawal; however, imprecision of prognostication and existing prognostication tools is a significant impediment to standardizing the approach to care-limiting decisions.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- SIBICC
- brain injury
- nihilism
- prognosis
- survey
- withdrawal of care
Publication and Content Type
- ref (subject category)
- art (subject category)
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To the university's database
- By the author/editor
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Sarigul, Buse
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Bell, Randy S.
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Chesnut, Randall
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Aguilera, Sergio
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Büki, Andras, 19 ...
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Citerio, Giusepp ...
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show more...
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Cooper, D. Jamie
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Diaz-Arrastia, R ...
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Diringer, Michae ...
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Figaji, Anthony
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Gao, Guoyi
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Geocadin, Romerg ...
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Ghajar, Jamshid
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Harris, Odette
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Hoffer, Alan
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Hutchinson, Pete ...
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Joseph, Mathew
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Kitagawa, Ryan
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Manley, Geoffrey
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Mayer, Stephan A ...
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Menon, David K.
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Meyfroidt, Geert
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Michael, Daniel ...
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Oddo, Mauro
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Okonkwo, David O ...
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Patel, Mayur B.
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Robertson, Claud ...
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Rosenfeld, Jeffr ...
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Rubiano, Andres ...
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Sahuquillo, Juan
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Servadei, Franco
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Shutter, Lori
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Stein, Deborah D ...
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Stocchetti, Nino
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Taccone, Fabio S ...
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Timmons, Shelly ...
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Tsai, Eve
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Ullman, Jamie S.
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Vespa, Paul
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Videtta, Walter
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Wright, David W.
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Zammit, Christop ...
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Hawryluk, Gregor ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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Journal of Neuro ...
- By the university
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Örebro University