Search: onr:"swepub:oai:DiVA.org:umu-171374" > Changing care pathw...
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000 | 04442naa a2200613 4500 | |
001 | oai:DiVA.org:umu-171374 | |
003 | SwePub | |
008 | 200602s2020 | |||||||||||000 ||eng| | |
009 | oai:prod.swepub.kib.ki.se:143104014 | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1713742 URI |
024 | 7 | a https://doi.org/10.1007/s00134-020-05965-z2 DOI |
024 | 7 | a http://kipublications.ki.se/Default.aspx?queryparsed=id:1431040142 URI |
040 | a (SwePub)umud (SwePub)ki | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Huijben, Jilske A4 aut |
245 | 1 0 | a Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe :b a CENTER-TBI analysis |
264 | c 2020-02-25 | |
264 | 1 | b Springer Science and Business Media LLC,c 2020 |
338 | a electronic2 rdacarrier | |
520 | a PURPOSE: 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. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Neurologi0 (SwePub)302072 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Neurology0 (SwePub)302072 hsv//eng |
653 | a Intensive care unit | |
653 | a Intracranial pressure | |
653 | a Outcome | |
653 | a Traumatic brain injury | |
700 | 1 | a Wiegers, Eveline J A4 aut |
700 | 1 | a Lingsma, Hester F4 aut |
700 | 1 | a Citerio, Giuseppe4 aut |
700 | 1 | a Maas, Andrew I R4 aut |
700 | 1 | a Menon, David K4 aut |
700 | 1 | a Ercole, Ari4 aut |
700 | 1 | a Nelson, Davidu Karolinska Institutet4 aut |
700 | 1 | a van der Jagt, Mathieu4 aut |
700 | 1 | a Steyerberg, Ewout W4 aut |
700 | 1 | a Helbok, Raimund4 aut |
700 | 1 | a Lecky, Fiona4 aut |
700 | 1 | a Peul, Wilco4 aut |
700 | 1 | a Birg, Tatiana4 aut |
700 | 1 | a Zoerle, Tommaso4 aut |
700 | 1 | a Carbonara, Marco4 aut |
700 | 1 | a Stocchetti, Nino4 aut |
700 | 1 | a Brorsson, Camillau Umeå universitet,Anestesiologi och intensivvård4 ctb0 (Swepub:umu)brca0001 |
710 | 2 | a Karolinska Institutetb Anestesiologi och intensivvård4 org |
773 | 0 | t Intensive Care Medicined : Springer Science and Business Media LLCg 46:5, s. 995-1004q 46:5<995-1004x 0342-4642x 1432-1238 |
856 | 4 | u https://doi.org/10.1007/s00134-020-05965-zy Fulltext |
856 | 4 | u https://umu.diva-portal.org/smash/get/diva2:1433978/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print |
856 | 4 | u https://link.springer.com/content/pdf/10.1007/s00134-020-05965-z.pdf |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-171374 |
856 | 4 8 | u https://doi.org/10.1007/s00134-020-05965-z |
856 | 4 8 | u http://kipublications.ki.se/Default.aspx?queryparsed=id:143104014 |
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