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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

Sarigul, Buse (författare)
Tuzla Public Hospital, Tuzla, Istanbul, Turkey
Bell, Randy S. (författare)
Uniformed Services University of Health Sciences, Avera Brain and Spine Institute, Sioux Falls, South Dakota, USA
Chesnut, Randall (författare)
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 (författare)
Almirante Nef Naval Hospital, Viña del Mar, Chile
Büki, Andras, 1966- (författare)
Örebro universitet,Institutionen för medicinska vetenskaper,Department of Neurosurgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
Citerio, Giuseppe (författare)
School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; NeuroIntensive Care, Department of Neuroscience, IRCCS Fondazione San Gerardo dei Tintori, Monza, Italy
Cooper, D. Jamie (författare)
Intensive Care Medicine, Australian and New Zealand Intensive Care Research Centre, Alfred Hospital, Melbourne, Victoria, Australia
Diaz-Arrastia, Ramon (författare)
Department of Neurology, University of Pennsylvania Perelman School of Medicine, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania, USA
Diringer, Michael (författare)
Department of Neurology, Washington University School of Medicine, Barnes-Jewish Hospital, St. Louis, Missouri, USA
Figaji, Anthony (författare)
Department of Neurosurgery, Division of Neurosurgery and Neuroscience Institute, University of Cape Town, Groote Schuur Hospital, Cape Town, South Africa
Gao, Guoyi (författare)
Division of Neurotrauma, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
Geocadin, Romergryko G. (författare)
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Ghajar, Jamshid (författare)
Department of Neurosurgery, Stanford Neuroscience Health Center, Palo Alto, California, USA
Harris, Odette (författare)
Brain Trauma Foundation, Palo Alto, California, USA
Hoffer, Alan (författare)
University Hospitals of Cleveland, Cleveland, Ohio, USA
Hutchinson, Peter (författare)
Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
Joseph, Mathew (författare)
Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India
Kitagawa, Ryan (författare)
Vivian L Smith Department of Neurosurgery, McGovern Medical School at UTHealth, Houston, Texas, USA
Manley, Geoffrey (författare)
Department of Neurosurgery, University of California San Francisco, San Francisco General Hospital & Trauma Center, San Francisco, California, USA
Mayer, Stephan A. (författare)
Westchester Medical Center, New York Medical College, Valhalla, New York, USA
Menon, David K. (författare)
Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, United Kingdom
Meyfroidt, Geert (författare)
Department and Laboratory of Intensive Care Medicine, University Hospitals Leuven and KU Leuven, Leuven, Belgium
Michael, Daniel B. (författare)
Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Beaumont Health, Michigan Head & Spine Institute, Southfield, Michigan, USA
Oddo, Mauro (författare)
Directorate of Innovation and Clinical Research, CHUV-Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
Okonkwo, David O. (författare)
Departments of Neurological Surgery, Neurology and Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Patel, Mayur B. (författare)
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
Robertson, Claudia (författare)
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
Rosenfeld, Jeffrey V. (författare)
Department of Neurosurgery, The Alfred Hospital, Melbourne, Victoria, Australia; Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia
Rubiano, Andres M. (författare)
INUB/MEDITECH Research Group, Neurosciences Institute, El Bosque University, Bogotá, Colombia; MEDITECH Foundation, Clinical Research, Cali, Colombia
Sahuquillo, Juan (författare)
Department of Neurosurgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Spain
Servadei, Franco (författare)
Department of Neurosurgery, IRCCS Humanitas Research Hospital and Humanitas University, Milano, Italy
Shutter, Lori (författare)
Critical Care Medicine, Neurology and Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
Stein, Deborah D. (författare)
Program in Trauma, University of Maryland School of Medicine, Baltimore, Maryland, USA
Stocchetti, Nino (författare)
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
Taccone, Fabio Silvio (författare)
Department of Intensive Care, Hospital Erasme, Université Libre de Bruxelles (ULB) Brussels, Belgium
Timmons, Shelly D. (författare)
Department of Neurological Surgery, Indiana University School of Medicine, Indiana, USA
Tsai, Eve (författare)
Division of Neurosurgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
Ullman, Jamie S. (författare)
Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
Vespa, Paul (författare)
Department of Neurosurgery and Neurology, UCLA School of Medicine, Neurocritical Care, Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica, California, USA
Videtta, Walter (författare)
Intensive Care Medicine, Posadas Hospital, Buenos Aires, Argentina
Wright, David W. (författare)
Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
Zammit, Christopher (författare)
Department of Emergency Medicine, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, New York, USA
Hawryluk, Gregory W. J. (författare)
Neurological Institute, Akron General Hospital, Fairlawn, Ohio, USA
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 (creator_code:org_t)
2023-03-18
2023
Engelska.
Ingår i: Journal of Neurotrauma. - : Mary Ann Liebert. - 0897-7151 .- 1557-9042. ; 40:15-16, s. 1707-1717
Relaterad länk:
https://doi.org/10.1...
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https://urn.kb.se/re...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • 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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Neurology (hsv//eng)

Nyckelord

SIBICC
brain injury
nihilism
prognosis
survey
withdrawal of care

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