Can We Cluster ICU Treatment Strategies for Traumatic Brain Injury by Hospital Treatment Preferences?
Ceyisakar IE, Huijben JA, Maas AIR, Lingsma HF, Van Leeuwen N (2022)
Publication Type: Journal article
Publication year: 2022
Journal
Book Volume: 36
Pages Range: 846-856
Journal Issue: 3
DOI: 10.1007/s12028-021-01386-y
Abstract
Background: In traumatic brain injury (TBI), large between-center differences in treatment and outcome for patients managed in the intensive care unit (ICU) have been shown. The aim of this study is to explore if European neurotrauma centers can be clustered, based on their treatment preference in different domains of TBI care in the ICU. Methods: Provider profiles of centers participating in the Collaborative European Neurotrauma Effectiveness Research in TBI study were used to assess correlations within and between the predefined domains: intracranial pressure monitoring, coagulation and transfusion, surgery, prophylactic antibiotics, and more general ICU treatment policies. Hierarchical clustering using Ward’s minimum variance method was applied to group data with the highest similarity. Heat maps were used to visualize whether hospitals could be grouped to uncover types of hospitals adhering to certain treatment strategies. Results: Provider profiles were available from 66 centers in 20 different countries in Europe and Israel. Correlations within most of the predefined domains varied from low to high correlations (mean correlation coefficients 0.2–0.7). Correlations between domains were lower, with mean correlation coefficients of 0.2. Cluster analysis showed that policies could be grouped, but hospitals could not be grouped based on their preference. Conclusions: Although correlations between treatment policies within domains were found, the failure to cluster hospitals indicates that a specific treatment choice within a domain is not a proxy for other treatment choices within or outside the domain. These results imply that studying the effects of specific TBI interventions on outcome can be based on between-center variation without being substantially confounded by other treatments. Trial registration: We do not report the results of a health care intervention.
Involved external institutions
University of Antwerp / Universiteit Antwerpen
Belgium (BE)
Erasmus University Medical Center (MC)
Netherlands (NL)
Belgium (BE)
Erasmus University Medical Center (MC)
Netherlands (NL)
How to cite
APA:
Ceyisakar, I.E., Huijben, J.A., Maas, A.I.R., Lingsma, H.F., & Van Leeuwen, N. (2022). Can We Cluster ICU Treatment Strategies for Traumatic Brain Injury by Hospital Treatment Preferences? Neurocritical Care, 36(3), 846-856. https://doi.org/10.1007/s12028-021-01386-y
MLA:
Ceyisakar, Iris E., et al. "Can We Cluster ICU Treatment Strategies for Traumatic Brain Injury by Hospital Treatment Preferences?" Neurocritical Care 36.3 (2022): 846-856.
BibTeX: Download