Van Essen TA, Den Boogert HF, Cnossen MC, De Ruiter GCW, Haitsma I, Polinder S, Steyerberg EW, Menon D, Maas AIR, Lingsma HF, Peul WC, Cecilia A, Hadie A, Vanni A, Judith A, Krisztina A, Norberto A, Nada A, Lasse A, Azasevac A, Audny A, Anna A, Hilko A, Gerard A, Kaspars A, Philippe A, Luisa AM, Camelia B, Rafael B, Ronald B, Pal B, Ursula B, Romuald B, Ronny B, Francisco Javier B, Bo-Michael B, Antonio B, Remy B, Habib B, Thierry B, Maurizio B, Luigi B, Christopher B, Federico B, Harald B, Erta B, Morten B, Hugo DB, Pierre B, Peter B, Alexandra B, Vibeke B, Joanne B, Camilla B, Andras B, Monika B, Emiliana C, Rosa CM, Peter C, Lozano Guillermo C, Marco C, Elsa C, Carpenter K, Ana M CL, Francesco C, Giorgio C, Arturo C, Giuseppe C, Maryse C, Mark C, Jonathan C, Lizzie CK, Johnny C, Jamie CD, Marta C, Amra C, Nicola C, Endre C, Marek C, Claire DF, Francois D, Pierre D, Helen D, Veronique DK, Francesco DC, Bart D, Godard DRCW, Dula D, Ding Shenghao , Diederik D, Abhishek D, Emma D, Jens D, Guy-Loup D, George E, Heiko E, Ari E, Patrick E, Erzsebet E, Martin F, Valery FL, Feng Junfeng , Kelly F, Francesca F, Gilles F, Ulderico F, Shirin F, Alex F, Pablo G, Damien G, Dashiell G, Gao Guoyi , Karin G, Pradeep G, Alexandre G, Lelde G, Benoit G, Ben G, Jagos G, Pedro GA, Francesca G, Russell GL, Deepak G, Juanita HA, Iain H, Jed HA, Raimund H, Eirik H, Daniel H, Astrid H, Stefan H, Lindsay H, Jilske H, Peter HJ, Kristine HA, Bram J, Stefan J, Mike J, Bojan J, Jiang Ji-Yao , Kelly J, Konstantinos K, Mladen K, Ari K, Maija K, Thomas K, Riku K, Angelos KG, Balint K, Erwin K, Ksenija K, Daniel K, Lars-Owe K, Noemi K, Alfonso L, Linda L, Steven L, Fiona L, Christian L, Rolf L, Valerie L, Jin L, Leon L, Roger L, Hester L, Dirk L, Angels L, Andrew MIR, Stephen M, Marc M, Marek M, Sebastian M, Alex M, Geoffrey M, Didier M, Francisco ML, Costanza M, Armando M, Hugues M, Alessandro M, Julia M, Charles M, Catherine M, Bela M, David M, Tomas M, Cristina MK, Davide M, Visakh M, Lynnette M, Holger M, Nandesh N, Ancuta N, David N, Virginia N, Daan N, Quentin N, Jozsef N, Mauro O, Annemarie O, Matej O, Fabrizio O, Aarno P, Paul PM, Adriana P, Jean-Francois P, Natascha P, Vincent P, Paolo P, Peulwilco , Anna PK, Sebastien PF, Matti P, Horia P, Maria Antonia P, Suzanne P, Inigo P, Jussi P, Louis P, Andreea R, Arminas R, Rahul R, Malinka R, Ruben R, Veronika R, Jonathan R, Samuli R, Saulius R, Cecilie R, Olav R, Gerwin R, Jonathan R, Jeffrey R, Christina R, Guy R, Rolf R, Sandra R, Daniel R, Martin R, Marco S, Barbara S, Juan S, Oliver S, Francesca S, Renan SP, Janos S, Edgar S, Luminita S, Davide S, Nadine S, Inger S, Barbara S, Silke S, Herbert S, Guus S, Frederik SR, Elisabeth S, Michael S, Ozcan S, Toril S, Lidwien S, Dirk S, Peter S, Abayomi S, Emmanuel S, Simon S, Nicole S, Ana S, Robert S, William S, Ewout SW, Nino S, Nina S, Anneliese S, Fabio Silvio T, Riikka T, Viktoria T, Paivi T, Steven TM, Braden TA, Olli T, Ralph T, Guido T, Alice T, Matt T, Dick T, Christos T, Luaba TJF, Tony T, Maria TC, Peter V, Shirley V, Egils V, Gregory VDS, Mathieu VDJ, Joukje VDN, Jeroen VDTJM, Thomas VEA, Wim VH, Caroline VH, Dominique VP, Thijs VV, Julia VW, Audrey V, Alessia V, Emmanuel V, Kimberley V, Jan V, Paul VM, Anne V, Rimantas V, Giacinta V, Carmen VL, Victor V, Daphne V, Peter V, Zoltan V, Derick W, Kevin WKW, Lei W, Lars W, Eno W, Guy W, Lindsay W, Maren WKL, Stefan W, Peter Y, Alexander Y, Menashe Z, Yang Z, Agate Z, Fabrizio Z (2019)
Publication Type: Journal article
Publication year: 2019
Book Volume: 161
Pages Range: 435-449
Journal Issue: 3
DOI: 10.1007/s00701-018-3761-z
Background: Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe. Methods: A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP). Results: The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions. Conclusion: Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care.
APA:
Van Essen, T.A., Den Boogert, H.F., Cnossen, M.C., De Ruiter, G.C.W., Haitsma, I., Polinder, S.,... Fabrizio, Z. (2019). Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study. Acta Neurochirurgica, 161(3), 435-449. https://dx.doi.org/10.1007/s00701-018-3761-z
MLA:
Van Essen, Thomas A., et al. "Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study." Acta Neurochirurgica 161.3 (2019): 435-449.
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