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dc.contributor.authorVan Essen, Thomas
dc.contributor.authorden Boogert, HF
dc.contributor.authorCnossen, MC
dc.contributor.authorDe Ruiter, Godard CW
dc.contributor.authorHaitsma, Ian
dc.contributor.authorPolinder, S
dc.contributor.authorSteyerberg, Ewout W.
dc.contributor.authorMenon, David
dc.contributor.authorMaas, Andrew I. R.
dc.contributor.authorLingsma, Hester F
dc.contributor.authorPeul, Wilco
dc.contributor.authorAndelic, Nada
dc.contributor.authorHelseth, Eirik
dc.contributor.authorRoise, O
dc.contributor.authorRøe, Cecilie
dc.contributor.authorVik, Anne
dc.contributor.authorSkandsen, Toril
dc.contributor.authorAnke, Audny
dc.contributor.authorFrisvold, Shirin Kordasti
dc.date.accessioned2019-03-14T10:41:28Z
dc.date.available2019-03-14T10:41:28Z
dc.date.issued2018-12-19
dc.description.abstract<p><i>Background</i>: 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.</p> <p><i>Methods</i>: 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).</p> <p><i>Results</i>: 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.</p> <p><i>Conclusion</i>: 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.</p>en_US
dc.description.sponsorshipThe Hersenstichting Nederland (Dutch Brain Foundation)en_US
dc.descriptionSource at <a href=https://doi.org/10.1007/s00701-018-3761-z> https://doi.org/10.1007/s00701-018-3761-z</a>.en_US
dc.identifier.citationVan Essen, T., den Boogert, H.F., Cnossen, M.C., De Ruiter, G.C.W., Haitsma, I., Polinder, S., ... Peul, W.C. (2018). Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study. <i>Acta Neurochirurgica, 161</i>(3), 435–449. https://doi.org/10.1007/s00701-018-3761-zen_US
dc.identifier.cristinIDFRIDAID 1665415
dc.identifier.doi10.1007/s00701-018-3761-z
dc.identifier.issn0001-6268
dc.identifier.issn0942-0940
dc.identifier.urihttps://hdl.handle.net/10037/14975
dc.language.isoengen_US
dc.publisherSpringeren_US
dc.relation.journalActa Neurochirurgica
dc.relation.projectIDinfo:eu-repo/grantAgreement/EC/FP7-HEALTH/602150/EU/Periodic Report Summary 4 - CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI)/CENTER-TBI/en_US
dc.rights.accessRightsopenAccessen_US
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Neurosurgery: 786en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrokirurgi: 786en_US
dc.subjectTraumatic brain injuryen_US
dc.subjectNeurosurgeryen_US
dc.subjectPractice variationen_US
dc.subjectAcute subdural hematomaen_US
dc.titleVariation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI studyen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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