TY  - JOUR
PY  - 2017//
TI  - Prognostication in critically ill patients with severe traumatic brain injury: the TBI-Prognosis multicentre feasibility study
JO  - BMJ open
A1  - Turgeon, Alexis F.
A1  - Lauzier, François
A1  - Zarychanski, Ryan
A1  - Fergusson, Dean A.
A1  - Léger, Caroline
A1  - McIntyre, Lauralyn A.
A1  - Bernard, Francis
A1  - Rigamonti, Andrea
A1  - Burns, Karen
A1  - Griesdale, Donald E.
A1  - Green, Robert
A1  - Scales, Damon C.
A1  - Meade, Maureen O.
A1  - Savard, Martin
A1  - Shemilt, Michèle
A1  - Paquet, Jérôme
A1  - Gariépy, Jean-Luc
A1  - Lavoie, Andre
A1  - Reddy, Kesh
A1  - Jichici, Draga
A1  - Pagliarello, Giuseppe
A1  - Zygun, David
A1  - Moore, Lynne
SP  - e013779
EP  - e013779
VL  - 7
IS  - 4
N2  - OBJECTIVE: Severe traumatic brain injury is a significant cause of morbidity and mortality in young adults. Assessing long-term neurological outcome after such injury is difficult and often characterised by uncertainty. The objective of this feasibility study was to establish the feasibility of conducting a large, multicentre prospective study to develop a prognostic model of long-term neurological outcome in critically ill patients with severe traumatic brain injury. <br><br>DESIGN: A prospective cohort study. SETTING: 9 Canadian intensive care units enrolled patients suffering from acute severe traumatic brain injury. Clinical, biological, radiological and electrophysiological data were systematically collected during the first week in the intensive care unit. Mortality and functional outcome (Glasgow Outcome Scale extended) were assessed on hospital discharge, and then 3, 6 and 12 months following injury. OUTCOMES: The compliance to protocolised test procedures was the primary outcome. Secondary outcomes were enrolment rate and compliance to follow-up. <br><br>RESULTS: We successfully enrolled 50 patients over a 12-month period. Most patients were male (80%), with a median age of 45 years (IQR 29.0-60.0), a median Injury Severity Score of 38 (IQR 25-50) and a Glasgow Coma Scale of 6 (IQR 3-7). Mortality was 38% (19/50) and most deaths occurred following a decision to withdraw life-sustaining therapies (18/19). The main reasons for non-enrolment were the time window for inclusion being after regular working hours (35%, n=23) and oversight (24%, n=16). Compliance with protocolised test procedures ranged from 92% to 100% and enrolment rate was 43%. No patients were lost to follow-up at 6 months and 2 were at 12 months. <br><br>CONCLUSIONS: In this multicentre prospective feasibility study, we achieved feasibility objectives pertaining to compliance to test, enrolment and follow-up. We conclude that the TBI-Prognosis prospective multicentre study in severe traumatic brain injury patients in Canada is feasible.<br><br>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.<p />  <p>Language: en</p>
LA  - en
SN  - 2044-6055
UR  - http://dx.doi.org/10.1136/bmjopen-2016-013779
ID  - ref1
ER  -