Olav Røise

• Borgen, Ida Maria Henriksen; Røe, Cecilie; Brunborg, Cathrine; Tenovuo, Olli; Azouvi, Philippe; Dawes, Helen; Majdan, Marek; Ranta, Jukka; Rusnak, Martin; Wiegers, E; Tverdal, Cathrine Buaas; Jacob, Louis; Cogne, Melanie; von Steinbuechel, Nicole; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røise, Olav; Skandsen, Toril & Vik, Anne (2021). Care transitions in the first 6 months following traumatic brain injury: Lessons from the CENTER-TBI study. Annals of Physical and Rehabilitation Medicine.  ISSN 1877-0657. . doi: 10.1016/j.rehab.2020.10.009 Show summary

  Background: No large international studies have investigated care transitions during or after acute hospitalisations for traumatic brain injury (TBI). Objectives: To characterise various TBI-care pathways and the number of associated transitions during the first 6 months after TBI and to assess the impact of these on functional TBI outcome controlled for demographic and injury-related factors. Methods: This was a cohort study of patients with TBI admitted to various trauma centres enrolled in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study. Number of transitions and specific care pathways were identified. Multiple logistic regression analyses were used to assess the impact of number of transitions and care pathways on functional outcome at 6 months post-injury as assessed by the Glasgow Outcome Scale-Extended (GOSE). Results: In total, 3133 patients survived the acute TBI-care pathway and had at least one documented in-hospital transition at 6-month follow-up. The median number of transitions was 3 (interquartile range 2-3). The number of transitions did not predict functional outcome at 6 months (odds ratio 1.08, 95% confidence interval 1.09-1.18; p = 0.063). A total of 378 different care pathways were identified; 8 were identical for at least 100 patients and characterized as "common pathways". Five of these common care pathways predicted better functional outcomes at 6 months, and the remaining 3 pathways were unrelated to outcome. In both models, increased age, violence as the cause of injury, pre-injury presence of systemic disease, both intracranial and overall injury severity, and regions of Southern/Eastern Europe were associated with unfavourable functional outcomes at 6 months. Conclusions: A high number of different and complex care pathways was found for patients with TBI, particularly those with severe injuries. This high number and variety of care pathway possibilities indicates a need for standardisation and development of "common data elements for TBI care pathways" for future studies.

• Søberg, Helene Lundgaard; Moksnes, Håkon Øgreid; Anke, Audny; Røise, Olav; Røe, Ellen-Cecilie Treu; Aas, Eline; Sveen, Unni; Gaarder, Christine; Næss, Pål Aksel; Helseth, Eirik; Dahl, Hilde Margrete; Becker, Frank; Løvstad, Marianne; Bartnes, Kristian; Schäfer, Christoph; Rasmussen, Mari Storli; Perrin, Paul B.; Lu, Juan; Hellstrøm, Torgeir & Hadzic-Andelic, Nada (2021). Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study. JMIR Research Protocols.  ISSN 1929-0748. . doi: 10.2196/25980
• Aase, Karina; Guise, Veslemøy; Billett, Stephen; Sollid, Stephen J. M.; Njå, Ove; Røise, Olav; Manser, Tanja; Anderson, Janet & Wiig, Siri (2020). Resilience in healthcare (RiH): a longitudinal research programme protocol. BMJ Open.  ISSN 2044-6055.  10(10) . doi: 10.1136/bmjopen-2020-038779 Full text in Research Archive.
• Andelic, Nada; Røe, Cecilie; Brunborg, Cathrine; Zeldovich, Marina; Løvstad, Marianne; Løke, Daniel; Borgen, Ida Maria Henriksen; Voormolen, Daphne; Howe, Emilie; Forslund, Marit Vindal; DAHL, HILDE MARGRETE; von Steinbuechel, Nicole; Helseth, Eirik; Røise, Olav; Frisvold, Shirin; Anke, Audny; Skandsen, Toril; Vik, Anne; Andreassen, Lasse; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo & Carbonara, Marco (2020). Frequency of fatigue and its changes in the first 6 months after traumatic brain injury: results from the CENTER-TBI study. Journal of Neurology.  ISSN 0340-5354.  268 . doi: 10.1007/s00415-020-10022-2 Full text in Research Archive. Show summary

  Background: Fatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities. Methods: Patients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subjective fatigue was measured by single item on the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), administered at baseline, three and 6 months postinjury. Patients were categorized by clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU). Injury severity, preinjury somatic- and psychiatric conditions, depressive and sleep problems were registered at baseline. For prediction of fatigue changes, descriptive statistics and mixed effect logistic regression analysis are reported. Results: Fatigue was experienced by 47% of patients at baseline, 48% at 3 months and 46% at 6 months. Patients admitted to ICU had a higher probability of experiencing fatigue than those in ER and ADM strata. Females and individuals with lower age, higher education, more severe intracranial injury, preinjury somatic and psychiatric conditions, sleep disturbance and feeling depressed postinjury had a higher probability of fatigue. Conclusion: A high and stable frequency of fatigue was found during the first 6 months after TBI. Specific socio-demographic factors, comorbidities and injury severity characteristics were predictors of fatigue in this study.

• Arango-Lasprilla, Juan Carlos L; Zedovich, Marina; Olabarrieta-Landa, Laiene; Forslund, Marit Vindal; Núñez-Fernández, Silvia; von Steinbuechel, Nicole; Howe, Emilie; Røe, Cecilie; Andelic, Nada; Skandsen, Toril; Vik, Anne; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røise, Olav; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Cavallo, Simona; Chevallard, Giorgio; Chieregato, Arturo; Citerio, Giuseppe & Ceyisakar, Iris (2020). Early Predictors of Employment Status One Year Post Injury in Individuals with Traumatic Brain Injury in Europe. Journal of Clinical Medicine.  ISSN 2077-0383.  9(6) . doi: DOI: 10.3390/jcm9062007 Full text in Research Archive. Show summary

  Sustaining a traumatic brain injury (TBI) often affects the individual’s ability to work, reducing employment rates post-injury across all severities of TBI. The objective of this multi-country study was to assess the most relevant early predictors of employment status in individuals after TBI at one-year post-injury in European countries. Using a prospective longitudinal non-randomized observational cohort (The Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) project), data was collected between December 2014–2019 from 63 trauma centers in 18 European countries. The 1015 individuals who took part in this study were potential labor market participants, admitted to a hospital and enrolled within 24 h of injury with a clinical TBI diagnosis and indication for a computed tomography (CT) scan, and followed up at one year. Results from a binomial logistic regression showed that older age, status of part-time employment or unemployment at time of injury, premorbid psychiatric problems, and higher injury severity (as measured with higher Injury severity score (ISS), lower Glasgow Coma Scale (GCS), and longer length of stay (LOS) in hospital) were associated with higher unemployment probability at one-year after injury. The study strengthens evidence for age, employment at time of injury, premorbid psychiatric problems, ISS, GCS, and LOS as important predictors for employment status one-year post-TBI across Europe

• Böhm, JK; Güting, Helge; Thorn, S; Schäfer, Nadine; Rambach, V; Schöchl, Herbert; Grottke, Oliver; Rossaint, Rolf; Stanworth, Simon; Curry, Nicola; Lefering, Rolf; Maegele, Marc; Andelic, Nada; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Andreassen, Lasse; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter & Lozano, Guillermo Carbayo (2020). Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI): A CENTER-TBI Analysis. Neurocritical Care.  ISSN 1541-6933. . doi: 10.1007/s12028-020-01151-7 Full text in Research Archive. Show summary

  Background: Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood. Methods: This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI. Emphasis was placed on the acute phase following TBI, primary on subgroups of patients with abnormal coagulation profile within 4 h of admission, and the impact of pre-injury anticoagulant and/or antiplatelet therapy. In order to minimise confounding factors, patients with isolated TBI (iTBI) (n = 598) were selected for this analysis. Results: Haemostatic disorders were observed in approximately 20% of iTBI patients. In a subgroup analysis, patients with pre-injury anticoagulant and/or antiplatelet therapy had a twice exacerbated coagulation profile as likely as those without premedication. This was in turn associated with increased rates of mortality and unfavourable outcome post-injury. A multivariate analysis of iTBI patients without pre-injury anticoagulant therapy identified several independent risk factors for coagulopathy which were present at hospital admission. Glasgow Coma Scale (GCS) less than or equal to 8, base excess (BE) less than or equal to − 6, hypothermia and hypotension increased risk significantly. Conclusion: Consideration of these factors enables early prediction and risk stratification of acute coagulopathy after TBI, thus guiding clinical management.

• Cuevas-Østrem, Mathias; Røise, Olav; Wisborg, Torben & Jeppesen, Elisabeth (2020). Epidemiology of geriatric trauma patients in Norway: A nationwide analysis of Norwegian Trauma Registry data, 2015-2018. A retrospective cohort study.. Injury.  ISSN 0020-1383. . doi: 10.1016/j.injury.2020.11.007 Full text in Research Archive.
• Czeiter, Endre; Amrein, Krisztina; Gravesteijn, BY; Lecky, Fiona; Menon, David K; Mondello, Stefania; Newcombe, Virginia F; Richter, Sophie; Steyerberg, Ewout W; Vande Vyvere, Thijs; Verheyden, Jan; Xu, Haiyan; Yang, Zhihui; Maas, Andrew I.R.; Wang, Kevin KW; Buki, Andras; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana & Calvi, Maria Rosa (2020). Blood biomarkers on admission in acute traumatic brain injury: Relations to severity, CT findings and care path in the CENTER-TBI study. EBioMedicine.  ISSN 2352-3964.  56 . doi: 10.1016/j.ebiom.2020.102785 Full text in Research Archive. Show summary

  Background: Serum biomarkers may inform and improve care in traumatic brain injury (TBI). We aimed to correlate serum biomarkers with clinical severity, care path and imaging abnormalities in TBI, and explore their incremental value over clinical characteristics in predicting computed tomographic (CT) abnormalities. Methods: We analyzed six serum biomarkers (S100B, NSE, GFAP, UCH-L1, NFL and t-tau) obtained <24 h post-injury from 2867 patients with any severity of TBI in the Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) Core Study, a prospective, multicenter, cohort study. Univariable and multivariable logistic regression analyses were performed. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals. Findings: All biomarkers scaled with clinical severity and care path (ER only, ward admission, or ICU), and with presence of CT abnormalities. GFAP achieved the highest discrimination for predicting CT abnormalities (AUC 0•89 [95%CI: 0•87-0•90]), with a 99% likelihood of better discriminating CT-positive patients than clinical characteristics used in contemporary decision rules. In patients with mild TBI, GFAP also showed incremental diagnostic value: discrimination increased from 0•84 [95%CI: 0•83-0•86] to 0•89 [95%CI: 0•87-0•90] when GFAP was included. Results were consistent across strata, and injury severity. Combinations of biomarkers did not improve discrimination compared to GFAP alone. Interpretation: Currently available biomarkers reflect injury severity, and serum GFAP, measured within 24 h after injury, outperforms clinical characteristics in predicting CT abnormalities. Our results support the further development of serum GFAP assays towards implementation in clinical practice, for which robust clinical assay platforms are required.

• Dijkland, Simone; Retel Helmrich, Isabel; Nieboer, Daan; van der Jagt, Mathieu; Dippel, Diederik W.J.; Menon, David K; Stocchetti, Nino; Maas, Andrew I.R.; Lingsma, Hester F; Steyerberg, Ewout W; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco & Chevallard, Giorgio (2020). Outcome Prediction after Moderate and Severe Traumatic Brain Injury: External Validation of Two Established Prognostic Models in 1742 European Patients. Journal of Neurotrauma.  ISSN 0897-7151. . doi: 10.1089/neu.2020.7300
• Feng, Junfeng; van Veen, Ernest; Chun, Yang; Huijben, Jilske A.; Lingsma, Hester F; Gao, Guoyi; jiang, jiyao; Maas, Andrew I. R.; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Cavallo, Simona; Chevallard, Giorgio & Chieregato, Arturo (2020). Comparison of Care System and Treatment Approaches for Patients with Traumatic Brain Injury in China versus Europe: A CENTER-TBI Survey Study. Journal of Neurotrauma.  ISSN 0897-7151.  37, s 1806- 1817 . doi: 10.1089/neu.2019.6900
• Glette, Malin Knutsen; Kringeland, Tone Åslaug; Røise, Olav & Wiig, Siri (2020). Would you be interested in participating in a study about hospital readmissions…? Experiences with methodological strategies and techniques for recruiting GPs to participate in qualitative research. Tidsskrift for omsorgsforskning.  ISSN 2387-5976.  6(2), s 178- 183 . doi: 10.18261/issn.2387-5984-2020-02-14 Full text in Research Archive.
• Gravesteijn, BY; Nieboer, Daan; Ercole, Ari; Lingsma, Hester F; Nelson, David; Van Calster, Ben; Steyerberg, Ewout W; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Chevallard, Giorgio; Chieregato, Arturo; Citerio, Giuseppe & Cnossen, Maryse (2020). Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury. Journal of Clinical Epidemiology.  ISSN 0895-4356.  122, s 95- 107 . doi: 10.1016/j.jclinepi.2020.03.005 Full text in Research Archive. Show summary

  Objective: We aimed to explore the added value of common machine learning (ML) algorithms for prediction of outcome for moderate and severe traumatic brain injury. Study Design and Setting: We performed logistic regression (LR), lasso regression, and ridge regression with key baseline predictors in the IMPACT-II database (15 studies, n = 11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks and were trained using the same predictors. To assess generalizability of predictions, we performed internal, internal-external, and external validation on the recent CENTER-TBI study (patients with Glasgow Coma Scale <13, n = 1,554). Both calibration (calibration slope/intercept) and discrimination (area under the curve) was quantified. Results: In the IMPACT-II database, 3,332/11,022 (30%) died and 5,233(48%) had unfavorable outcome (Glasgow Outcome Scale less than 4). In the CENTER-TBI study, 348/1,554(29%) died and 651(54%) had unfavorable outcome. Discrimination and calibration varied widely between the studies and less so between the studied algorithms. The mean area under the curve was 0.82 for mortality and 0.77 for unfavorable outcomes in the CENTER-TBI study. Conclusion: ML algorithms may not outperform traditional regression approaches in a low-dimensional setting for outcome prediction after moderate or severe traumatic brain injury. Similar to regression-based prediction models, ML algorithms should be rigorously validated to ensure applicability to new populations.

• Gravesteijn, BY; Sewalt, C.; Ercole, Ari; Lecky, Fiona; Menon, David; Steyerberg, Ewout W; Maas, AIR; Lingsma, Hester F; Klimek, Magdalena; Vik, Anne; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Lund, Stine Borgen; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Schirmer-Mikalsen, Kari; Sandrød, Oddrun; Åkerlund, Cecilia; Adams, Hadie; Amrein, Krisztina; Audibert, Gerard; Azzolini, Maria Luisa; Bartels, Ronald; Beer, Ronny; Bellander, Bo- Michael; Benali, Habib; Berardino, Maurizio; Beretta, Lorenzo; Blaabjerg, Morten; Brorsson, Camilla; Buki, Andras; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Carbayo, L; Carbonara, Marco; Castaño-León, Ana M.; Chevallard, Giorgio; Chieregato, Arturo; Citerio, Giuseppe; Coburn, Mark; Coles, J.; Cooper, J.; Correia, M. & Cnossen, M. (2020). Variation in the practice of tracheal intubation in Europe after traumatic brain injury: a prospective cohort study. Anaesthesia.  ISSN 0003-2409.  75(1), s 45- 53 . doi: 10.1111/anae.14838 Full text in Research Archive.
• Gravesteijn, BY; Sewalt, Charlie; Ercole, Ari; Akerlund, Cecilia; Nelson, David; Maas, Andrew IR; Menon, David; Lingsma, Hester F; Steyerberg, Ewout W; Andelic, Nada; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Andreassen, Lasse; Amrein, Krisztina; Antoni, Anna; Audiber, Gérard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartel, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Chevallard, Giorgio; Chieregato, Arturo & Citerio, Giuseppe (2020). Toward a New Multi-Dimensional Classification of Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research for Traumatic Brain Injury Study. Journal of Neurotrauma.  ISSN 0897-7151.  37(7) . doi: 10.1089/neu.2019.6764
• Gravesteijn, BY; Sewalt, Charlie; Nieboer, D.; Menon, David K.; Maas, Andrew I. R.; Lecky, Fiona E.; Klimek, Markus; Lingsma, Hester F; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Skandsen, Toril; Røe, Cecilie; Røise, Olav; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Cavallo, Simona; Chevallard, Giorgio & Chieregato, Arturo (2020). Tracheal intubation in traumatic brain injury: a multicentre prospective observational study. British Journal of Anaesthesia.  ISSN 0007-0912.  125(4), s 505- 517 . doi: 10.1016/j.bja.2020.05.067 Full text in Research Archive. Show summary

  Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. Results: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio=1.01; 95% confidence interval, 0.79–1.28; P=0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio=0.86; 95% confidence interval, 0.65–1.13; P=0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P=0.009 and P=0.02, respectively), whereas in-hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P=0.01): in-hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. Conclusion: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that extracranial injury should influence the decision in the prehospital setting, and level of consciousness in the in-hospital setting.

• Gravesteijn, BY; Sewalt, Charlie; Stocchetti, Nino; Citerio, Giuseppe; Ercole, Ari; Lingsma, Hester F; Von Steinbuchel, Nicole; Steyerberg, Ewout W; Wilson, Lindsay; Maas, Andrew I.R.; Menon, David K; Lecky, Fiona E.; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Cavallo, Simona; Chevallard, Giorgio & Chieregato, Arturo (2020). Prehospital Management of Traumatic Brain Injury across Europe: A CENTER-TBI Study. Prehospital Emergency Care.  ISSN 1090-3127. . doi: 10.1080/10903127.2020.1817210 Full text in Research Archive.
• Huie, Russel J; Mondello, Stefania; Lindsell, Christopher J.; Antiga, L; Yuh, Esther; Zanier, Elisa; Masson, Serge; Rosario, Bedda; Ferguson, Adam; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Ackerlund, Cecilia; Adams, Hadie; Agnoletti, Vanni; Allanson, Judith; Amrein, Krisztina; Andaluz, Norberto; Azasevac, Antun; Antoni, Anna; Ardon, Hilko; Audibert, Gerard; Auslands, Kaspars; Azouvi, Philippe; Azzolini, Luisa; Baciu, Camelia; Badenes, Rafael; Bartels, Ronald; Barzo, Pal; Bauerfeind, Ursula; Beauvais, Romuald; Beer, Ronny; Belda, Francisco Javier; Bellander, Bo Michael; Belli, Antonio; Bellier, Remy; Benali, Habib; Benard, Thierry; Berardino, Maurizio; Beretta, Luigi; Beynon, Christopher; Bilotta, Federico; Binder, Harald & Biqiri, Erta (2020). Biomarkers for Traumatic Brain Injury: Data Standards and Statistical Considerations. Journal of Neurotrauma.  ISSN 0897-7151. . doi: 10.1089/neu.2019.6762 Show summary

  Recent biomarker innovations hold potential for transforming diagnosis, prognostic modeling, and precision therapeutic targeting of traumatic brain injury (TBI). However, many biomarkers, including brain imaging, genomics, and proteomics, involve vast quantities of high-throughput and high-content data. Management, curation, analysis, and evidence synthesis of these data are not trivial tasks. In this review, we discuss data management concepts and statistical and data sharing strategies when dealing with biomarker data in the context of TBI research. We propose that application of biomarkers involves three distinct steps—discovery, evaluation, and evidence synthesis. First, complex/big data has to be reduced to useful data elements at the stage of biomarker discovery. Second, inferential statistical approaches must be applied to these biomarker data elements for assessment of biomarker clinical utility and validity. Last, synthesis of relevant research is required to support practice guidelines and enable health decisions informed by the highest quality, up-to-date evidence available. We focus our discussion around recent experiences from the International Traumatic Brain Injury Research (InTBIR) initiative, with a specific focus on four major clinical projects (Transforming Research and Clinical Knowledge in TBI, Collaborative European NeuroTrauma Effectiveness Research in TBI, Collaborative Research on Acute Traumatic Brain Injury in Intensive Care Medicine in Europe, and Approaches and Decisions in Acute Pediatric TBI Trial), which are currently enrolling subjects in North America and Europe. We discuss common data elements, data collection efforts, data-sharing opportunities, and challenges, as well as examine the statistical techniques required to realize successful adoption and use of biomarkers in the clinic as a foundation for precision medicine in TBI.

• Huijben, Jilske A.; Wiegers, E; Ercole, Ari; de Keizer, Nicolette; Maas, Andrew I. R.; Steyerberg, Ewout W.; Citerio, Giuseppe; Wilson, Lindsay; Polinder, Suzanne; Nieboer, Daan; Menon, David; Lingsma, Hester F.; Van Der Jagt, Mathieu; Andelic, Nada; Lund, Stine Borgen; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Schirmer-Mikalsen, Kari; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Andreassen, Lasse; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Beer, Ronny; Bellander, Bo-Michael; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Beqiri, Erta; Blaabjerg, Morten; Brorsson, Camilla; Buki, Andras; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Carbonara, Marco; Cavallo, Simona; Coburn, Mark; Coles, Jonathan; Correia, Marta; Czeiter, Endre; Dark, Paul M & Degos, Vincent (2020). Quality indicators for patients with traumatic brain injury in European intensive care units: a CENTER-TBI study. Critical Care.  ISSN 1364-8535. . doi: 10.1186/s13054-020-2791-0 Full text in Research Archive.
• Huijbers, Jilske; Wiegers, E; Lingsma, Hester F; Citerio, Giuseppe; Maas, Andrew I.R.; Menon, David K; Ercole, Ari; Nelson, David; van der Jagt, Mathieu; Steyerberg, Ewout; Helbok, Raimund; Lecky, Fiona; Peul, Wilco; Birg, Tatiana; Zoerle, Tomaso; Carbonara, Marco; Stocchetti, Nino; Andelic, Nada; Andreassen, Lasse; Lund, Stine Borgen; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Sandrød, Oddrun; Schirmer-Mikalsen, Kari; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Brorsson, Camilla; Azzolini, Maria Luisa; Bartels, Ronald; Beer, Ronny; Bellander, Bo-Michael; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Beqiri, Erta; Blaabjerg, Morten; Buki, Andras; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emaliana; Calvi, Maria Rosa; Cameron, Peter; Guillermo, Carbayo Lozano; Sundström, Nina; Tibboel, Dick; Ples, Horia; Sakowitz, Oliver & Ziverte, Agate (2020). Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis. Intensive Care Medicine.  ISSN 0342-4642.  46(5), s 995- 1004 . doi: 10.1007/s00134-020-05965-z Full text in Research Archive. Show summary

  Purpose: To describe ICU stay, selected management aspects, and outcome of Intensive Care Unit (ICU) patients with traumatic brain injury (TBI) in Europe, and to quantify variation across centers. Methods: This is a prospective observational multicenter study conducted across 18 countries in Europe and Israel. Admission characteristics, clinical data, and outcome were described at patient- and center levels. Between-center variation in the total ICU population was quantified with the median odds ratio (MOR), with correction for case-mix and random variation between centers. Results: A total of 2138 patients were admitted to the ICU, with median age of 49 years; 36% of which were mild TBI (Glasgow Coma Scale; GCS 13–15). Within, 72 h 636 (30%) were discharged and 128 (6%) died. Early deaths and long-stay patients (> 72 h) had more severe injuries based on the GCS and neuroimaging characteristics, compared with short-stay patients. Long-stay patients received more monitoring and were treated at higher intensity, and experienced worse 6-month outcome compared to short-stay patients. Between-center variations were prominent in the proportion of short-stay patients (MOR = 2.3, p < 0.001), use of intracranial pressure (ICP) monitoring (MOR = 2.5, p < 0.001) and aggressive treatments (MOR = 2.9, p < 0.001); and smaller in 6-month outcome (MOR = 1.2, p = 0.01). Conclusions: Half of contemporary TBI patients at the ICU have mild to moderate head injury. Substantial between-center variations exist in ICU stay and treatment policies, and less so in outcome. It remains unclear whether admission of short-stay patients represents appropriate prudence or inappropriate use of clinical resources.

• Jacob, Louis; Cogne, Melanie; Tenovuo, Olli; Røe, Cecilie; Andelic, Nada; Majdan, Marek; Ranta, Jukka; Ylen, Peter; Dawes, Helen; Azouvi, Philippe; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Cavallo, Simona; Chevallard, Giorgio; Chieregato, Arturo & Citerio, Giuseppe (2020). Predictors of access to rehabilitation in the year following traumatic brain injury: A European prospective and multicenter study. Neurorehabilitation and Neural Repair.  ISSN 1545-9683.  34(9), s 814- 830 . doi: 10.1177/1545968320946038 Show summary

  Background: Although rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care. Objective: Therefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI. Methods: Data from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge. Results: In the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24). Conclusions: Based on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

• Mathieu, Francois; Güting, Helge; Gravesteijn, Benjamin; Monteiro, Miguel; Glocker, Ben; Kornaropoulos, Evgenios; Kamnistas, Konstantinos; Robertson, Claudia; Levin, Harvey; Whitehouse, Daniel; Das, Tilak; Lingsma, Hester F; Maegele, Marc; Newcombe, Virginia F.J.; Menon, David K; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana & Calvi, Maria Rosa (2020). Impact of Antithrombotic Agents on Radiological Lesion Progression in Acute Traumatic Brain Injury: A CENTER-TBI Propensity-Matched Cohort Analysis. Journal of Neurotrauma.  ISSN 0897-7151.  37(19), s 2069- 2080 . doi: 10.1089/neu.2019.6911
• Mikolic, Ana; Polinder, Suzanne; Steyerberg, Ewout W; Retel Helmrich, Isabel; Giacino, Joseph T.; Maas, Andrew I.R.; van der Naalt, Joukje; Voormolen, Daphne; von Steinbüchel, Nicole; Wilson, Lindsay; Lingsma, Hester F; van Klaveren, David; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo & Carbonara, Marco (2020). Prediction of Global Functional Outcome and Post-Concussive Symptoms after Mild Traumatic Brain Injury: External Validation of Prognostic Models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study. Journal of Neurotrauma.  ISSN 0897-7151.  38(2), s 196- 209 . doi: 10.1089/neu.2020.7074 Full text in Research Archive.
• Mikolic, Ana; van Klaveren, David; Oude Groeniger, Joost; Wiegers, E; Lingsma, Hester F; Zeldovich, Marina; von Steinbüchel, Nicole; Maas, Andrew I.R.; Roeters van Lennep, Jeanine; Polinder, Suzanne; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco & Cavallo, Simona (2020). Differences between Men and Women in Treatment and Outcome after Traumatic Brain Injury. Journal of Neurotrauma.  ISSN 0897-7151.  38(2), s 235- 251 . doi: 10.1089/neu.2020.7228 Full text in Research Archive.
• Riemann, Lennart; Zweckberger, Klaus; Unterberg, Andreas; El Damaty,, Ahmed; Younsi, Alexander; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Chevallard, Giorgio; Chieregato, Arturo; Citerio, Giuseppe; Cnossen, Maryse; Coburn, Mark & Coles, Jonathan (2020). Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study. Frontiers in Neurology.  ISSN 1664-2295.  11 . doi: 10.3389/fneur.2020.00345 Full text in Research Archive. Show summary

  Background: Traumatic brain injury (TBI) is the leading cause of death and disability in children. It includes a range of different pathologies that differ considerably from adult TBI. Analyzing and understanding injury patterns of pediatric TBI is essential to establishing new preventive efforts as well as to improve clinical management. Methods: The multi-center, prospectively collected CENTER-TBI core and registry databases were screened and patients were included when younger than 18 years at enrollment and admitted to the regular ward (admission stratum) or intensive care unit (ICU stratum) following TBI. Patient demographics, injury causes, clinical findings, brain CT imaging details, and outcome (GOSE at 6 months follow-up) were retrieved and analyzed. Injury characteristics were compared between patients admitted to the regular ward and ICU and multivariate analysis of factors predicting an unfavorable outcome (GOSE 1-4) was performed. Results from the core study were compared to the registry dataset which includes larger patient numbers but no follow-up data. Results: Two hundred and twenty seven patients in the core dataset and 687 patients in the registry dataset were included in this study. In the core dataset, road-traffic incidents were the most common cause of injury overall and in the ICU stratum, while incidental falls were most common in the admission stratum. Brain injury was considered serious to severe in the majority of patients and concurrent injuries in other body parts were very common. Intracranial abnormalities were detected in 60% of initial brain CTs. Intra- and extracranial surgical interventions were performed in one-fifth of patients. The overall mortality rate was 3% and the rate of unfavorable outcome 10%, with those numbers being considerably higher among ICU patients. GCS and the occurrence of secondary insults could be identified as independent predictors for an unfavorable outcome. Injury characteristics from the core study could be confirmed in the registry dataset. Conclusion: Our study displays the most common injury causes and characteristics of pediatric TBI patients that are treated in the regular ward or ICU in Europe. Road-traffic incidents were especially common in ICU patients, indicating that preventive efforts could be effective in decreasing the incidence of severe TBI in children.

• Robba, Chiara; Galimberti, Stefania; Graziano, Francesca; Wiegers, E; Lingsma, Hester F; Iaquaniello, Carolina; Stocchetti, Nino; Menon, David; Citerio, Giuseppe; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Lund, Stine Borgen; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Sandrød, Oddrun; Schirmer-Mikalsen, Kari; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Beer, Ronny; Bellander, Bo-Michael; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Biqiri, Erta; Blaabjerg, Morten; Brorsson, Camilla; Buki, Andras; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Castaño-León, Ana M.; Chevallard, Giorgio; Chieregato, Arturo; Coburn, Mark; Coles, Jonathan; Cooper, Jamie; Correia, Marta & Czeiter, Endre (2020). Tracheostomy practice and timing in traumatic brain-injured patients: a CENTER-TBI study. Intensive Care Medicine.  ISSN 0342-4642.  46, s 983- 994 . doi: 10.1007/s00134-020-05935-5
• Robba, Chiara; Rebora, Paola; Banzato, Erika; Wiegers, E; Stocchetti, Nino; Menon, David; Citerio, Giuseppe; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Lund, Stine Borgen; Sandrød, Oddrun; Schirmer-Mikalsen, Kari; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Beretta, Luigi; Calvi, Maria Rosa; Bartels, Ronald; den Boogert, Hugo; Beer, Ronny; Helbok, Raimund; Bellander, Bo-Michael; Benali, Habib; Degos, Vincent; Galanaud, Damien; Perlbarg, Vincent; Vanhaudenhuyse, Audrey; Berardino, Maurizio; Blaabjerg, Morten; Brorsson, Camilla; Buki, Andras; Czeiter, Endre; Cabeleira, Manuel; Czosnyka, Marek; Smielewski, Peter; Caccioppola, Alessio; Calappi, Emiliana; Carbonara, Marco; Mulazzi, Davide; Ortolano, Fabrizio; Zoerle, Tommaso & Cameron, Peter (2020). Incidence, Risk Factors, and Effects on Outcome of Ventilator-Associated Pneumonia in Patients With Traumatic Brain Injury: Analysis of a Large, Multicenter, Prospective, Observational Longitudinal Study. Chest.  ISSN 0012-3692.  158(6), s 2292- 2303 . doi: 10.1016/j.chest.2020.06.064
• Skansaar, Ola Fougner; Tverdal, Cathrine Buaas; Rønning, Pål André; Skogen, Karoline; Brommeland, Tor; Røise, Olav; Aarhus, Mads; Andelic, Nada & Helseth, Eirik (2020). Traumatic brain injury—the effects of patient age on treatment intensity and mortality. BMC Neurology.  ISSN 1471-2377.  20:376, s 1- 10 . doi: 10.1186/s12883-020-01943-6 Full text in Research Archive.
• Timmers, Marjolein; van Dijck, Jeroen T. J. M.; van Wijk, Roel P J; Legrand, Valerie; van Veen, Ernest; Maas, Andrew I.R.; Menon, David K; Citerio, Giuseppe; Stocchetti, Nino; Kompanje, Erwin J.O.; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco & Cavallo, Simona (2020). How do 66 European institutional review boards approve one protocol for an international prospective observational study on traumatic brain injury? Experiences from the CENTER-TBI study. BMC Medical Ethics.  ISSN 1472-6939.  21:36(1) . doi: 10.1186/s12910-020-00480-8 Full text in Research Archive.
• van Veen, Ernest; van der Jagt, Mathieu; Citerio, Guiseppe; Stocchetti, Nino; Epker, Jelle; Gommers, Diederik; Burdorf, Lex; Menon, David K; Maas, Andrew I.R.; Lingsma, Hester F; Kompanje, Erwin J.O.; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo & Carbonara, Marco (2020). End-of-life practices in traumatic brain injury patients: Report of a questionnaire from the CENTER-TBI study. Journal of critical care.  ISSN 0883-9441.  58, s 78- 88 . doi: 10.1016/j.jcrc.2020.04.001 Full text in Research Archive.
• van Wijk, Roel P J; van Dijck, Jeroen T. J. M.; Timmers, Marjolein; van Veen, Ernest; Citerio, Giuseppe; Lingsma, Hester F; Maas, Andrew I. R.; Menon, David K; Peul, Wilco C.; Stocchetti, Nino; Kompanje, Erwin J.O.; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo & Carbonara, Marco (2020). Informed consent procedures in patients with an acute inability to provide informed consent: Policy and practice in the CENTER-TBI study. Journal of critical care.  ISSN 0883-9441.  59(15), s 6- 15 . doi: 10.1016/j.jcrc.2020.05.004 Show summary

  Purpose: Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed consent policy and practice. Methods: Variation was explored in the CENTER-TBI study. Policies were reported by using a questionnaire and national legislation. Data on used informed consent procedures were available for 4498 patients from 57 centres across 17 European countries. Results: Variation in the use of informed consent procedures was found between and within EU member states. Proxy informed consent (N = 1377;64%) was the most frequently used type of consent in the ICU, followed by patient informed consent (N = 426;20%) and deferred consent (N = 334;16%). Deferred consent was only actively used in 15 centres (26%), although it was considered valid in 47 centres (82%). Conclusions: Alternatives to patient consent are essential for TBI research. While there seems to be concordance amongst national legislations, there is regional variability in institutional practices with respect to the use of different informed consent procedures. Variation could be caused by several reasons, including inconsistencies in clear legislation or knowledge of such legislation amongst researchers.

• Vande Vyvere, Thijs; De La Rosa, Ezequiel; Wilms, Guido; Nieboer, Daan; Steyerberg, Ewout; Maas, Andrew I.R.; Verheyden, Jan; van den Hauwe, Luc; Parizel, Paul M.; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Chevallard, Giorgio; Chieregato, Arturo & Citerio, Giuseppe (2020). Prognostic Validation of the NINDS Common Data Elements for the Radiologic Reporting of Acute Traumatic Brain Injuries: A CENTER-TBI Study. Journal of Neurotrauma.  ISSN 0897-7151.  37(11), s 1269- 1282 . doi: 10.1089/neu.2019.6710
• Voormolen, Daphne; Polinder, Suzanne; von Steinbuechel, Nicole; Feng, Yan; Wilson, Lindsay; Oppe, Mark; Haagsma, Juanita; Andelic, Nada; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Skandsen, Toril; Røe, Cecilie; Røise, Olav; Åkerlund, Cecilia; Vik, Anne; Andreassen, Lasse; Adams, Hadie; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter;  Lozano, Guillermo Carbayo; Carbonara, Marco; Castaño-León, Ana M.; Chevallard, Giorgio; Chieregato, Arturo & Citerio, Giuseppe (2020). Health-related quality of life after traumatic brain injury: deriving value sets for the QOLIBRI-OS for Italy, The Netherlands and The United Kingdom. Quality of Life Research.  ISSN 0962-9343.  29 . doi: 10.1007/s11136-020-02583-6 Full text in Research Archive. Show summary

  Purpose: The Quality of Life after Brain Injury overall scale (QOLIBRI-OS) measures health-related quality of life (HRQoL) after traumatic brain injury (TBI). The aim of this study was to derive value sets for the QOLIBRI-OS in three European countries, which will allow calculation of utility scores for TBI health states. Methods: A QOLIBRI-OS value set was derived by using discrete choice experiments (DCEs) and visual analogue scales (VAS) in general population samples from the Netherlands, United Kingdom and Italy. A three-stage procedure was used: (1) A selection of health states, covering the entire spectrum of severity, was defined; (2) General population samples performed the health state valuation task using a web-based survey with three VAS questions and an at random selection of sixteen DCEs; (3) DCEs were analysed using a conditional logistic regression and were then anchored on the VAS data. Utility scores for QOLIBRI-OS health states were generated resulting in estimates for all potential health states. Results: The questionnaire was completed by 13,623 respondents. The biggest weight increase for all attributes is seen from “slightly” to “not at all satisfied”, resulting in the largest impact on HRQoL. “Not at all satisfied with how brain is working” should receive the greatest weight in utility calculations in all three countries. Conclusion: By transforming the QOLIBRI-OS into utility scores, we enabled the application in economic evaluations and in summary measures of population health, which may be used to inform decision-makers on the best interventions and strategies for TBI patients.

• Voormolen, Daphne; Zeldovich, Marina; Haagsma, Juanita; Polinder, Suzanne; Friedrich, Sarah; Maas, Andrew I. R.; Wilson, Lindsay; Steyerberg, Ewout W; Covic, Amra; Andelic, Nada; Plass, AM; Wu, Yi-Jhen; Asendorf, Thomas; von Steinbuechel, Nicole; Åkerlund, Cecilia; Amrein, Krisztina; Andreassen, Lasse; Anke, Audny; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril & Vik, Anne (2020). Outcomes after Complicated and Uncomplicated Mild Traumatic Brain Injury at Three-and Six-Months Post-Injury: Results from the CENTER-TBI Study. Journal of Clinical Medicine.  ISSN 2077-0383.  9 . doi: 10.3390/jcm9051525 Full text in Research Archive.
• Wiig, Siri; Aase, Karina; Billett, Stephen; Canfield, Carolyn; Røise, Olav; Njå, Ove; Guise, Veslemøy; Haraldseid-Driftland, Cecilie; Ree, Eline; Anderson, Janet & Macrae, Carl (2020). Defining the boundaries and operational concepts of resilience in the resilience in healthcare research program. BMC Health Services Research.  ISSN 1472-6963.  330 . doi: 10.1186/s12913-020-05224-3 Full text in Research Archive.
• Wilson, Lindsay; Horton, Lindsay; Kunzmann, Kevin; Sahakian, Barbara J.; Newcombe, Virginia; Stamatakis, E; Steinbuechel, Nicole; Cunitz, Kathrin; Covic, Amra; Maas, Andrew; van Praag, Dominigue; Menon, David; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter & Lozano, Guillermo Carbayo (2020). Understanding the relationship between cognitive performance and function in daily life after traumatic brain injury. Journal of Neurology, Neurosurgery and Psychiatry.  ISSN 0022-3050. . doi: 10.1136/jnnp-2020-324492 Full text in Research Archive. Show summary

  Objective: Cognitive impairment is a key cause of disability after traumatic brain injury (TBI) but relationships with overall functioning in daily life are often modest. The aim is to examine cognition at different levels of function and identify domains associated with disability. Methods: 1554 patients with mild-to-severe TBI were assessed at 6 months post injury on the Glasgow Outcome Scale—Extended (GOSE), the Short Form-12v2 and a battery of cognitive tests. Outcomes across GOSE categories were compared using analysis of covariance adjusting for age, sex and education. Results: Overall effect sizes were small to medium, and greatest for tests involving processing speed (ηp2 0.057–0.067) and learning and memory (ηp2 0.048–0.052). Deficits in cognitive performance were particularly evident in patients who were dependent (GOSE 3 or 4) or who were unable to participate in one or more major life activities (GOSE 5). At higher levels of function (GOSE 6–8), cognitive performance was surprisingly similar across categories. There were decreases in performance even in patients reporting complete recovery without significant symptoms. Medium to large effect sizes were present for summary measures of cognition (ηp2 0.111), mental health (ηp2 0.131) and physical health (ηp2 0.252). Conclusions: This large-scale study provides novel insights into cognitive performance at different levels of disability and highlights the importance of processing speed in function in daily life. At upper levels of outcome, any influence of cognition on overall function is markedly attenuated and differences in mental health are salient.

• Zeldovich, Marina; Wu, Yi-Jhen; Gorbunova, Anastasia; Mikolic, Ana; Polinder, Suzanne; Plass, Anne Marie; Covic, Amra; Asendorf, Thomas; Andelic, Nada; Voormolen, Daphne; von Steinbuechel, Nicole; Åkerlund, Cecilia; Amrein, Krisztina; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril; Vik, Anne; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Buki, Andras; Bullinger, Monika; Cabeleira, Manuel; Caccioppola, Alessio; Calappi, Emiliana; Calvi, Maria Rosa; Cameron, Peter; Lozano, Guillermo Carbayo; Carbonara, Marco; Cavallo, Simona & Chevallard, Giorgio (2020). Influence of Sociodemographic, Premorbid, and Injury-Related Factors on Post-Concussion Symptoms after Traumatic Brain Injury. Journal of Clinical Medicine.  ISSN 2077-0383.  9 . doi: 10.3390/jcm9061931 Full text in Research Archive.
• Bjøro, Benedikte; Mykkeltveit, Ida Helene; Rustøen, Tone; Altinbas, Bahar Candas; Røise, Olav & Bentsen, Signe Berit (2019). Intraoperative peripheral nerve injury related to lithotomy positioning with steep Trendelenburg in patients undergoing robotic-assisted laparoscopic surgery - A systematic review. Journal of Advanced Nursing.  ISSN 0309-2402.  76(2), s 490- 503 . doi: 10.1111/jan.14271
• Glette, Malin Knutsen; Kringeland, Tone Åslaug; Røise, Olav & Wiig, Siri (2019). Hospital physicians’ views on discharge and readmission processes: a qualitative study from Norway. BMJ Open.  ISSN 2044-6055.  9, s 1- 15 . doi: 10.1136/bmjopen-2019-031297 Full text in Research Archive.
• Steyerberg, Ewout W; Wiegers, E; Sewalt, C.; Buki, Andras; Citerio, Giuseppe; De Keyser, Veronique; Ercole, Ari; Kunzmann, K.R.; Lanyon, Linda; Lecky, Fiona; Lingsma, Hester F; Manley, Geoffrey T; Nelson, D; Peul, Wilco; Stocchetti, Nino; von Steinbüchel, Nicole; Vande Vyvere, Thijs; Verheyden, Jan; Wilson, Lindsay; Maas, AIR; Menon, David; Vik, Anne; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røise, Olav; Skandsen, Toril; Røe, Cecilie; Amrein, Krisztina; Antoni, Anna; Auslands, Kapars; Badenes, Rafael; Bartels, Ronald; Barzo, Pal; Beer, Ronny; Bellander, Bo-Michael; Belli, Antonio; Benali, Habib; Berardino, Maurizio; Beretta, Luigi; Blaabjerg, Morten; Bragge, Peter; Brazinova, Alexandra; Brinck, Vibeke; Brooker, Joanne; Brorsson, Camilla; Bullinger, Monika & Cabeleira, Manuel (2019). Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI: a European prospective, multicentre, longitudinal, cohort study.. Lancet Neurology.  ISSN 1474-4422.  8(10), s 923- 934 . doi: 10.1016/S1474-4422(19)30232-7 Show summary

  BACKGROUND: The burden of traumatic brain injury (TBI) poses a large public health and societal problem, but the characteristics of patients and their care pathways in Europe are poorly understood. We aimed to characterise patient case-mix, care pathways, and outcomes of TBI. METHODS: CENTER-TBI is a Europe-based, observational cohort study, consisting of a core study and a registry. Inclusion criteria for the core study were a clinical diagnosis of TBI, presentation fewer than 24 h after injury, and an indication for CT. Patients were differentiated by care pathway and assigned to the emergency room (ER) stratum (patients who were discharged from an emergency room), admission stratum (patients who were admitted to a hospital ward), or intensive care unit (ICU) stratum (patients who were admitted to the ICU). Neuroimages and biospecimens were stored in repositories and outcome was assessed at 6 months after injury. We used the IMPACT core model for estimating the expected mortality and proportion with unfavourable Glasgow Outcome Scale Extended (GOSE) outcomes in patients with moderate or severe TBI (Glasgow Coma Scale [GCS] score ≤12). The core study was registered with ClinicalTrials.gov, number NCT02210221, and with Resource Identification Portal (RRID: SCR_015582). FINDINGS: Data from 4509 patients from 18 countries, collected between Dec 9, 2014, and Dec 17, 2017, were analysed in the core study and from 22 782 patients in the registry. In the core study, 848 (19%) patients were in the ER stratum, 1523 (34%) in the admission stratum, and 2138 (47%) in the ICU stratum. In the ICU stratum, 720 (36%) patients had mild TBI (GCS score 13-15). Compared with the core cohort, the registry had a higher proportion of patients in the ER (9839 [43%]) and admission (8571 [38%]) strata, with more than 95% of patients classified as having mild TBI. Patients in the core study were older than those in previous studies (median age 50 years [IQR 30-66], 1254 [28%] aged >65 years), 462 (11%) had serious comorbidities, 772 (18%) were taking anticoagulant or antiplatelet medication, and alcohol was contributory in 1054 (25%) TBIs. MRI and blood biomarker measurement enhanced characterisation of injury severity and type. Substantial inter-country differences existed in care pathways and practice. Incomplete recovery at 6 months (GOSE <8) was found in 207 (30%) patients in the ER stratum, 665 (53%) in the admission stratum, and 1547 (84%) in the ICU stratum. Among patients with moderate-to-severe TBI in the ICU stratum, 623 (55%) patients had unfavourable outcome at 6 months (GOSE <5), similar to the proportion predicted by the IMPACT prognostic model (observed to expected ratio 1·06 [95% CI 0·97-1·14]), but mortality was lower than expected (0·70 [0·62-0·76]). INTERPRETATION: Patients with TBI who presented to European centres in the core study were older than were those in previous observational studies and often had comorbidities. Overall, most patients presented with mild TBI. The incomplete recovery of many patients should motivate precision medicine research and the identification of best practices to improve these outcomes. FUNDING: European Union 7th Framework Programme, the Hannelore Kohl Stiftung, OneMind, and Integra LifeSciences Corporation.

• Voomolen, DC; Haagsma, JA; Polinder, Suzanne; Maas, AIR; Steyerberg, Ewout W; Vulekovic, Peter; Sewalt, CA; Gravesteijn, BY; Covic, Amra; Andelic, Nada; Plass, AM; von Steinbüchel, Nicole; Vik, Anne; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Skandsen, Toril; Røise, Olav; Røe, Cecilie; Åkerlund, Cecilia; Amrein, Krisztina; Antoni, Anna; Audibert, Gerard; Azouvi, Philippe; Azzolini, Maria Luisa; Bartels, Ronald; Barzo, Pal; Beauvais, Romuald; Beer, Ronny; Menon, David; Lanyon, Linda; Brazinova, Alexandra; Buki, Andras; Tenovuo, Olli; Hecke, Wim Van; Puybasset, Louis; Citero, Guiseppe; Richardson, Sylvia; Maegele, Marc; Peul, Wilco; Lecky, Fiona; Laureys, Steven; Dietz, Martin; Stewart, William; Sakowitz, Oliver; Rueckert, Daniel; Lötjönen, Jyrki; Wilson, Lindsey & Fabricius, Martin (2019). Post-Concussion Symptoms in Complicated vs. Uncomplicated Mild Traumatic Brain Injury Patients at Three and Six Months Post-Injury: Results from the CENTER-TBI Study. Journal of Clinical Medicine.  ISSN 2077-0383.  8(11) . doi: 10.3390/jcm8111921 Full text in Research Archive. Show summary

  Abstract The aim of this study was to assess the occurrence of post-concussion symptoms and post-concussion syndrome (PCS) in a large cohort of patients after complicated and uncomplicated mild traumatic brain injury (mTBI) at three and six months post-injury. Patients were included through the prospective cohort study: Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI). Patients enrolled with mTBI (Glasgow Coma Scale 13-15) were further differentiated into complicated and uncomplicated mTBI based on the presence or absence of computed tomography abnormalities, respectively. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) assessed post-concussion symptoms and PCS according to the mapped ICD-10 classification method. The occurrence of post-concussion symptoms and syndrome at both time points was calculated. Chi square tests were used to test for differences between and within groups. Logistic regression was performed to analyse the association between complicated versus uncomplicated mTBI and the prevalence of PCS. Patients after complicated mTBI reported slightly more post-concussion symptoms compared to those after uncomplicated mTBI. A higher percentage of patients after complicated mTBI were classified as having PCS at three (complicated: 46% vs. uncomplicated: 35%) and six months (complicated: 43% vs. uncomplicated 34%). After adjusting for baseline covariates, the effect of complicated versus uncomplicated mTBI at three months appeared minimal: odds ratio 1.25 (95% confidence interval: 0.95-1.66). Although patients after complicated mTBI report slightly more post-concussion symptoms and show higher PCS rates compared to those after uncomplicated mTBI at three and six months, complicated mTBI was only found a weak indicator for these problems. KEYWORDS: complicated mild traumatic brain injury; post-concussion symptoms; post-concussion syndrome; traumatic brain injury

• Glette, Malin Knutsen; Kringeland, Tone Åslaug; Røise, Olav & Wiig, Siri (2018). Exploring physicians' decision-making in hospital readmission processes - a comparative case study. BMC Health Services Research.  ISSN 1472-6963.  18(725) . doi: 10.1186/s12913-018-3538-3 Full text in Research Archive.
• Glette, Malin Knutsen; Røise, Olav; Kringeland, Tone Åslaug; Churruca, Kate; Braithwaite, Jeffrey & Wiig, Siri (2018). Nursing home leaders’and nurses’experiences of resources,staffing and competence levels and the relation to hospital readmissions –a case study. BMC Health Services Research.  ISSN 1472-6963.  18(955), s 1- 15 . doi: 10.1186/s12913-018-3769-3 Full text in Research Archive.
• Huijben, Jilske A.; Volovici, Victor; Cnossen, Maryse C.; Haitsma, Iain K.; Stocchetti, Nino; Maas, Andrew I. R.; Menon, David K.; Ercole, Ari; Citerio, Giuseppe; Nelson, David; Polinder, Suzanne; Steyerberg, Ewout W.; Lingsma, Hester F.; van der Jagt, Mathieu; Vik, Anne; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røise, Olav; Skandsen, Toril; Håberg, Asta & Røe, Cecilie (2018). Variation in general supportive and preventive intensive care management of traumatic brain injury: a survey in 66 neurotrauma centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Critical Care.  ISSN 1364-8535.  22(1), s 1- 9 . doi: 10.1186/s13054-018-2000-6 Full text in Research Archive.
• Van Essen, Thomas; den Boogert, HF; Cnossen, MC; De Ruiter, Godard CW; Haitsma, Ian; Polinder, S; Steyerberg, Ewout W.; Menon, David; Maas, Andrew I. R.; Lingsma, Hester F; Peul, Wilco; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Håberg, Asta; Røe, Cecilie; Røise, Olav; Skandsen, Toril & Vik, Anne (2018). Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study.. Acta Neurochirurgica.  ISSN 0001-6268. . doi: 10.1007/s00701-018-3761-z Full text in Research Archive.
• van Veen, Ernest; Van Der Jagt, Mathieu; Cnossen, Maryse C.; Maas, Andrew I. R.; De Beaufort, Inez D.; Menon, David K.; Citerio, Giuseppe; Stocchetti, Nino; Rietdijk, Wim J. R.; van Dijck, Jeroen T. J. M.; Kompanje, Erwin J. O.; Vik, Anne; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røise, Olav; Skandsen, Toril; Håberg, Asta & Røe, Cecilie (2018). Brain death and postmortem organ donation: report of a questionnaire from the CENTER-TBI study. Critical Care.  ISSN 1364-8535.  22(306), s 1- 11 . doi: 10.1186/s13054-018-2241-4 Full text in Research Archive.
• Vande Vyvere, Thijs; Wilms, Guido; Claes, Lene; Leon, Francisco Martin; Nieboer, Daan; Verheyden, Jan; van den Hauwe, Luc; Pullens, Pim; Maas, Andrew I.R.; Parizel, Paul M.; Vik, Anne; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Frisvold, Shirin; Helseth, Eirik; Røe, Cecilie; Røise, Olav; Skandsen, Toril & Håberg, Asta (2018). Central versus Local Radiological Reading of Acute Computed Tomography Characteristics in Multi-Center Traumatic Brain Injury Research. Journal of Neurotrauma.  ISSN 0897-7151.  35, s 1- 13 . doi: 10.1089/neu.2018.6061
• Wiig, Siri; Bourrier, Mathilde; Aase, Karina & Røise, Olav (2018). Transparency in Health Care: Disclosing Adverse Events to the Public, In  Risk Communication for the Future,.  Springer.  ISBN 978-3-319-74098-0.  8.  s 111 - 127 Full text in Research Archive.
• Clarke-Jenssen, John; Røise, Olav; Øvre, Stein A. & Madsen, Jan Erik (2017). Long-term survival and risk factors for failure of the native hip joint after operatively treated displaced acetabular fractures. The Bone & Joint Journal.  ISSN 2049-4394.  99B(6), s 834- 840 . doi: 10.1302/0301-620X.99B6.BJJ-2016-1013.R1 Full text in Research Archive.
• Clarke-Jenssen, John; Westberg, Marianne; Røise, Olav; Storeggen, Stein Arne Øvre; Bere, Tone Tufte; Silberg, Inger Elisabeth & Madsen, Jan Erik (2017). Reduced survival for uncemented compared to cemented total hip arthroplasty after operatively treated acetabular fractures. Injury.  ISSN 0020-1383.  48(11), s 2534- 2539 . doi: 10.1016/j.injury.2017.08.071 Full text in Research Archive.
• Cnossen, Maryse C.; Huijben, Jilske A.; Van Der Jagt, Mathieu; Volovici, Victor; Van Essen, Thomas; Polinder, Suzanne; Nelson, David; Ercole, Ari; Stocchetti, Nino; Citerio, Giuseppe; Peul, Wilco C.; Maas, Andrew I.R.; Menon, David; Steyerberg, Ewout W.; Lingsma, Hester F.; Andelic, Nada; Andreassen, Lasse; Anke, Audny; Lund, Stine Borgen; Frisvold, Shirin; Helseth, Eirik; Håberg, Asta; Røe, Cecilie; Røise, Olav; Skandsen, Toril & Vik, Anne (2017). Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury: A survey in 66 neurotrauma centers participating in the CENTER-TBI study. Critical Care.  ISSN 1364-8535.  21:233, s 1- 12 . doi: 10.1186/s13054-017-1816-9
• Kibsgård, Thomas; Röhrl, Stephan Maximillian; Røise, Olav; Sturesson, Bengt & Stuge, Britt (2017). Movement of the sacroiliac joint during the Active Straight Leg Raise test in patients with long-lasting severe sacroiliac joint pain. Clinical Biomechanics.  ISSN 0268-0033.  47, s 40- 45 . doi: 10.1016/j.clinbiomech.2017.05.014
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• Adelved, Aron; Töttermann, Anna; Glott, Thomas; Hellund, Johan Castberg; Madsen, Jan Erik & Røise, Olav (2016). Long-term functional outcome after traumatic lumbosacral dissociation. A retrospective case series of 13 patients. Injury.  ISSN 0020-1383.  47(7), s 1562- 1568 . doi: 10.1016/j.injury.2016.04.006
• Clarke-Jenssen, John; Wikerøy, Annette Konstanse Bordewich; Røise, Olav; Øvre, Stein A. & Madsen, Jan Erik (2016). Long-term survival of the native hip after a minimally displaced, nonoperatively treated acetabular fracture. Journal of Bone and Joint Surgery. American volume.  ISSN 0021-9355.  98(16), s 1392- 1399 . doi: 10.2106/JBJS.15.01154
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• Clarke-Jenssen, John; Øvre, Stein A.; Røise, Olav & Madsen, Jan Erik (2015). Acetabular fracture assessment in four different pelvic trauma centers: have the Judet views become superfluous?. Archives of Orthopaedic and Trauma Surgery.  ISSN 0936-8051.  135(7), s 913- 918 . doi: 10.1007/s00402-015-2223-9
• Søberg, Helene L.; Bautz-Holter, Erik; Finset, Arnstein; Røise, Olav & Andelic, Nada (2015). Physical and mental health 10 years after multiple trauma: A prospective cohort study. Journal of Trauma and Acute Care Surgery.  ISSN 2163-0755.  78(3), s 628- 633 . doi: 10.1097/TA.0000000000000541
• Utheim, Nils Christian; Josefsen, Roger; Nakstad, Per Hjalmar; Solgaard, Torfinn & Røise, Olav (2015). Occipital condyle fracture and lower cranial nerve palsy after blunt head trauma - a literature review and case report. Journal of Trauma Management & Outcomes.  ISSN 1752-2897.  9(2) . doi: 10.1186/s13032-015-0024-3
• Adelved, Aron; Tötterman, Anna; Glott, Thomas; Søberg, Helene L.; Madsen, Jan Erik & Røise, Olav (2014). Patient-reported health minimum 8 years after operatively treated displaced sacral fractures: A prospective cohort study. Journal of Orthopaedic Trauma.  ISSN 0890-5339.  28(12), s 686- 693 . doi: 10.1097/BOT.0000000000000242
• Adelved, Aron; Tötterman, Anna; Hellund, Johan Castberg; Glott, Thomas; Madsen, Jan Erik & Røise, Olav (2014). Radiological findings correlate with neurological deficits but not with pain after operatively treated sacral fractures. An 11-year follow-up study of 28 patients. Acta Orthopaedica.  ISSN 1745-3674.  85(4), s 408- 414 . doi: 10.3109/17453674.2014.908344
• Kibsgård, Thomas Johan; Røise, Olav & Stuge, Britt (2014). Pelvic joint fusion in patients with severe pelvic girdle pain - A prospective single-subject research design study. BMC Musculoskeletal Disorders.  ISSN 1471-2474.  15(1) . doi: 10.1186/1471-2474-15-85
• Kibsgård, Thomas Johan; Røise, Olav; Sturesson, Bengt; Röhrl, Stephan Maximillian & Stuge, Britt (2014). Radiosteriometric analysis of movement in the sacroiliac joint during a single-leg stance in patients with long-lasting pelvic girdle pain. Clinical Biomechanics.  ISSN 0268-0033.  29(4), s 406- 411 . doi: 10.1016/j.clinbiomech.2014.02.002
• Engebretsen, Stine; Røise, Olav & Ribu, Lis (2013). Bruk av triage i norske akuttmottak. Tidsskrift for Den norske legeforening.  ISSN 0029-2001.  133(3), s 285- 289 . doi: 10.4045/tidsskr.11.1121
• Kibsgård, Thomas Johan; Røise, Olav; Sudmann, Einar & Stuge, Britt (2013). Pelvic joint fusions in patients with chronic pelvic girdle pain: a 23-year follow-up. European spine journal.  ISSN 0940-6719.  22(4), s 871- 877 . doi: 10.1007/s00586-012-2512-8
• Ringdal, Kjetil G.; Skaga, Nils Oddvar; Hestnes, Morten; Steen, Petter Andreas; Røislien, Jo; Rehn, Marius; Røise, Olav; Krüger, Andreas J. & Lossius, Hans Morten (2013). Abbreviated Injury Scale: Not a reliable basis for summation of injury severity in trauma facilities?. Injury.  ISSN 0020-1383.  44(5), s 691- 699 . doi: 10.1016/j.injury.2012.06.032
• Adelved, Aron; Tötterman, Anna; Glott, Thomas; Madsen, Jan Erik & Røise, Olav (2012). Functional outcome 10 years after surgical treatment of displaced sacral fractures. Spine.  ISSN 0362-2436.  37(16), s E1009- E1016 . doi: 10.1097/BRS.0b013e31823a0d83
• Husebye, Inger Elisabeth Ellingsen; Lyberg, Torstein; Opdahl, Helge; Aspelin, Trude; Støen, Ragnhild Øydna; Madsen, Jan Erik & Røise, Olav (2012). Intramedullary nailing of femoral shaft fractures in polytraumatized patients. A longitudinal, prospective and observational study of the procedure-related impact on cardiopulmonary- and inflammatory responses. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.  ISSN 1757-7241.  20 . doi: 10.1186/1757-7241-20-2
• Kibsgård, Thomas Johan; Røise, Olav; Stuge, Britt & Röhrl, Stephan Maximillian (2012). Precision and Accuracy Measurement of Radiostereometric Analysis Applied to Movement of the Sacroiliac Joint. Clinical Orthopaedics and Related Research.  ISSN 0009-921X.  470(11), s 3187- 3194 . doi: 10.1007/s11999-012-2413-5
• Søberg, Helene L.; Finset, Arnstein; Røise, Olav & Bautz-Holter, Erik (2012). The Trajectory of Physical and Mental Health From Injury to 5 Years After Multiple Trauma: A Prospective, Longitudinal Cohort Study. Archives of Physical Medicine and Rehabilitation.  ISSN 0003-9993.  93(5), s 765- 774 . doi: 10.1016/j.apmr.2011.08.050
• Wikerøy, Annette Konstanse Bordewich; Clarke-Jenssen, John; Øvre, Stein A.; Nordsletten, Lars; Madsen, Jan Erik; Hellund, Johan Castberg & Røise, Olav (2012). The natural history of bone bruise and bone remodelling in the traumatised hip A prospective 2-year follow-up study of bone bruise changes and DEXA measurements in 13 patients with conservatively treated traumatic hip dislocations and/or fractures. Injury.  ISSN 0020-1383.  43(10), s 1672- 1677 . doi: 10.1016/j.injury.2012.05.025
• Groven, Sigrid; Eken, Torsten; Skaga, Nils Oddvar; Røise, Olav; Næss, Pål Aksel & Gaarder, Christine (2011). Long-Lasting Performance Improvement After Formalization of a Dedicated Trauma Service. Journal of Trauma.  ISSN 0022-5282.  70(3), s 569- 574 . doi: 10.1097/TA.0b013e31820d1a9b
• Husebye, Inger Elisabeth Ellingsen; Opdahl, Helge; Røise, Olav; Aspelin, Trude & Lyberg, Torstein (2011). Coagulation, fibrinolysis and cytokine responses to intramedullary nailing of the femur: An experimental study in pigs comparing traditional reaming and reaming with a one-step reamer-irrigator-aspirator system. Injury.  ISSN 0020-1383.  42(7), s 630- 637 . doi: 10.1016/j.injury.2010.06.025
• Søberg, Helene L.; Røise, Olav; Bautz-Holter, Erik & Finset, Arnstein (2011). Returning to Work After Severe Multiple Injuries: Multidimensional Functioning and the Trajectory From Injury to Work at 5 Years. Journal of Trauma.  ISSN 0022-5282.  71(2), s 425- 434 . doi: 10.1097/TA.0b013e3181eff54f
• Vassend, Olav; Quale, Anette Johansen; Røise, Olav & Schanke, Anne-Kristine (2011). Predicting the long-term impact of acquired severe injuries on functional health status: The role of optimism, emotional distress, and pain. Spinal Cord.  ISSN 1362-4393.  49(12), s 1193- 1197 . doi: 10.1038/sc.2011.70
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• Husebye, Inger Elisabeth Ellingsen; Lyberg, Torstein; Opdahl, Helge; Laurvik, Helene & Røise, Olav (2010). Cardiopulmonary Response to Reamed Intramedullary Nailing of the Femur Comparing Traditional Reaming With a One-Step Reamer-Irrigator-Aspirator Reaming System: An Experimental Study in Pigs. Journal of Trauma.  ISSN 0022-5282.  69(4), s E6- E14 . doi: 10.1097/TA.0b013e3181d27928
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• Søberg, Helene L.; Bautz-Holter, Erik; Røise, Olav & Finset, Arnstein (2010). Mental Health and Posttraumatic Stress Symptoms 2 Years After Severe Multiple Trauma: Self-Reported Disability and Psychosocial Functioning. Archives of Physical Medicine and Rehabilitation.  ISSN 0003-9993.  91(3), s 481- 488 . doi: 10.1016/j.apmr.2009.11.007
• Dormagen, Johann Baptist; Tøtterman, Anna; Røise, Olav; Sandvik, Leiv & Kløw, Nils-Einar (2009). Efficacy of plain radiography and computer tomography in localizing the site of pelvic arterial bleeding in trauma patients. Acta Radiologica.  ISSN 0284-1851.
• Husebye, EE; Lyberg, T; Madsen, Jan Erik; Nordsletten, Lars & Røise, Olav (2009). THE EARLY EFFECTS OF INTRAMEDULLARY REAMING OF THE FEMUR ON BONE MINERAL DENSITY; AN EXPERIMENTAL STUDY IN PIGS. Scandinavian Journal of Surgery.  ISSN 1457-4969.  98(3), s 189- 194
• Johansen, Anette; Schanke, Anne-Kristine; Frøslie, Kathrine Frey & Røise, Olav (2009). Severity of injury does not have any impact on posttraumatic stress symptoms in severely injured patients. Injury.  ISSN 0020-1383.  40(5), s 498- 505 . doi: 10.1016/j.injury.2008.11.006
• Søberg, Helene L.; Finset, Arnstein; Røise, Olav & Bautz-Holter, Erik (2008). Identification and comparison of rehabilitation goals after multiple injuries: an ICF analysis of the patients', physiotherapists' and other allied professionals' reported goals. Journal of Rehabilitation Medicine.  ISSN 1650-1977.  40(5), s 340- 346

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• Adelved, Aron; Tötterman, Anna; Glott, Thomas; Søberg, Helene L.; Madsen, Jan Erik & Røise, Olav (2013). Patient-Reported Health After Operatively Treated Displaced Sacral Fractures: A 10-Year Follow-Up.
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• Adelved, Aron; Tötterman, Anna; Glott, Thomas; Madsen, Jan Erik & Røise, Olav (2011). Long-Term Outcome After Displaced Sacral Fractures Treated With Internal Fixation.
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