Clinical profile of patients with acute traumatic brain injury undergoing cranial surgery in the United States: report from the 18-centre TRACK-TBI cohort studyResearch in context

Background: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery. Methods: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014...

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Published in:Lancet Regional Health - Americas (Online) 2024-11, Vol.39, p.100915
Main Authors: John K. Yue, John H. Kanter, Jason K. Barber, Michael C. Huang, Thomas A. van Essen, Mahmoud M. Elguindy, Brandon Foreman, Frederick K. Korley, Patrick J. Belton, Dana Pisică, Young M. Lee, Ryan S. Kitagawa, Mary J. Vassar, Xiaoying Sun, Gabriela G. Satris, Justin C. Wong, Adam R. Ferguson, J. Russell Huie, Kevin K.W. Wang, Hansen Deng, Vincent Y. Wang, Yelena G. Bodien, Sabrina R. Taylor, Debbie Y. Madhok, Michael A. McCrea, Laura B. Ngwenya, Anthony M. DiGiorgio, Phiroz E. Tarapore, Murray B. Stein, Ava M. Puccio, Joseph T. Giacino, Ramon Diaz-Arrastia, Hester F. Lingsma, Pratik Mukherjee, Esther L. Yuh, Claudia S. Robertson, David K. Menon, Andrew I.R. Maas, Amy J. Markowitz, Sonia Jain, David O. Okonkwo, Nancy R. Temkin, Geoffrey T. Manley, Jason E. Chung, Bukre Coskun, Shawn R. Eagle, Leila L. Etemad, Brian Fabian, Feeser V. Ramana, Shankar Gopinath, Christine J. Gotthardt, Ramesh Grandhi, Sabah Hamidi, Ruchira M. Jha, Christopher Madden, Randall Merchant, Lindsay D. Nelson, Richard B. Rodgers, Andrea L.C. Schneider, David M. Schnyer, Abel Torres-Espin, Joye X. Tracey, Alex B. Valadka, Ross D. Zafonte
Format: Article
Language:English
Subjects:
Craniotomy
Decompressive craniectomy
Glasgow outcome scale
Medical decisionmaking
Neuroimaging
Triage
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Summary:Background: Contemporary surgical practices for traumatic brain injury (TBI) remain unclear. We describe the clinical profile of an 18-centre US TBI cohort with cranial surgery. Methods: The prospective, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study (2014–2018; ClinicalTrials.gov #NCT02119182) enrolled subjects who presented to trauma centre and received head computed tomography within 24-h (h) post-TBI. We performed a secondary data analysis in subjects aged ≥17-years with hospitalisation. Clinical characteristics, surgery type/timing, hospital and six-month outcomes were reported. Findings: Of 2032 subjects (age: mean = 41.4-years, range = 17–89-years; male = 71% female = 29%), 260 underwent cranial surgery, comprising 65% decompressive craniectomy, 23% craniotomy, 12% other surgery. Subjects with surgery (vs. without surgery) presented with worse neurological injury (median Glasgow Coma Scale = 6 vs. 15; midline shift ≥5 mm: 48% vs. 2%; cisternal effacement: 61% vs. 4%; p 
ISSN:2667-193X