Management and outcomes following emergency surgery for traumatic brain injury - A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study)

David Clark^{1

2}, Alexis Joannides¹, Omar Ibrahim Abdallah³, Amos Olufemi Adeleye^{1

4}, Abdul Hafid Bajamal^{1

5}, Tom Bashford^{1

6}, Arnold Bhebhe², Hagos Biluts^{1

7}, Natalia Budohoska¹, Karol Budohoski¹, Iype Cherian⁸, Niklas Marklund⁹, Rocio Fernandez Mendez⁶, Tony Figaji^{1

10}, Deepak Kumar Gupta^{1

11}, Corrado Iaccarino¹², Ali Ilunga², Mathew Joseph^{1

13}, Tariq Khan^{1

14}, Tsegazeab Laeke^{1

7}, Vicknes Waran^{1

15}, Kee Park¹⁶, Gail Rosseau¹⁷, Andres Rubiano^{1

18}, Youssuf Saleh¹⁹, Hamisi K Shabani^{1

20}, Brandon Smith¹, Kachinga Sichizya^{1

2}, Manoj Tewari^{1

21}, Abenezer Tirsit^{1

22}, Myat Thu^{1

23}, Manjul Tripathi^{1

21}, Rikin Trivedi¹, Sofia Villar²⁴, Indira Devi Bhagavatula^{1

25}, Franco Servadei²⁶, David Menon¹, Angelos Kolias¹, Peter Hutchinson¹; Global Neurotrauma Outcomes Study (GNOS) collaborative

Affiliations

¹ National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
² University Teaching Hospital, Lusaka, Zambia.
³ Sohag University Hospitals, Sohag, Egypt.
⁴ University College Hospital Ibadan, Ibadan, Oyo, Nigeria.
⁵ Dr Soetomo Hospital, Surabaya, Jawa Timur, Indonesia.
⁶ University of Cambridge, Cambridge, Cambridgeshire, United Kingdom.
⁷ Neurosurgery Unit, Surgery Department, Addis Ababa University, College of Health Sciences, Addis Ababa, Oromia, Ethiopia.
⁸ Nobel Medical College Teaching Hospital P Ltd, Biratnagar, Morang, Nepal.
⁹ Lund University, Skane University Hospital, Lund, Sweden.
¹⁰ University of Cape Town, Rondebosch, Western Cape, South Africa.
¹¹ All India Institute of Medical Sciences, New Delhi, Delhi, India.
¹² University Hospital of Parma, Parma, Emilia-Romagna, Italy.
¹³ Christian Medical College Vellore Association, Vellore, Tamil Nadu, India.
¹⁴ North West General Hospital & Research Center, Peshawar, Khyber Pakhtunkhwa, Pakistan.
¹⁵ University of Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
¹⁶ Harvard Medical School, Boston, MA, USA.
¹⁷ George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
¹⁸ Universidad El Bosque, Department of Neurosurgery, Bogota, Colombia.
¹⁹ University of Oxford, Oxford, Oxfordshire, United Kingdom.
²⁰ Muhimbili Orthopaedic Institute and Muhimbili University College of Allied Health Sciences, Dar es Salaam, Tanzania.
²¹ Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, India.
²² Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Oromia, Ethiopia.
²³ Yangon General Hospital, Yangon, Yangon Region, Myanmar.
²⁴ MRC Biostatistics Unit, Cambridge, Cambridgeshire, UK.
²⁵ National Institute of Mental Health & Neuro Science, Bangalore, India.
²⁶ Humanitas University and Research Hospital, Department of Neurosurgery, Milan, Italy.

PMID: 32211566
PMCID: PMC7082548
DOI: 10.1016/j.isjp.2020.02.001

Management and outcomes following emergency surgery for traumatic brain injury - A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study)

David Clark et al. Int J Surg Protoc. 2020.

. 2020 Feb 28:20:1-7.

doi: 10.1016/j.isjp.2020.02.001. eCollection 2020.

Authors

Affiliations

¹ National Institute of Health Research Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
² University Teaching Hospital, Lusaka, Zambia.
³ Sohag University Hospitals, Sohag, Egypt.
⁴ University College Hospital Ibadan, Ibadan, Oyo, Nigeria.
⁵ Dr Soetomo Hospital, Surabaya, Jawa Timur, Indonesia.
⁶ University of Cambridge, Cambridge, Cambridgeshire, United Kingdom.
⁷ Neurosurgery Unit, Surgery Department, Addis Ababa University, College of Health Sciences, Addis Ababa, Oromia, Ethiopia.
⁸ Nobel Medical College Teaching Hospital P Ltd, Biratnagar, Morang, Nepal.
⁹ Lund University, Skane University Hospital, Lund, Sweden.
¹⁰ University of Cape Town, Rondebosch, Western Cape, South Africa.
¹¹ All India Institute of Medical Sciences, New Delhi, Delhi, India.
¹² University Hospital of Parma, Parma, Emilia-Romagna, Italy.
¹³ Christian Medical College Vellore Association, Vellore, Tamil Nadu, India.
¹⁴ North West General Hospital & Research Center, Peshawar, Khyber Pakhtunkhwa, Pakistan.
¹⁵ University of Malaya Medical Centre, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
¹⁶ Harvard Medical School, Boston, MA, USA.
¹⁷ George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
¹⁸ Universidad El Bosque, Department of Neurosurgery, Bogota, Colombia.
¹⁹ University of Oxford, Oxford, Oxfordshire, United Kingdom.
²⁰ Muhimbili Orthopaedic Institute and Muhimbili University College of Allied Health Sciences, Dar es Salaam, Tanzania.
²¹ Post Graduate Institute of Medical Education and Research Chandigarh, Chandigarh, India.
²² Tikur Anbessa Specialized Hospital, Addis Ababa University, Addis Ababa, Oromia, Ethiopia.
²³ Yangon General Hospital, Yangon, Yangon Region, Myanmar.
²⁴ MRC Biostatistics Unit, Cambridge, Cambridgeshire, UK.
²⁵ National Institute of Mental Health & Neuro Science, Bangalore, India.
²⁶ Humanitas University and Research Hospital, Department of Neurosurgery, Milan, Italy.

PMID: 32211566
PMCID: PMC7082548
DOI: 10.1016/j.isjp.2020.02.001

Abstract

Introduction: Traumatic brain injury (TBI) accounts for a significant amount of death and disability worldwide and the majority of this burden affects individuals in low-and-middle income countries. Despite this, considerable geographical differences have been reported in the care of TBI patients. On this background, we aim to provide a comprehensive international picture of the epidemiological characteristics, management and outcomes of patients undergoing emergency surgery for traumatic brain injury (TBI) worldwide.

Methods and analysis: The Global Neurotrauma Outcomes Study (GNOS) is a multi-centre, international, prospective observational cohort study. Any unit performing emergency surgery for TBI worldwide will be eligible to participate. All TBI patients who receive emergency surgery in any given consecutive 30-day period beginning between 1st of November 2018 and 31st of December 2019 in a given participating unit will be included. Data will be collected via a secure online platform in anonymised form. The primary outcome measures for the study will be 14-day mortality (or survival to hospital discharge, whichever comes first). Final day of data collection for the primary outcome measure is February 13th. Secondary outcome measures include return to theatre and surgical site infection.

Ethics and dissemination: This project will not affect clinical practice and has been classified as clinical audit following research ethics review. Access to source data will be made available to collaborators through national or international anonymised datasets on request and after review of the scientific validity of the proposed analysis by the central study team.

Keywords: Brain injuries; Epidemiology; Global health; Injuries; Neurosurgery; Traumatic.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

References

1. GBD collaborators Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(1):56–87. [published Online First: 2018/11/26] - PMC - PubMed
1. Esposito T.J., Reed R.L., Gamelli R.L. Neurosurgical coverage: essential, desired, or irrelevant for good patient care and trauma center status. Ann. Surg. 2005;242(3):364–370. discussion 70–4. - PMC - PubMed
1. Seelig J.M., Becker D.P., Miller J.D. Traumatic acute subdural hematoma: major mortality reduction in comatose patients treated within four hours. N. Engl. J. Med. 1981;304(25):1511–1518. - PubMed
1. Haselsberger K., Pucher R., Auer L.M. Prognosis after acute subdural or epidural haemorrhage. Acta Neurochir. (Wien) 1988;90(3–4):111–116. - PubMed
1. Cohen J.E., Montero A., Israel Z.H. Prognosis and clinical relevance of anisocoria-craniotomy latency for epidural hematoma in comatose patients. J. Trauma. 1996;41(1):120–122. - PubMed

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Management and outcomes following emergency surgery for traumatic brain injury - A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study)

Affiliations

Management and outcomes following emergency surgery for traumatic brain injury - A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study)

Authors

Affiliations

Abstract

Conflict of interest statement

References

LinkOut - more resources

Full Text Sources