NDLI: Traumatic brain injury patient volume and mortality in neurosurgical intensive care units: a Finnish nationwide study

Content Provider	Springer Nature : BioMed Central
Author	Raj, Rahul Bendel, Stepani Reinikainen, Matti Hoppu, Sanna Luoto, Teemu Ala-Kokko, Tero Tetri, Sami Laitio, Ruut Koivisto, Timo Rinne, Jaakko Kivisaari, Riku Siironen, Jari Skrifvars, Markus B.
Abstract	Background Differences in outcomes after traumatic brain injury (TBI) between neurosurgical centers exist, although the reasons for this are not clear. Thus, our aim was to assess the association between the annual volume of TBI patients and mortality in neurosurgical intensive care units (NICUs). Methods We collected data on all patients treated in the five Finnish university hospitals to examine all patients with TBI treated in NICUs in Finland from 2009 to 2012. We used a random effect logistic regression model to adjust for important prognostic factors to assess the independent effect of ICU volume on 6-month mortality. Subgroup analyses were performed for patients with severe TBI, moderate-to-severe TBI, and those who were undergoing mechanical ventilation or intracranial pressure monitoring. Results Altogether 2,328 TBI patients were treated during the study period in five NICUs. The annual TBI patient volume ranged from 61 to 206 patients between the NICUs. Univariate analysis, showed no association between the NICUs’ annual TBI patient volume and 6-month mortality (p = 0.063). The random effect model showed no independent association between the NICUs’ annual TBI patient volume and 6-month mortality (OR = 1.000, 95% CI = 0.996–1.004, p = 0.876). None of the pre-defined subgroup analyses indicated any association between NICU volume and patient mortality (p > 0.05 for all). Discussion and Conclusion We did not find any association between annual TBI patient volume and 6-month mortality in NICUs. These findings should be interpreted taking into account that we only included NICUs, which by international standards all treated high volumes of TBI patients, and that we were not able to study the effect of NICU volume on neurological outcome.
Related Links	https://sjtrem.biomedcentral.com/counter/pdf/10.1186/s13049-016-0320-6.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	17577241
DOI	10.1186/s13049-016-0320-6
Journal	Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2016-11-08
Access Restriction	Open
Subject Keyword	Scandinavian Journal of Trauma Resuscitation and Emergency Medicine Emergency Medicine Traumatic Surgery Traumatic Brain Injury Mean Arterial Pressure Glasgow Coma Scale Severe Traumatic Brain Injury Traumatic Brain Injury Patient
Content Type	Text
Resource Type	Article
Subject	Emergency Medicine Critical Care and Intensive Care Medicine
Journal Impact Factor	3/2023
5-Year Journal Impact Factor	3.5/2023

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