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dc.contributor.authorGravesteijn, Benjamin Y
dc.contributor.authorSewalt, Charlie A
dc.contributor.authorErcole, Ari
dc.contributor.authorAkerlund, Cecilia
dc.contributor.authorNelson, David
dc.contributor.authorMaas, Andrew IR
dc.contributor.authorMenon, David
dc.contributor.authorLingsma, Hester F
dc.contributor.authorSteyerberg, Ewout W
dc.contributor.authorCollaborative European NeuroTrauma Effectiveness Research for Traumatic Brain Injury Collaborators
dc.date.accessioned2019-10-29T00:31:42Z
dc.date.available2019-10-29T00:31:42Z
dc.date.issued2020-04-01
dc.identifier.issn0897-7151
dc.identifier.urihttps://www.repository.cam.ac.uk/handle/1810/298156
dc.description.abstractTraumatic brain injury (TBI) is currently classified as mild, moderate, or severe TBI by trichotomizing the Glasgow Coma Scale (GCS). We aimed to explore directions for a more refined multidimensional classification system. For that purpose, we performed a hypothesis-free cluster analysis in the Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI) database: a European all-severity TBI cohort (n = 4509). The first building block consisted of key imaging characteristics, summarized using principal component analysis from 12 imaging characteristics. The other building blocks were demographics, clinical severity, secondary insults, and cause of injury. With these building blocks, the patients were clustered into four groups. We applied bootstrap resampling with replacement to study the stability of cluster allocation. The characteristics that predominantly defined the clusters were injury cause, major extracranial injury, and GCS. The clusters consisted of 1451, 1534, 1006, and 518 patients, respectively. The clustering method was quite stable: the proportion of patients staying in one cluster after resampling and reclustering was 97.4% (95% confidence interval [CI]: 85.6-99.9%). These clusters characterized groups of patients with different functional outcomes: from mild to severe, 12%, 19%, 36%, and 58% of patients had unfavorable 6 month outcome. Compared with the mild and the upper intermediate cluster, the lower intermediate and the severe cluster received more key interventions. To conclude, four types of TBI patients may be defined by injury mechanism, presence of major extracranial injury and GCS. Describing patients according to these three characteristics could potentially capture differences in etiology and care pathways better than with GCS only.
dc.format.mediumPrint-Electronic
dc.languageeng
dc.publisherMary Ann Liebert Inc
dc.rightsAll rights reserved
dc.subjectCollaborative European NeuroTrauma Effectiveness Research for Traumatic Brain Injury Collaborators
dc.subjectHumans
dc.subjectTreatment Outcome
dc.subjectCluster Analysis
dc.subjectCohort Studies
dc.subjectProspective Studies
dc.subjectBiomedical Research
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectEurope
dc.subjectFemale
dc.subjectMale
dc.subjectIntersectoral Collaboration
dc.subjectBrain Injuries, Traumatic
dc.titleToward a New Multi-Dimensional Classification of Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research for Traumatic Brain Injury Study.
dc.typeArticle
prism.endingPage1010
prism.issueIdentifier7
prism.publicationDate2020
prism.publicationNameJ Neurotrauma
prism.startingPage1002
prism.volume37
dc.identifier.doi10.17863/CAM.45213
dcterms.dateAccepted2019-10-23
rioxxterms.versionofrecord10.1089/neu.2019.6764
rioxxterms.versionAM
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2020-04
dc.contributor.orcidErcole, Ari [0000-0001-8350-8093]
dc.contributor.orcidMenon, David [0000-0002-3228-9692]
dc.identifier.eissn1557-9042
rioxxterms.typeJournal Article/Review
pubs.funder-project-idEuropean Commission (602150)
pubs.funder-project-idAcademy of Medical Sciences (unknown)
cam.orpheus.successThu Jan 30 10:36:29 GMT 2020 - Embargo updated
rioxxterms.freetoread.startdate2020-11-30


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