Head injuries in four British neurosurgical centres
An issue in the design of trials in traumatic brain injury is whether variation amongst centres in 'conventional' management could mask the impact of a powerful new pharmacological agent. We report the results of an observational study of 988 patients admitted to one of four British neuros...
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| Veröffentlicht in: | British journal of neurosurgery 1999-12, Vol.13 (6), p.564-569 |
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| container_title | British journal of neurosurgery |
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| creator | Murray, G.M. Teasdale, G.D. Murray, D.J. Miller, J.D. Pickard, M.D.M. Shaw, L.S. |
| description | An issue in the design of trials in traumatic brain injury is whether variation amongst centres in 'conventional' management could mask the impact of a powerful new pharmacological agent. We report the results of an observational study of 988 patients admitted to one of four British neurosurgical units between 1986 and 1988 within 3 days of a severe head injury. The centres fell into two pairs on the basis of the 'intensity' of management. In Edinburgh and Southampton, more frequent use of intracranial pressure monitoring, ventilation and osmotic diuretics was made than in Glasgow and Liverpool. The odds ratio for an independent outcome at 6 months in Edinburgh or Southampton, relative to Glasgow or Liverpool, controlling for case mix, was 1.43 (95% CI, 1.03-1.98, p=0.033). Thus, there is weak evidence of an association between the approach to management and clinical outcome at 6 months. |
| doi_str_mv | 10.1080/02688699943060 |
| format | Article |
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Teasdale, G.D. Murray, D.J. Miller, J.D. Pickard, M.D.M. Shaw, L.S.</creator><creatorcontrib>Murray, G.M. Teasdale, G.D. Murray, D.J. Miller, J.D. Pickard, M.D.M. Shaw, L.S.</creatorcontrib><description>An issue in the design of trials in traumatic brain injury is whether variation amongst centres in 'conventional' management could mask the impact of a powerful new pharmacological agent. We report the results of an observational study of 988 patients admitted to one of four British neurosurgical units between 1986 and 1988 within 3 days of a severe head injury. The centres fell into two pairs on the basis of the 'intensity' of management. In Edinburgh and Southampton, more frequent use of intracranial pressure monitoring, ventilation and osmotic diuretics was made than in Glasgow and Liverpool. The odds ratio for an independent outcome at 6 months in Edinburgh or Southampton, relative to Glasgow or Liverpool, controlling for case mix, was 1.43 (95% CI, 1.03-1.98, p=0.033). 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Teasdale, G.D. Murray, D.J. Miller, J.D. Pickard, M.D.M. Shaw, L.S.</creatorcontrib><title>Head injuries in four British neurosurgical centres</title><title>British journal of neurosurgery</title><addtitle>Br J Neurosurg</addtitle><description>An issue in the design of trials in traumatic brain injury is whether variation amongst centres in 'conventional' management could mask the impact of a powerful new pharmacological agent. We report the results of an observational study of 988 patients admitted to one of four British neurosurgical units between 1986 and 1988 within 3 days of a severe head injury. The centres fell into two pairs on the basis of the 'intensity' of management. In Edinburgh and Southampton, more frequent use of intracranial pressure monitoring, ventilation and osmotic diuretics was made than in Glasgow and Liverpool. The odds ratio for an independent outcome at 6 months in Edinburgh or Southampton, relative to Glasgow or Liverpool, controlling for case mix, was 1.43 (95% CI, 1.03-1.98, p=0.033). Thus, there is weak evidence of an association between the approach to management and clinical outcome at 6 months.</description><subject>Accidents, Traffic</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Brain</subject><subject>Case Mix;Clinical Trials;Head Injury;Intensive Care;Intracranial Pressure Monitoring</subject><subject>Clinical trials</subject><subject>Clinical Trials as Topic</subject><subject>Craniocerebral Trauma - epidemiology</subject><subject>Critical care</subject><subject>Data Collection</subject><subject>Female</subject><subject>Head injuries</subject><subject>Humans</subject><subject>Injuries of the nervous system and the skull. Diseases due to physical agents</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Organizational Policy</subject><subject>Practice Patterns, Physicians</subject><subject>Prospective Studies</subject><subject>Traumas. 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| subjects | Accidents, Traffic Adult Biological and medical sciences Brain Case Mix Clinical Trials Head Injury Intensive Care Intracranial Pressure Monitoring Clinical trials Clinical Trials as Topic Craniocerebral Trauma - epidemiology Critical care Data Collection Female Head injuries Humans Injuries of the nervous system and the skull. Diseases due to physical agents Length of Stay Male Medical sciences Middle Aged Neurology Organizational Policy Practice Patterns, Physicians Prospective Studies Traumas. Diseases due to physical agents United Kingdom - epidemiology |
| title | Head injuries in four British neurosurgical centres |
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