Gabbe Belinda J, Keeves Jemma, McKimmie Ancelin, Gadowski Adelle M, Holland Andrew J, Semple Bridgette D, Young Jesse T, Crowe Louise, Ownsworth Tamara, Bagg Matthew K, Antonic-Baker Ana, Hicks Amelia J, Hill Regina, Curtis Kate, Romero Lorena, Ponsford Jennie L, Lannin Natasha A, O'Brien Terence J, Cameron Peter A, Cooper D Jamie, Rushworth Nick, Fitzgerald Melinda
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, United Kingdom.
J Neurotrauma. 2024 Apr 1. doi: 10.1089/neu.2023.0461.
The objective of the Australian Traumatic Brain Injury (AUS-TBI) Initiative is to develop a data dictionary to inform data collection and facilitate prediction of outcomes of people who experience moderate-severe TBI in Australia. The aim of this systematic review was to summarize the evidence of the association between demographic, injury event, and social characteristics with outcomes, in people with moderate-severe TBI, to identify potentially predictive indicators. Standardized searches were implemented across bibliographic databases to March 31, 2022. English-language reports, excluding case series, which evaluated the association between demographic, injury event, and social characteristics, and any clinical outcome in at least 10 patients with moderate-severe TBI were included. Abstracts and full text records were independently screened by at least two reviewers in Covidence. A pre-defined algorithm was used to assign a judgement of predictive value to each observed association. The review findings were discussed with an expert panel to determine the feasibility of incorporation of routine measurement into standard care. The search strategy retrieved 16,685 records; 867 full-length records were screened, and 111 studies included. Twenty-two predictors of 32 different outcomes were identified; 7 were classified as high-level (age, sex, ethnicity, employment, insurance, education, and living situation at the time of injury). After discussion with an expert consensus group, 15 were recommended for inclusion in the data dictionary. This review identified numerous predictors capable of enabling early identification of those at risk for poor outcomes and improved personalization of care through inclusion in routine data collection.
澳大利亚创伤性脑损伤(AUS-TBI)倡议的目标是制定一个数据字典,为数据收集提供信息,并促进对澳大利亚中重度创伤性脑损伤患者的预后预测。本系统评价的目的是总结中重度创伤性脑损伤患者的人口统计学、损伤事件和社会特征与预后之间关联的证据,以确定潜在的预测指标。在截至2022年3月31日的书目数据库中进行了标准化检索。纳入至少10例中重度创伤性脑损伤患者的英文报告(不包括病例系列),这些报告评估了人口统计学、损伤事件和社会特征与任何临床结局之间的关联。摘要和全文记录由至少两名审阅者在Covidence中独立筛选。使用预定义算法对每个观察到的关联赋予预测价值判断。与一个专家小组讨论了评价结果,以确定将常规测量纳入标准护理的可行性。检索策略检索到16685条记录;筛选了867条全文记录,纳入111项研究。确定了32种不同结局的22个预测因素;7个被归类为高级别(年龄、性别、种族、就业、保险、教育和受伤时的生活状况)。在与专家共识小组讨论后,建议将15个因素纳入数据字典。本评价确定了许多预测因素,能够通过纳入常规数据收集来早期识别预后不良风险人群,并改善护理的个性化。