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Comparison of Care System and Treatment Approaches for Patients with Traumatic Brain Injury in China versus Europe: A CENTER-TBI Survey Study
Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Shanghai Institute of Head Trauma, Shanghai, People's Republic of China.
Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Intensive Care, Erasmus University Medical Center, Rotterdam, the Netherlands.
Department of Neurosurgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People's Republic of China; Shanghai Institute of Head Trauma, Shanghai, People's Republic of China.
Department of Public Health, Erasmus University Medical Center, Rotterdam, the Netherlands.
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Number of Authors: 3492020 (English)In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 37, no 16, p. 1806-1817Article in journal (Refereed) Published
Abstract [en]

Traumatic brain injury (TBI) poses a huge public health and societal problem worldwide. Uncertainty exists on how care system and treatment approaches for TBI worked in China may differ from those in Europe. Better knowledge on this is important to facilitate interpretation of findings reported by Chinese researchers and to inform opportunities for collaborative studies. We aimed to investigate concordance and variations in TBI care between Chinese and European neurotrauma centers. Investigators from 52 centers in China and 68 in Europe involved in the Collaborative European Neuro Trauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study were invited to complete provider profiling (PP) questionnaires, which covered the main aspects of care system and treatment approaches of TBI care. Participating Chinese and European centers were mainly publicly funded and academic. More centers in China indicated available dedicated neuro-intensive care than those in Europe (98% vs. 60%), and treatment decisions in the ICU were mainly determined by neurosurgeons (58%) in China while in Europe, (neuro)intensivists often took the lead (61%). The ambulance dispatching system was automatic in half of Chinese centers (49%), whereas selective dispatching was more common in European centers (74%). For treatment of refractory intracranial hypertension, a decompressive craniectomy was more frequently regarded as general policy in China compared with in Europe (89% vs. 45%). We observed both concordance and substantial variations with regard to the various aspects of TBI care between Chinese and European centers. These findings are fundamental to guide future research and offer opportunities for collaborative comparative effectiveness research to identify best practices.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2020. Vol. 37, no 16, p. 1806-1817
Keywords [en]
TBI care, comparison, provider profiling, traumatic brain injury, variation
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-81441DOI: 10.1089/neu.2019.6900ISI: 000529989700001PubMedID: 32174214Scopus ID: 2-s2.0-85088253210OAI: oai:DiVA.org:oru-81441DiVA, id: diva2:1427949
Funder
EU, FP7, Seventh Framework Programme, 602150
Note

Funding Agencies:

National Natural Science Foundation of China (NSFC)

Hannelore Kohl Stiftung (Germany)  

OneMind (USA)  

Integra LifeSciences Corporation (USA)  

Available from: 2020-05-04 Created: 2020-05-04 Last updated: 2020-12-09Bibliographically approved

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Oresic, Matej

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