Quality indicators for patients with traumatic brain injury in European intensive care units: a CENTER-TBI study
Creators: name: Huijben, Jilske A.
name: Wiegers, Eveline J. A.
name: Ercole, Ari
name: De Keizer, Nicolette F.
name: Maas, Andrew I. R.
name: Steyerberg, Ewout W.
name: Citerio, Giuseppe
name: Wilson, Lindsay
name: Polinder, Suzanne
name: Nieboer, Daan
name: Menon, David
name: Lingsma, Hester F.
name: Van Der Jagt, Mathieu
name: Åkerlund, Cecilia
name: Amrein, Krisztina
name: Andelic, Nada
name: Andreassen, Lasse
name: Audibert, Gérard
name: Azouvi, Philippe
name: Azzolini, Maria Luisa
name: Bartels, Ronald
name: Beer, Ronny
name: Bellander, Bo-Michael
name: Benali, Habib
name: Berardino, Maurizio
name: Beretta, Luigi
name: Beqiri, Erta
name: Blaabjerg, Morten
name: Lund, Stine Borgen
name: Brorsson, Camilla
name: Buki, Andras
name: Cabeleira, Manuel
name: Caccioppola, Alessio
name: Calappi, Emiliana
name: Calvi, Maria Rosa
name: Cameron, Peter
name: Lozano, Guillermo Carbayo
name: Carbonara, Marco
name: Castaño-León, Ana M.
name: Cavallo, Simona
name: Chevallard, Giorgio
name: Chieregato, Arturo
name: Coburn, Mark
name: Coles, Jonathan
name: Cooper, Jamie D.
name: Correia, Marta
name: Czeiter, Endre
name: Czosnyka, Marek
name: Dahyot-Fizelier, Claire
name: Dark, Paul
name: De Keyser, Véronique
name: Degos, Vincent
name: Corte, Francesco Della
name: Den Boogert, Hugo
name: Depreitere, Bart
name: Dilvesi, Dula
name: Dixit, Abhishek
name: Dreier, Jens
name: Dulière, Guy-Loup
name: Ezer, Erzsébet
name: Fabricius, Martin
name: Foks, Kelly
name: Frisvold, Shirin
name: Furmanov, Alex
name: Galanaud, Damien
name: Gantner, Dashiell
name: Ghuysen, Alexandre
name: Giga, Lelde
name: Golubovic, Jagos
name: Gomez, Pedro A.
name: Grossi, Francesca
name: Gupta, Deepak
name: Haitsma, Iain
name: Helbok, Raimund
name: Helseth, Eirik
name: Hutchinson, Peter J.
name: Jankowski, Stefan
name: Johnson, Faye
name: Karan, Mladen
name: Kolias, Angelos G.
name: Kondziella, Daniel
name: Koraropoulos, Evgenios
name: Koskinen, Lars-Owe
name: Kovács, Noémi
name: Kowark, Ana
name: Lagares, Alfonso
name: Laureys, Steven
name: Lecky, Fiona
name: Ledoux, Didier
name: Lejeune, Aurelie
name: Lightfoot, Roger
name: Manara, Alex
name: Martino, Costanza
name: Maréchal, Hugues
name: Mattern, Julia
name: McMahon, Catherine
name: Menovsky, Tomas
name: Misset, Benoit
name: Muraleedharan, Visakh
name: Murray, Lynnette
name: Negru, Ancuta
name: Nelson, David
name: Newcombe, Virginia
name: Nyirádi, József
name: Ortolano, Fabrizio
name: Payen, Jean-François
name: Perlbarg, Vincent
name: Persona, Paolo
name: Peul, Wilco
name: Piippo-Karjalainen, Anna
name: Ples, Horia
name: Pomposo, Inigo
name: Posti, Jussi P.
name: Puybasset, Louis
name: Radoi, Andreea
name: Ragauskas, Arminas
name: Raj, Rahul
name: Rhodes, Jonathan
name: Richter, Sophie
name: Rocka, Saulius
name: Roe, Cecilie
name: Roise, Olav
name: Rosenfeld, Jeffrey V.
name: Rosenlund, Christina
name: Rosenthal, Guy
name: Rossaint, Rolf
name: Rossi, Sandra
name: Sahuquillo, Juan
name: Sandrød, Oddrun
name: Sakowitz, Oliver
name: Sanchez-Porras, Renan
name: Schirmer-Mikalsen, Kari
name: Schou, Rico Frederik
name: Smielewski, Peter
name: Sorinola, Abayomi
name: Stamatakis, Emmanuel
name: Stocchetti, Nino
name: Sundström, Nina
name: Takala, Riikka
name: Tamás, Viktória
name: Tamosuitis, Tomas
name: Tenovuo, Olli
name: Thomas, Matt
name: Tibboel, Dick
name: Tolias, Christos
name: Trapani, Tony
name: Tudora, Cristina Maria
name: Vajkoczy, Peter
name: Vallance, Shirley
name: Valeinis, Egils
name: Vámos, Zoltán
name: Van Der Steen, Gregory
name: Van Dijck, Jeroen T. J. M.
name: Van Essen, Thomas A.
name: Van Wijk, Roel P. J.
name: Vargiolu, Alessia
name: Vega, Emmanuel
name: Vik, Anne
name: Vilcinis, Rimantas
name: Volovici, Victor
name: Voormolen, Daphne
name: Vulekovic, Petar
name: Williams, Guy
name: Winzeck, Stefan
name: Wolf, Stefan
name: Younsi, Alexander
name: Zeiler, Frederick A.
name: Ziverte, Agate
name: Zoerle, Tommaso
name: Clusmann, Hans
Publisher: name: Apollo - University of Cambridge Repository
Year: 2020
Subjects: Research
Quality indicators
Benchmarking
Traumatic brain injuries
Intensive care units
Quality of health care

description: Abstract: Background: The aim of this study is to validate a previously published consensus-based quality indicator set for the management of patients with traumatic brain injury (TBI) at intensive care units (ICUs) in Europe and to study its potential for quality measurement and improvement. Methods: Our analysis was based on 2006 adult patients admitted to 54 ICUs between 2014 and 2018, enrolled in the CENTER-TBI study. Indicator scores were calculated as percentage adherence for structure and process indicators and as event rates or median scores for outcome indicators. Feasibility was quantified by the completeness of the variables. Discriminability was determined by the between-centre variation, estimated with a random effect regression model adjusted for case-mix severity and quantified by the median odds ratio (MOR). Statistical uncertainty of outcome indicators was determined by the median number of events per centre, using a cut-off of 10. Results: A total of 26/42 indicators could be calculated from the CENTER-TBI database. Most quality indicators proved feasible to obtain with more than 70% completeness. Sub-optimal adherence was found for most quality indicators, ranging from 26 to 93% and 20 to 99% for structure and process indicators. Significant (p &lt; 0.001) between-centre variation was found in seven process and five outcome indicators with MORs ranging from 1.51 to 4.14. Statistical uncertainty of outcome indicators was generally high; five out of seven had less than 10 events per centre. Conclusions: Overall, nine structures, five processes, but none of the outcome indicators showed potential for quality improvement purposes for TBI patients in the ICU. Future research should focus on implementation efforts and continuous reevaluation of quality indicators. Trial registration: The core study was registered with ClinicalTrials.gov, number NCT02210221, registered on August 06, 2014, with Resource Identification Portal (RRID: SCR_015582).