More than 40 traumatic brain injury experts were surveyed on the use of prognostication and withdrawal of care decisions in severe traumatic brain injury (TBI). The survey results are published in the peer-reviewed Journal of Neurotrauma . Click here to read the article now.
Gregory Hawryluk, MD, PhD , Akron General Hospital, and coauthors surveyed panelists from the S eattle I nternational severe traumatic B rain I njury C onsensus C onference (SIBICC), querying them on the use of prognostic calculators, variability in and responsibility for goals of care decisions, acceptability of neurological outcomes, and putative means of improving decisions that may limit care.
The responses to most questions were highly variable. Most panelists reported infrequent use of prognostic calculators. Overall, panelists felt that it would be beneficial for physicians to improve consensus on what constitutes an acceptable neurological outcome and what chance of achieving that outcome is acceptable. “Over 50% of panelists felt that if it was certain to be enduring, a vegetative state or lower severe disability would justify a withdrawal of care decision,” stated the authors.
“The SIBICC algorithms broke ground by addressing insufficiently informed aspects of TBI care such as when and how to de-escalate therapy,” concluded the authors.
“This is a tremendously important topic, with profound consequences for our most seriously injured patients,” says David L. Brody, MD, PhD , Editor-in-Chief of Journal of Neurotrauma . “Researchers and clinicians and who care for patients with severe TBI should read this paper carefully.”
About the Journal
Journal of Neurotrauma is an authoritative peer-reviewed journal published 24 times per year in print and online that focuses on the latest advances in the clinical and laboratory investigation of traumatic brain and spinal cord injury. Emphasis is on the basic pathobiology of injury to the nervous system, and the papers and reviews evaluate preclinical and clinical trials targeted at improving the early management and long-term care and recovery of patients with traumatic brain injury. Journal of Neurotrauma is the official journal of the National Neurotrauma Society and the International Neurotrauma Society. Complete tables of content and a sample issue may be viewed on the Journal of Neurotrauma website .
About the Publisher
Mary Ann Liebert, Inc., publishers is known for establishing authoritative peer-reviewed journals in promising areas of science and biomedical research. A complete list of the firm’s more than 100 journals, books, and newsmagazines is available on the Mary Ann Liebert, Inc., publishers website .
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Prognostication and Goals of Care Decisions in Severe Traumatic Brain Injury: A Survey of The Seattle International Severe Traumatic Brain Injury Consensus Conference Working Group