Olav Røise

• Seljemo, Camilla; Wiig, Siri; Røise, Olav; Ellis, Louise A.; Braithwaite, Jeffrey & Ree, Eline (2024). How Norwegian homecare managers tackled COVID-19 and displayed resilience-in-action: Multiple perspectives of frontline-staff. Journal of Contingencies and Crisis Management. ISSN 0966-0879. 32(1). doi: 10.1111/1468-5973.12558.
• Finstad, Jeanette; Røise, Olav; Clausen, Thomas; Rosseland, Leiv Arne & Havnes, Ingrid Amalia (2024). A qualitative longitudinal study of traumatic orthopaedic injury survivors' experiences with pain and the long-term recovery trajectory. BMJ Open. ISSN 2044-6055. 14(1). doi: 10.1136/bmjopen-2023-079161.
• Van Essen, Thomas; van Erp, Inge A. M.; Lingsma, Hester F; Pisica, Dana; Yue, John K & Singh, Ranjit D. [Show all 55 contributors for this article] (2023). Comparative effectiveness of decompressive craniectomy versus craniotomy for traumatic acute subdural hematoma (CENTER-TBI): an observational cohort study. EClinicalMedicine. ISSN 2589-5370. 9(63). doi: 10.1016/j.eclinm.2023.102161. Full text in Research Archive
• Zeldovich, Marina; Bockhop, Fabian; Covic, Amra; Mueller, Isabelle; Polinder, Suzanne & Mikolic, Ana [Show all 58 contributors for this article] (2023). Factorial validity and comparability of the six translations of the Rivermead Post-Concussion Symptoms Questionnaire translations: results from the CENTER-TBI study. Journal of Patient-Reported Outcomes. ISSN 2509-8020. 7(90). doi: 10.1186/s41687-023-00632-5. Full text in Research Archive
• Riemann, Lennart; Mikolic, Ana; Maas, Andrew; Unterberg, Andreas; Younsi, Alexander & Åkerlund, Cecilia [Show all 67 contributors for this article] (2023). Computed Tomography Lesions and Their Association With Global Outcome in Young People With Mild Traumatic Brain Injury. Journal of Neurotrauma. ISSN 0897-7151. 40(11-12), p. 1243–1254. doi: 10.1089/neu.2022.0055.
• Woodrow, Rebecca E; Winzeck, Stefan; Luppi, Andrea I; Kelleher-Unger, Isaac R; Spindler, Lennart R B & Wilson, J T Lindsay [Show all 86 contributors for this article] (2023). Acute thalamic connectivity precedes chronic post-concussive symptoms in mild traumatic brain injury. Brain. ISSN 0006-8950. 146(8), p. 3484–3499. doi: 10.1093/brain/awad056. Full text in Research Archive
• Åkerlund, Cecilia A. I.; Holst, Anders; Bhattacharyay, Shubhayu; Stocchetti, Nino; Steyerberg, Ewout & Smielewski, Peter [Show all 111 contributors for this article] (2023). Clinical descriptors of disease trajectories in patients with traumatic brain injury in the intensive care unit (CENTER-TBI): a multicentre observational cohort study. Lancet Neurology. ISSN 1474-4422. 1, p. 71–80. doi: 10.1016/S1474-4422(23)00358-7.
• Schäfer, Christoph; Moksnes, Håkon Øgreid; Rasmussen, Mari Storli; Hellstrøm, Torgeir; Søberg, Helene L. & Røise, Olav [Show all 15 contributors for this article] (2023). Adherence to Guidelines for Acute Rehabilitation in the Norwegian Trauma Plan. Journal of Rehabilitation Medicine. ISSN 1650-1977. 55. doi: 10.2340/jrm.v55.6552. Full text in Research Archive
• Mikolić, Ana; Steyerberg, Ewout W.; Polinder, Suzanne; Wilson, Lindsay; Zeldovich, Marina & von Steinbueche, Nicole [Show all 258 contributors for this article] (2023). Prognostic Models for Global Functional Outcome and Post-Concussion Symptoms Following Mild Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study. Journal of Neurotrauma. ISSN 0897-7151. 40(15-16), p. 1651–1670. doi: 10.1089/neu.2022.0320. Full text in Research Archive
• Naberezhneva, Natalia; Uleberg, Oddvar; Dahlhaug, Marianne; Giil-Jensen, Vigdis; Ringdal, Kjetil G. & Røise, Olav (2023). Excellent agreement of Norwegian trauma registry data compared to corresponding data in electronic patient records. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. ISSN 1757-7241. 31(1). doi: 10.1186/s13049-023-01118-5. Full text in Research Archive
• Moksnes, Håkon Øgreid; Schäfer, Christoph; Rasmussen, Mari Storli; Søberg, Helene L.; Røise, Olav & Anke, Audny Gabriele Wagner [Show all 15 contributors for this article] (2023). Functional Outcomes at 6 and 12 Months Post-Injury in a Trauma Centre Population with Moderate-to-Severe Traumatic Injuries. Journal of Clinical Medicine. ISSN 2077-0383. 12(16). doi: 10.3390/jcm12165300. Full text in Research Archive
• Cuevas-Østrem, Mathias; Thorsen, Kjetil; Wisborg, Torben; Røise, Olav; Helseth, Eirik & Jeppesen, Elisabeth (2023). Care pathways and factors associated with interhospital transfer to neurotrauma centers for patients with isolated moderate-to-severe traumatic brain injury: a population-based study from the Norwegian trauma registry. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. ISSN 1757-7241. 31(1). doi: 10.1186/s13049-023-01097-7. Full text in Research Archive
• Moksnes, Håkon Øgreid; Schäfer, Christoph; Rasmussen, Mari Storli; Søberg, Helene L.; Røise, Olav & Anke, Audny Gabriele Wagner [Show all 15 contributors for this article] (2023). Factors associated with discharge destination from acute care after moderate-to-severe traumatic injuries in Norway: a prospective population-based study. Injury Epidemiology. ISSN 2197-1714. 10. doi: 10.1186/s40621-023-00431-y. Full text in Research Archive
• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2023). The role of local context for managers’ strategies when adapting to the COVID-19 pandemic in Norwegian homecare services: a multiple case study. BMC Health Services Research. ISSN 1472-6963. 23. doi: 10.1186/s12913-023-09444-1. Full text in Research Archive
• Van Praag, Dominique L.G.; Wouters, Kristien; Van Den Eede, Filip; Wilson, Lindsay; Maas, Andrew I.R. & Åkerlund, Cecilia [Show all 250 contributors for this article] (2022). Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury. Brain and Spine. ISSN 2772-5294. 2. doi: 10.1016/j.bas.2021.100854.
• Wilson, Lindsay; Horton, Lindsay; Polinder, Suzanne; Newcombe, Virginia F.J.; Steinbuechel, Nicole v. & Maas, Andrew I. R. [Show all 50 contributors for this article] (2022). Tailoring Multi-Dimensional Outcomes to Level of Functional Recovery after Traumatic Brain Injury. Journal of Neurotrauma. ISSN 0897-7151. 39(19-20), p. 1363–1381. doi: 10.1089/neu.2022.0013.
• Helmrich, Isabel Retel; Czeiter, Endre; Amrein, Krisztina; Büki, András; Lingsma, Hester F & Menon, David K [Show all 50 contributors for this article] (2022). Incremental prognostic value of acute serum biomarkers for functional outcome after traumatic brain injury (CENTER-TBI): an observational cohort study. Lancet Neurology. ISSN 1474-4422. 21(9), p. 792–802. doi: 10.1016/S1474-4422(22)00218-6. Show summary

  Background Several studies have reported an association between serum biomarker values and functional outcome following traumatic brain injury. We aimed to examine the incremental (added) prognostic value of serum biomarkers over demographic, clinical, and radiological characteristics and over established prognostic models, such as IMPACT and CRASH, for prediction of functional outcome. Methods We used data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) core study. We included patients aged 14 years or older who had blood sampling within 24 h of injury, results from a CT scan, and outcome assessment according to the Glasgow Outcome Scale-Extended (GOSE) at 6 months. Amounts in serum of six biomarkers (S100 calcium-binding protein B, neuron-specific enolase, glial fibrillary acidic protein, ubiquitin C-terminal hydrolase L1 [UCH-L1], neurofilament protein-light, and total tau) were measured. The incremental prognostic value of these biomarkers was determined separately and in combination. The primary outcome was the GOSE 6 months after injury. Incremental prognostic value, using proportional odds and a dichotomised analysis, was assessed by delta C-statistic and delta R2 between models with and without serum biomarkers, corrected for optimism with a bootstrapping procedure. Findings Serum biomarker values and 6-month GOSE were available for 2283 of 4509 patients. Higher biomarker levels were associated with worse outcome. Adding biomarkers improved the C-statistic by 0·014 (95% CI 0·009–0·020) and R2 by 4·9% (3·6–6·5) for predicting GOSE compared with demographic, clinical, and radiological characteristics. UCH-L1 had the greatest incremental prognostic value. Adding biomarkers to established prognostic models resulted in a relative increase in R2 of 48–65% for IMPACT and 30–34% for CRASH prognostic models. Interpretation Serum biomarkers have incremental prognostic value for functional outcome after traumatic brain injury. Our findings support integration of biomarkers—particularly UCH-L1—in established prognostic models. Funding European Union's Seventh Framework Programme, Hannelore Kohl Stiftung, OneMind, Integra LifeSciences, and NeuroTrauma Sciences

• Åkerlund, Cecilia; Holst, Anders; Stocchetti, Nino; Steyerberg, Ewout W; Menon, David K & Ercole, Ari [Show all 50 contributors for this article] (2022). Clustering identifies endotypes of traumatic brain injury in an intensive care cohort: a CENTER-TBI study. Critical Care. ISSN 1364-8535. 26. doi: 10.1186/s13054-022-04079-w. Full text in Research Archive Show summary

  Background While the Glasgow coma scale (GCS) is one of the strongest outcome predictors, the current classification of traumatic brain injury (TBI) as ‘mild’, ‘moderate’ or ‘severe’ based on this fails to capture enormous heterogeneity in pathophysiology and treatment response. We hypothesized that data-driven characterization of TBI could identify distinct endotypes and give mechanistic insights. Methods We developed an unsupervised statistical clustering model based on a mixture of probabilistic graphs for presentation (< 24 h) demographic, clinical, physiological, laboratory and imaging data to identify subgroups of TBI patients admitted to the intensive care unit in the CENTER-TBI dataset (N = 1,728). A cluster similarity index was used for robust determination of optimal cluster number. Mutual information was used to quantify feature importance and for cluster interpretation. Results Six stable endotypes were identified with distinct GCS and composite systemic metabolic stress profiles, distinguished by GCS, blood lactate, oxygen saturation, serum creatinine, glucose, base excess, pH, arterial partial pressure of carbon dioxide, and body temperature. Notably, a cluster with ‘moderate’ TBI (by traditional classification) and deranged metabolic profile, had a worse outcome than a cluster with ‘severe’ GCS and a normal metabolic profile. Addition of cluster labels significantly improved the prognostic precision of the IMPACT (International Mission for Prognosis and Analysis of Clinical trials in TBI) extended model, for prediction of both unfavourable outcome and mortality (both p < 0.001). Conclusions Six stable and clinically distinct TBI endotypes were identified by probabilistic unsupervised clustering. In addition to presenting neurology, a profile of biochemical derangement was found to be an important distinguishing feature that was both biologically plausible and associated with outcome. Our work motivates refining current TBI classifications with factors describing metabolic stress. Such data-driven clusters suggest TBI endotypes that merit investigation to identify bespoke treatment strategies to improve care.

• Volovici, Victor; Pisică, Dana; Gravesteijn, Benjamin; Dirven, Clemens M. F.; Steyerberg, Ewout W. & Ercole, Ari [Show all 50 contributors for this article] (2022). Comparative effectiveness of intracranial hypertension management guided by ventricular versus intraparenchymal pressure monitoring: a CENTER-TBI study. Acta Neurochirurgica. ISSN 0001-6268. 164, p. 1693–1705. doi: 10.1007/s00701-022-05257-z. Full text in Research Archive
• Rivera, Diego; Greving, Sven; Arango-Lasprilla, Juan Carlos; von Steinbuechel, Nicole; Zeldovich, Marina & Åkerlund, Cecilia [Show all 85 contributors for this article] (2022). Comparability of (Post-Concussion) Symptoms across Time in Individuals after Traumatic Brain Injury: Results from the CENTER-TBI Study. Journal of Clinical Medicine. ISSN 2077-0383. 11(14), p. 1–23. doi: 10.3390/jcm11144090. Full text in Research Archive Show summary

  settingsOrder Article Reprints Open AccessArticle Comparability of (Post-Concussion) Symptoms across Time in Individuals after Traumatic Brain Injury: Results from the CENTER-TBI Study by Diego Rivera 1,2ORCID,Sven Greving 3,Juan Carlos Arango-Lasprilla 4ORCID,Nicole von Steinbuechel 3,Marina Zeldovich 3,*ORCID andCENTER-TBI Participants and Investigators † 1 Department of Health Sciences, Public University of Navarre, Arrosadia Campus, 31006 Pamplona, Spain 2 Instituto de Investigación Sanitaria de Navarra (IdiSNA), Irunlarrea Street 3, 31008 Pamplona, Spain 3 Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Waldweg 37A, 37073 Göttingen, Germany 4 Department of Psychology, Virginia Commonwealth University, Richmond, VA 23284-2018, USA * Author to whom correspondence should be addressed. † The full list of the CENTER-TBI participants and investigators can be found in the Supplementary Materials. J. Clin. Med. 2022, 11(14), 4090; https://doi.org/10.3390/jcm11144090 Received: 20 May 2022 / Revised: 10 July 2022 / Accepted: 13 July 2022 / Published: 14 July 2022 (This article belongs to the Special Issue Traumatic Brain Injury: Diagnosis, Management, and Outcomes) Download Browse Figures Versions Notes Abstract Post-concussion symptoms often occur after TBI, persist and cause disabilities. The Rivermead Post-Concussion Symptoms Questionnaire (RPQ) is widely used in this population, but little is known about the comparability of the symptoms over time, i.e., longitudinal measurement invariance (MI). The objectives of this study were to analyze the longitudinal MI of RPQ symptoms from three to twelve months after TBI and to find factors related to RPQ symptoms. The study involved 1023 individuals after TBI who took part in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study and completed the RPQ at three, six and twelve months post-injury. Longitudinal confirmatory factor analysis showed that the three-factor structure (somatic, emotional and cognitive) remains stable within one year after TBI. Linear mixed models revealed that sex, injury cause and prior psychiatric problems were related to the RPQ three-factor structure as well as to the RPQ total score. The study strengthens evidence for the RPQ’s factorial structure stability within one year after TBI and identifies sex, injury cause and prior psychiatric problems as important factors that may help clinicians to prevent future complications of symptomatology after TBI.

• Van Essen, Thomas; Lingsma, Hester F; Pisică, Dana; Singh, Ranjit D.; Volovici, Victor & den Boogert, Hugo F [Show all 50 contributors for this article] (2022). Surgery versus conservative treatment for traumatic acute subdural haematoma: a prospective, multicentre, observational, comparative effectiveness study. Lancet Neurology. ISSN 1474-4422. 21(7), p. 620–631. doi: 10.1016/s1474-4422(22)00166-1. Show summary

  Background Despite being well established, acute surgery in traumatic acute subdural haematoma is based on low-grade evidence. We aimed to compare the effectiveness of a strategy preferring acute surgical evacuation with one preferring initial conservative treatment in acute subdural haematoma. Methods We did a prospective, observational, comparative effectiveness study using data from participants enrolled in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) cohort. We included patients with no pre-existing severe neurological disorders who presented with acute subdural haematoma within 24 h of traumatic brain injury. Using an instrumental variable analysis, we compared outcomes between centres according to treatment preference for acute subdural haematoma (acute surgical evacuation or initial conservative treatment), measured by the case-mix-adjusted percentage of acute surgery per centre. The primary endpoint was functional outcome at 6 months as rated with the Glasgow Outcome Scale Extended, which was estimated with ordinal regression as a common odds ratio (OR) and adjusted for prespecified confounders. Variation in centre preference was quantified with the median OR (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). Findings Between Dec 19, 2014 and Dec 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI, of whom 1407 (31%) presented with acute subdural haematoma and were included in our study. Acute surgical evacuation was done in 336 (24%) patients, by craniotomy in 245 (73%) of those patients and by decompressive craniectomy in 91 (27%). Delayed decompressive craniectomy or craniotomy after initial conservative treatment (n=982) occurred in 107 (11%) patients. The percentage of patients who underwent acute surgery ranged from 5·6% to 51·5% (IQR 12·3–35·9) between centres, with a two-times higher probability of receiving acute surgery for an identical patient in one centre versus another centre at random (adjusted MOR for acute surgery 1·8; p<0·0001]). Centre preference for acute surgery over initial conservative treatment was not associated with improvements in functional outcome (common OR per 23·6% [IQR increase] more acute surgery in a centre 0·92, 95% CI 0·77–1·09). Interpretation Our findings show that treatment for patients with acute subdural haematoma with similar characteristics differed depending on the treating centre, because of variation in the preferred approach. A treatment strategy preferring an aggressive approach of acute surgical evacuation over initial conservative treatment was not associated with better functional outcome. Therefore, in a patient with acute subdural haematoma for whom a neurosurgeon sees no clear superiority for acute surgery over conservative treatment, initial conservative treatment might be considered. Funding The Hersenstichting Nederland (also known as the Dutch Brain Foundation), the European Commission Seventh Framework Programme, the Hannelore Kohl Stiftung (Germany), OneMind (USA), Integra LifeSciences Corporation (USA), and NeuroTrauma Sciences (USA).

• Rezoagli, Emanuele; Petrosino, Matteo; Rebora, Paola; Menon, David K.; Mondello, Stefania & Cooper, D. James [Show all 50 contributors for this article] (2022). High arterial oxygen levels and supplemental oxygen administration in traumatic brain injury: insights from CENTER-TBI and OzENTER-TBI. Intensive Care Medicine. ISSN 0342-4642. 48, p. 1709–1725. doi: 10.1007/s00134-022-06884-x. Full text in Research Archive Show summary

  Purpose The effect of high arterial oxygen levels and supplemental oxygen administration on outcomes in traumatic brain injury (TBI) is debated, and data from large cohorts of TBI patients are limited. We investigated whether exposure to high blood oxygen levels and high oxygen supplementation is independently associated with outcomes in TBI patients admitted to the intensive care unit (ICU) and undergoing mechanical ventilation. Methods This is a secondary analysis of two multicenter, prospective, observational, cohort studies performed in Europe and Australia. In TBI patients admitted to ICU, we describe the arterial partial pressure of oxygen (PaO2) and the oxygen inspired fraction (FiO2). We explored the association between high PaO2 and FiO2 levels within the first week with clinical outcomes. Furthermore, in the CENTER-TBI cohort, we investigate whether PaO2 and FiO2 levels may have differential relationships with outcome in the presence of varying levels of brain injury severity (as quantified by levels of glial fibrillary acidic protein (GFAP) in blood samples obtained within 24 h of injury). Results The analysis included 1084 patients (11,577 measurements) in the CENTER-TBI cohort, of whom 55% had an unfavorable outcome, and 26% died at a 6-month follow-up. Median PaO2 ranged from 93 to 166 mmHg. Exposure to higher PaO2 and FiO2 in the first seven days after ICU admission was independently associated with a higher mortality rate. A trend of a higher mortality rate was partially confirmed in the OzENTER-TBI cohort (n = 159). GFAP was independently associated with mortality and functional neurologic outcome at follow-up, but it did not modulate the outcome impact of high PaO2 and FiO2 levels, which remained independently associated with 6-month mortality. Conclusions In two large prospective multicenter cohorts of critically ill patients with TBI, levels of PaO2 and FiO2 varied widely across centers during the first seven days after ICU admission. Exposure to high arterial blood oxygen or high supplemental oxygen was independently associated with 6-month mortality in the CENTER-TBI cohort, and the severity of brain injury did not modulate this relationship. Due to the limited sample size, the findings were not wholly validated in the external OzENTER-TBI cohort. We cannot exclude the possibility that the worse outcomes associated with higher PaO2 were due to use of higher FiO2 in patients with more severe injury or physiological compromise. Further, these findings may not apply to patients in whom FiO2 and PaO2 are titrated to brain tissue oxygen monitoring (PbtO2) levels. However, at minimum, these findings support the need for caution with oxygen therapy in TBI, particularly since titration of supplemental oxygen is immediately applicable at the bedside.

• Whitehouse, Daniel; Monteiro, Miguel; Czeiter, Endre; Vyvere, Thijs Vande; Valerio, Fernanda & Ye, Zheng [Show all 50 contributors for this article] (2022). Relationship of admission blood proteomic biomarkers levels to lesion type and lesion burden in traumatic brain injury: A CENTER-TBI study. EBioMedicine. ISSN 2352-3964. 75, p. 1–15. doi: 10.1016/j.ebiom.2021.103777. Full text in Research Archive Show summary

  Background We aimed to understand the relationship between serum biomarker concentration and lesion type and volume found on computed tomography (CT) following all severities of TBI. Methods Concentrations of six serum biomarkers (GFAP, NFL, NSE, S100B, t-tau and UCH-L1) were measured in samples obtained <24 hours post-injury from 2869 patients with all severities of TBI, enrolled in the CENTER-TBI prospective cohort study (NCT02210221). Imaging phenotypes were defined as intraparenchymal haemorrhage (IPH), oedema, subdural haematoma (SDH), extradural haematoma (EDH), traumatic subarachnoid haemorrhage (tSAH), diffuse axonal injury (DAI), and intraventricular haemorrhage (IVH). Multivariable polynomial regression was performed to examine the association between biomarker levels and both distinct lesion types and lesion volumes. Hierarchical clustering was used to explore imaging phenotypes; and principal component analysis and k-means clustering of acute biomarker concentrations to explore patterns of biomarker clustering. Findings 2869 patient were included, 68% (n=1946) male with a median age of 49 years (range 2-96). All severities of TBI (mild, moderate and severe) were included for analysis with majority (n=1946, 68%) having a mild injury (GCS 13-15). Patients with severe diffuse injury (Marshall III/IV) showed significantly higher levels of all measured biomarkers, with the exception of NFL, than patients with focal mass lesions (Marshall grades V/VI). Patients with either DAI+IVH or SDH+IPH+tSAH, had significantly higher biomarker concentrations than patients with EDH. Higher biomarker concentrations were associated with greater volume of IPH (GFAP, S100B, t-tau;adj r2 range:0·48-0·49; p<0·05), oedema (GFAP, NFL, NSE, t-tau, UCH-L1;adj r2 range:0·44-0·44; p<0·01), IVH (S100B;adj r2 range:0.48-0.49; p<0.05), Unsupervised k-means biomarker clustering revealed two clusters explaining 83·9% of variance, with phenotyping characteristics related to clinical injury severity. Interpretation Interpretation: Biomarker concentration within 24 hours of TBI is primarily related to severity of injury and intracranial disease burden, rather than pathoanatomical type of injury. Funding CENTER-TBI is funded by the European Union 7th Framework programme (EC grant 602150).

• Maas, Andrew I. R.; Menon, David K.; Manley, Geoffrey; Abrams, Mathew; Åkerlund, Cecilia & Andelic, Nada [Show all 50 contributors for this article] (2022). Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurology. ISSN 1474-4422. 21(11), p. 1004–1060. doi: 10.1016/S1474-4422(22)00309-X.
• Howe, Emilie; Zeldovich, Marina; Andelic, Nada; von Steinbuechel, Nicole; Fure, Silje Christine Reistad & Borgen, Ida Maria Henriksen [Show all 51 contributors for this article] (2022). Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study. BMC Health Services Research. ISSN 1472-6963. 22(1), p. 1–16. doi: 10.1186/s12913-022-08908-0. Full text in Research Archive Show summary

  Background Despite existing guidelines for managing mild traumatic brain injury (mTBI), evidence-based treatments are still scarce and large-scale studies on the provision and impact of specific rehabilitation services are needed. This study aimed to describe the provision of rehabilitation to patients after complicated and uncomplicated mTBI and investigate factors associated with functional outcome, symptom burden, and TBI-specific health-related quality of life (HRQOL) up to six months after injury. Methods Patients (n = 1379) with mTBI from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study who reported whether they received rehabilitation services during the first six months post-injury and who participated in outcome assessments were included. Functional outcome was measured with the Glasgow Outcome Scale – Extended (GOSE), symptom burden with the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and HRQOL with the Quality of Life after Brain Injury – Overall Scale (QOLIBRI-OS). We examined whether transition of care (TOC) pathways, receiving rehabilitation services, sociodemographic (incl. geographic), premorbid, and injury-related factors were associated with outcomes using regression models. For easy comparison, we estimated ordinal regression models for all outcomes where the scores were classified based on quantiles. Results Overall, 43% of patients with complicated and 20% with uncomplicated mTBI reported receiving rehabilitation services, primarily in physical and cognitive domains. Patients with complicated mTBI had lower functional level, higher symptom burden, and lower HRQOL compared to uncomplicated mTBI. Rehabilitation services at three or six months and a higher number of TOC were associated with unfavorable outcomes in all models, in addition to pre-morbid psychiatric problems. Being male and having more than 13 years of education was associated with more favorable outcomes. Sustaining major trauma was associated with unfavorable GOSE outcome, whereas living in Southern and Eastern European regions was associated with lower HRQOL. Conclusions Patients with complicated mTBI reported more unfavorable outcomes and received rehabilitation services more frequently. Receiving rehabilitation services and higher number of care transitions were indicators of injury severity and associated with unfavorable outcomes. The findings should be interpreted carefully and validated in future studies as we applied a novel analytic approach.

• Deilkås, Ellen C Tveter; Rosta, Judith; Baathe, Fredrik; Søfteland, Eirik; Lexberg, Åse & Røise, Olav [Show all 7 contributors for this article] (2022). Physician participation in quality improvement work- interest and opportunity: a cross-sectional survey. BMC Primary Care. ISSN 2731-4553. 23(1), p. 1–9. doi: 10.1186/s12875-022-01878-6. Full text in Research Archive
• Dara, Kevin; Bere, Tone Tufte; Hellund, Johan Castberg; Flugsrud, Gunnar B & Røise, Olav (2022). Long-term results after isolated iliac wing fractures. Injury. ISSN 0020-1383. 53(11), p. 3795–3799. doi: 10.1016/j.injury.2022.08.033. Full text in Research Archive
• Finstad, Jeanette; Clausen, Thomas; Rosseland, Leiv Arne; Røise, Olav & Havnes, Ingrid Amalia (2022). Patient experiences after physical trauma: The negative effect of the COVID-19 pandemic on recovery. International Journal of Environmental Research and Public Health (IJERPH). ISSN 1661-7827. 19:12258(19), p. 1–9. doi: 10.3390/ijerph191912258. Full text in Research Archive Show summary

  The coronavirus disease 2019 (COVID-19) pandemic generated a crisis within the healthcare system, during which acute, COVID-19-related health needs were prioritized over less urgent needs, including vulnerable subgroups. This study explored experiences of recovery among survivors of physical injuries associated with severe pain during the COVID-19 pandemic in Norway. In-depth interviews were conducted among 13 participants. Findings generated by a thematic analysis revealed that the pandemic, including the contagion control measures and interrupted healthcare, were of negative consequence for the participants’ recovery experiences and mental and physical health. Despite experiencing severe pain and perceived needs for support, the participants experienced being deprioritized by the healthcare system. They experienced a reduced capacity to cope with pandemic-related stress and to perform everyday tasks, which they perceived as generating an additional burden for their loved ones. Alcohol was reported to be used in an effort to relieve the associated mental distress. As suggested by this study, injury survivors constitute a vulnerable subgroup for whom the continuity of rehabilitation services during a national crisis, as well as the integration of mental health support, can be essential for mitigating the negative impact of the crisis on recovery and for promoting optimal long-term health outcomes. Keywords: COVID-19; pandemic; physical trauma; recovery; rehabilitation; mental health; substance use; qualitative research

• Bockhop, Fabian; Zeldovich, Marina; Cunitz, Katrin; Van Praag, Dominique; van der Vlegel, Marjolein & Beissbarth, Tim [Show all 258 contributors for this article] (2022). Measurement invariance of six language versions of the post-traumatic stress disorder checklist for DSM-5 in civilians after traumatic brain injury. Scientific Reports. ISSN 2045-2322. 12(1), p. 1–15. doi: 10.1038/s41598-022-20170-2. Full text in Research Archive
• Cuevas-Østrem, Mathias; Wisborg, Torben; Røise, Olav & Jeppesen, Elisabeth (2022). Differences in time-critical interventions and radiological examinations between adult and older trauma patients: A national register-based study. Journal of Trauma and Acute Care Surgery. ISSN 2163-0755. 93(4), p. 503–512. doi: 10.1097/TA.0000000000003570. Full text in Research Archive
• Thomas, Ilias; Dickens, Alex M.; Posti, Jussi P.; Czeiter, Endre; Duberg, Daniel & Sinioja, Tim [Show all 255 contributors for this article] (2022). Serum metabolome associated with severity of acute traumatic brain injury. Nature Communications. ISSN 2041-1723. 13(1), p. 1–15. doi: 10.1038/s41467-022-30227-5. Full text in Research Archive
• van der Vlegel, Marjolein; Mikolić, Ana; Lee Hee, Quentin; Kaplan, Z.L. Rana; Retel Helmrich, Isabel R.A. & van Veen, Ernest [Show all 255 contributors for this article] (2022). Health care utilization and outcomes in older adults after Traumatic Brain Injury: A CENTER-TBI study. Injury. ISSN 0020-1383. 53(8), p. 2774–2782. doi: 10.1016/j.injury.2022.05.009. Full text in Research Archive Show summary

  Introduction The incidence of Traumatic Brain Injury (TBI) is increasingly common in older adults aged ≥65 years, forming a growing public health problem. However, older adults are underrepresented in TBI research. Therefore, we aimed to provide an overview of health-care utilization, and of six-month outcomes after TBI and their determinants in older adults who sustained a TBI. Methods We used data from the prospective multi-center Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. In-hospital and post-hospital health care utilization and outcomes were described for patients aged ≥65 years. Ordinal and linear regression analyses were performed to identify determinants of the Glasgow Outcome Scale Extended (GOSE), health-related quality of life (HRQoL), and mental health symptoms six-months post-injury. Results Of 1254 older patients, 45% were admitted to an ICU with a mean length of stay of 9 days. Nearly 30% of the patients received inpatient rehabilitation. In total, 554/1254 older patients completed the six-month follow-up questionnaires. The mortality rate was 9% after mild and 60% after moderate/severe TBI, and full recovery based on GOSE was reported for 44% of patients after mild and 6% after moderate/severe TBI. Higher age and increased injury severity were primarily associated with functional impairment, while pre-injury systemic disease, psychiatric conditions and lower educational level were associated with functional impairment, lower generic and disease-specific HRQoL and mental health symptoms. Conclusion The rate of impairment and disability following TBI in older adults is substantial, and poorer outcomes across domains are associated with worse preinjury health. Nonetheless, a considerable number of patients fully or partially returns to their preinjury functioning. There should not be pessimism about outcomes in older adults who survive.

• Eiding, Helge; Røise, Olav & Kongsgaard, Ulf (2022). Potentially Severe Incidents During Interhospital Transport of Critically Ill Patients, Frequently Occurring But Rarely Reported: A Prospective Study. Journal of patient safety. ISSN 1549-8417. 18(1), p. E315–E319. doi: 10.1097/PTS.0000000000000769. Full text in Research Archive
• Yuh, Esther; Jain, Sonia; Sun, Xiaoying; Pisică, Dana; Harris, Mark H. & Taylor, Sabrina R. [Show all 56 contributors for this article] (2021). Pathological Computed Tomography Features Associated With Adverse Outcomes After Mild Traumatic Brain Injury: A TRACK-TBI Study With External Validation in CENTER-TBI. JAMA Neurology. ISSN 2168-6149. 78(9), p. 1137–1148. doi: 10.1001/jamaneurol.2021.2120. Full text in Research Archive Show summary

  Importance A head computed tomography (CT) with positive results for acute intracranial hemorrhage is the gold-standard diagnostic biomarker for acute traumatic brain injury (TBI). In moderate to severe TBI (Glasgow Coma Scale [GCS] scores 3-12), some CT features have been shown to be associated with outcomes. In mild TBI (mTBI; GCS scores 13-15), distribution and co-occurrence of pathological CT features and their prognostic importance are not well understood. Objective To identify pathological CT features associated with adverse outcomes after mTBI. Design, Setting, and Participants The longitudinal, observational Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study enrolled patients with TBI, including those 17 years and older with GCS scores of 13 to 15 who presented to emergency departments at 18 US level 1 trauma centers between February 26, 2014, and August 8, 2018, and underwent head CT imaging within 24 hours of TBI. Evaluations of CT imaging used TBI Common Data Elements. Glasgow Outcome Scale–Extended (GOSE) scores were assessed at 2 weeks and 3, 6, and 12 months postinjury. External validation of results was performed via the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Data analyses were completed from February 2020 to February 2021. Exposures Acute nonpenetrating head trauma. Main Outcomes and Measures Frequency, co-occurrence, and clustering of CT features; incomplete recovery (GOSE scores <8 vs 8); and an unfavorable outcome (GOSE scores <5 vs ≥5) at 2 weeks and 3, 6, and 12 months. Results In 1935 patients with mTBI (mean [SD] age, 41.5 [17.6] years; 1286 men [66.5%]) in the TRACK-TBI cohort and 2594 patients with mTBI (mean [SD] age, 51.8 [20.3] years; 1658 men [63.9%]) in an external validation cohort, hierarchical cluster analysis identified 3 major clusters of CT features: contusion, subarachnoid hemorrhage, and/or subdural hematoma; intraventricular and/or petechial hemorrhage; and epidural hematoma. Contusion, subarachnoid hemorrhage, and/or subdural hematoma features were associated with incomplete recovery (odds ratios [ORs] for GOSE scores <8 at 1 year: TRACK-TBI, 1.80 [95% CI, 1.39-2.33]; CENTER-TBI, 2.73 [95% CI, 2.18-3.41]) and greater degrees of unfavorable outcomes (ORs for GOSE scores <5 at 1 year: TRACK-TBI, 3.23 [95% CI, 1.59-6.58]; CENTER-TBI, 1.68 [95% CI, 1.13-2.49]) out to 12 months after injury, but epidural hematoma was not. Intraventricular and/or petechial hemorrhage was associated with greater degrees of unfavorable outcomes up to 12 months after injury (eg, OR for GOSE scores <5 at 1 year in TRACK-TBI: 3.47 [95% CI, 1.66-7.26]). Some CT features were more strongly associated with outcomes than previously validated variables (eg, ORs for GOSE scores <5 at 1 year in TRACK-TBI: neuropsychiatric history, 1.43 [95% CI .98-2.10] vs contusion, subarachnoid hemorrhage, and/or subdural hematoma, 3.23 [95% CI 1.59-6.58]). Findings were externally validated in 2594 patients with mTBI enrolled in the CENTER-TBI study. Conclusions and Relevance In this study, pathological CT features carried different prognostic implications after mTBI to 1 year postinjury. Some patterns of injury were associated with worse outcomes than others. These results support that patients with mTBI and these CT features need TBI-specific education and systematic follow-up.

• Mikolic, Ana; Groeniger, Joost Oude; Zeldovich, Marina; Wilson, Lindsay; van Lennep, Jeanine Roeters & van Klaveren, David [Show all 51 contributors for this article] (2021). Explaining Outcome Differences between Men and Women following Mild Traumatic Brain Injury. Journal of Neurotrauma. ISSN 0897-7151. 38(23). doi: 10.1089/neu.2021.0116. Full text in Research Archive Show summary

  Men and women differ in outcomes following mild traumatic brain injury (TBI). In the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we previously found that women had worse 6-month functional outcome (Glasgow Outcome Score Extended [GOSE]), health-related quality of life (HRQoL), and mental health following mild TBI. The aim of this study was to investigate whether those differences were mediated by psychiatric history, gender-related sociodemographic variables, or by care pathways. We analyzed sex/gender differences in 6-month GOSE, generic and TBI-specific HRQoL, and post-concussion and mental health symptoms using three sets of mediators: psychiatric history, sociodemographic variables (living alone, living with children, education and employment status/job category), and care-pathways (referral to study hospital and discharge destination after emergency department); while controlling for a substantial number of potential confounders (pre-injury health and injury-related characteristics). We included 1842 men and 1022 women (16+) with a Glasgow Coma Score 13-15, among whom 83% had GOSE available and about 60% other 6-month outcomes. We used natural effects models to decompose the total effect of sex/gender on the outcomes into indirect effects that passed through the specified mediators and the remaining direct effects. In our study population, women had worse outcomes and these were only partly explained by psychiatric history, and not considerably explained by sociodemographic variables nor by care pathways. Factors other than differences in specified variables seem to underlie observed differences between men and women in outcomes after mild TBI. Future studies should explore more aspects of gender roles and identity and biological factors underpinning sex and gender differences in TBI outcomes.

• Riemann, Lennart; Voormolen, Daphne; Rauen, Katrin; Zweckberger, Klaus; Unterberg, Andreas & Younsi, Alexander [Show all 50 contributors for this article] (2021). Persistent postconcussive symptoms in children and adolescents with mild traumatic brain injury receiving initial head computed tomography. Journal of Neurosurgery: Pediatrics. ISSN 1933-0707. 27(5), p. 538–547. doi: 10.3171/2020.9.PEDS20421.
• Ceyisakar, Iris; Huijben, Jilske A.; Maas, Andrew I. R.; Lingsma, Hester F.; van Leeuwen, Nikki & Andelic, Nada [Show all 49 contributors for this article] (2021). Can We Cluster ICU Treatment Strategies for Traumatic Brain Injury by Hospital Treatment Preferences? Neurocritical Care. ISSN 1541-6933. 36(3), p. 846–856. doi: 10.1007/s12028-021-01386-y. Full text in Research Archive
• Huijben, Jilske A.; Dixit, Abhishek; Stocchetti, Nino; Maas, Andrew I. R.; Lingsma, Hester F. & van der Jagt, Mathieu [Show all 55 contributors for this article] (2021). Use and impact of high intensity treatments in patients with traumatic brain injury across Europe: a CENTER-TBI analysis. Critical Care. ISSN 1364-8535. 25(78). doi: 10.1186/s13054-020-03370-y. Full text in Research Archive
• Citerio, Giuseppe; Robba, Chiara; Rebora, Paola; Petrosino, Matteo; Rossi, elenora & Malgeri, L [Show all 53 contributors for this article] (2021). Management of arterial partial pressure of carbon dioxide in the frst week after traumatic brain injury: results from the CENTER-TBI study. Intensive Care Medicine. ISSN 0342-4642. 47, p. 961–973. doi: 10.1007/s00134-021-06470-7. Full text in Research Archive
• Horton, lindsay; Rhodes, Jonathan; Menon, David K.; Maas, Andrew I. R.; Wilson, Lindsay & Andelic, Nada [Show all 48 contributors for this article] (2021). Questionnaires vs Interviews for the Assessment of Global Functional Outcomes After Traumatic Brain Injury. JAMA Network Open. ISSN 2574-3805. 4(11). Full text in Research Archive
• Wiegers, E; Lingsma, Hester F.; Huijben, Jilske A.; Cooper, David James; Citerio, Giuseppe & Frisvold, Shirin [Show all 53 contributors for this article] (2021). Fluid balance and outcome in critically ill patients with traumatic brain injury (CENTER-TBI and OzENTER-TBI): a prospective, multicentre, comparative effectiveness study. Lancet Neurology. ISSN 1474-4422. 20(8), p. 627–638. doi: 10.1016/S1474-4422(21)00162-9.
• van Veen, Ernest; Van Der Jagt, Mathieu; Citerio, Giuseppe; Stocchetti, Nino; Gommers, Diederik & Burdorf, Alex [Show all 51 contributors for this article] (2021). Occurrence and timing of withdrawal of life-sustaining measures in traumatic brain injury patients: a CENTER-TBI study. Intensive Care Medicine. ISSN 0342-4642. 47, p. 1115–1129. doi: 10.1007/s00134-021-06484-1. Full text in Research Archive
• Gravesteijn, Benjamin; Sewalt, Charlie; Venema, Esmee; Nieboer, Daan; Steyerberg, Ewout W. & Andelic, Nada [Show all 49 contributors for this article] (2021). Missing Data in Prediction Research: A Five-Step Approach for Multiple Imputation, Illustrated in the CENTER-TBI Study. Journal of Neurotrauma. ISSN 0897-7151. 13(38), p. 1842–1857. doi: 10.1089/neu.2020.7218.
• Sewalt, Charlie; Gravesteijn, Benjamin; Menon, David; Lingsma, Hester F.; Maas, Andrew I. R. & Stocchetti, Nino [Show all 51 contributors for this article] (2021). Primary versus early secondary referral to a specialized neurotrauma center in patients with moderate/severe traumatic brain injury: a CENTER TBI study. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. ISSN 1757-7241. 29(1), p. 1–11. doi: 10.1186/s13049-021-00930-1. Full text in Research Archive
• Böhm, Julia K.; Schaeben, Victoria; Schäfer, Nadine; Güting, Helge; Lefering, Rolf & Thorn, Sophie [Show all 52 contributors for this article] (2021). Extended Coagulation Profiling in Isolated Traumatic Brain Injury: A CENTER-TBI Analysis. Neurocritical Care. ISSN 1541-6933. 36(3), p. 927–941. doi: 10.1007/s12028-021-01400-3. Full text in Research Archive Show summary

  Background Trauma-induced coagulopathy in traumatic brain injury (TBI) remains associated with high rates of complications, unfavorable outcomes, and mortality. The underlying mechanisms are largely unknown. Embedded in the prospective multinational Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, coagulation profiles beyond standard conventional coagulation assays were assessed in patients with isolated TBI within the very early hours of injury. Methods Results from blood samples (citrate/EDTA) obtained on hospital admission were matched with clinical and routine laboratory data of patients with TBI captured in the CENTER-TBI central database. To minimize confounding factors, patients with strictly isolated TBI (iTBI) (n = 88) were selected and stratified for coagulopathy by routine international normalized ratio (INR): (1) INR < 1.2 and (2) INR ≥ 1.2. An INR > 1.2 has been well adopted over time as a threshold to define trauma-related coagulopathy in general trauma populations. The following parameters were evaluated: quick’s value, activated partial thromboplastin time, fibrinogen, thrombin time, antithrombin, coagulation factor activity of factors V, VIII, IX, and XIII, protein C and S, plasminogen, D-dimer, fibrinolysis-regulating parameters (thrombin activatable fibrinolysis inhibitor, plasminogen activator inhibitor 1, antiplasmin), thrombin generation, and fibrin monomers. Results Patients with iTBI with INR ≥ 1.2 (n = 16) had a high incidence of progressive intracranial hemorrhage associated with increased mortality and unfavorable outcome compared with patients with INR < 1.2 (n = 72). Activity of coagulation factors V, VIII, IX, and XIII dropped on average by 15–20% between the groups whereas protein C and S levels dropped by 20%. With an elevated INR, thrombin generation decreased, as reflected by lower peak height and endogenous thrombin potential (ETP), whereas the amount of fibrin monomers increased. Plasminogen activity significantly decreased from 89% in patients with INR < 1.2 to 76% in patients with INR ≥ 1.2. Moreover, D-dimer levels significantly increased from a mean of 943 mg/L in patients with INR < 1.2 to 1,301 mg/L in patients with INR ≥ 1.2. Conclusions This more in-depth analysis beyond routine conventional coagulation assays suggests a counterbalanced regulation of coagulation and fibrinolysis in patients with iTBI with hemostatic abnormalities. We observed distinct patterns involving key pathways of the highly complex and dynamic coagulation system that offer windows of opportunity for further research. Whether the changes observed on factor levels may be relevant and explain the worse outcome or the more severe brain injuries by themselves remains speculative.

• Wang, Biyao; Zeldovich, Marina; Rauen, Katrin; Wu, Yi-Jhen; Covic, Amra & Muller, Isabelle [Show all 50 contributors for this article] (2021). Longitudinal analyses of the reciprocity of depression and anxiety after traumatic brain injury and its clinical implications. Journal of Clinical Medicine. ISSN 2077-0383. 10(23). doi: 10.3390/jcm10235597. Full text in Research Archive
• Stenehjem, Jo Steinson; Røise, Olav; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Show all 10 contributors for this article] (2021). Injury Prevention and long-term Outcomes following Trauma - The IPOT project: a protocol for prospective nationwide registry-based studies in Norway. BMJ Open. ISSN 2044-6055. 11(5). doi: 10.1136/bmjopen-2020-046954. Full text in Research Archive
• Finstad, Jeanette; Røise, Olav; Rosseland, Leiv Arne; Clausen, Thomas & Havnes, Ingrid Amalia (2021). Discharge from the trauma centre: exposure to opioids, unmet information needs and lack of follow up—a qualitative study among physical trauma survivors. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. ISSN 1757-7241. 29(1), p. 1–12. doi: 10.1186/s13049-021-00938-7. Full text in Research Archive
• Andelic, Nada; Røe, Cecilie; Tenovuo, Olli; Azouvi, Philippe; Dawes, Helen & Majdan, Marek [Show all 56 contributors for this article] (2021). Unmet Rehabilitation Needs after Traumatic Brain Injury across Europe: Results from the CENTER-TBI Study. Journal of Clinical Medicine. ISSN 2077-0383. 10(5). doi: 10.3390/jcm10051035. Full text in Research Archive
• Horn, Joachim; Rasmussen, Hanne; Bukholm, Ida Rashida Khan; Røise, Olav & Terjesen, Terje (2021). Compensation claims in pediatric orthopedics in Norway between 2012 and 2018: a nationwide study of 487 patients. Acta Orthopaedica. ISSN 1745-3674. 92(5), p. 615–620. doi: 10.1080/17453674.2021.1932922. Full text in Research Archive
• Søberg, Helene Lundgaard; Moksnes, Håkon Øgreid; Anke, Audny; Røise, Olav; Røe, Ellen-Cecilie Treu & Aas, Eline [Show all 20 contributors for this article] (2021). Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study. JMIR Research Protocols. ISSN 1929-0748. 10(4), p. 1–10. doi: 10.2196/25980. Full text in Research Archive
• Borgen, Ida Maria Henriksen; Røe, Cecilie; Brunborg, Cathrine; Tenovuo, Olli; Azouvi, Philippe & Dawes, Helen [Show all 50 contributors for this article] (2021). Care transitions in the first 6 months following traumatic brain injury: Lessons from the CENTER-TBI study. Annals of Physical and Rehabilitation Medicine. ISSN 1877-0657. 64(6). doi: 10.1016/j.rehab.2020.10.009. Full text in Research Archive Show summary

  Background: No large international studies have investigated care transitions during or after acute hospitalisations for traumatic brain injury (TBI). Objectives: To characterise various TBI-care pathways and the number of associated transitions during the first 6 months after TBI and to assess the impact of these on functional TBI outcome controlled for demographic and injury-related factors. Methods: This was a cohort study of patients with TBI admitted to various trauma centres enrolled in the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study. Number of transitions and specific care pathways were identified. Multiple logistic regression analyses were used to assess the impact of number of transitions and care pathways on functional outcome at 6 months post-injury as assessed by the Glasgow Outcome Scale-Extended (GOSE). Results: In total, 3133 patients survived the acute TBI-care pathway and had at least one documented in-hospital transition at 6-month follow-up. The median number of transitions was 3 (interquartile range 2-3). The number of transitions did not predict functional outcome at 6 months (odds ratio 1.08, 95% confidence interval 1.09-1.18; p = 0.063). A total of 378 different care pathways were identified; 8 were identical for at least 100 patients and characterized as "common pathways". Five of these common care pathways predicted better functional outcomes at 6 months, and the remaining 3 pathways were unrelated to outcome. In both models, increased age, violence as the cause of injury, pre-injury presence of systemic disease, both intracranial and overall injury severity, and regions of Southern/Eastern Europe were associated with unfavourable functional outcomes at 6 months. Conclusions: A high number of different and complex care pathways was found for patients with TBI, particularly those with severe injuries. This high number and variety of care pathway possibilities indicates a need for standardisation and development of "common data elements for TBI care pathways" for future studies.

• van Veen, Ernest; van der Jagt, Mathieu; Citerio, Guiseppe; Stocchetti, Nino; Epker, Jelle & Gommers, Diederik [Show all 50 contributors for this article] (2020). End-of-life practices in traumatic brain injury patients: Report of a questionnaire from the CENTER-TBI study. Journal of critical care. ISSN 0883-9441. 58, p. 78–88. doi: 10.1016/j.jcrc.2020.04.001. Full text in Research Archive
• Timmers, Marjolein; van Dijck, Jeroen T. J. M.; van Wijk, Roel P J; Legrand, Valerie; van Veen, Ernest & Maas, Andrew I.R. [Show all 50 contributors for this article] (2020). How do 66 European institutional review boards approve one protocol for an international prospective observational study on traumatic brain injury? Experiences from the CENTER-TBI study. BMC Medical Ethics. ISSN 1472-6939. 21:36(1). doi: 10.1186/s12910-020-00480-8. Full text in Research Archive
• Mikolic, Ana; van Klaveren, David; Oude Groeniger, Joost; Wiegers, E; Lingsma, Hester F & Zeldovich, Marina [Show all 50 contributors for this article] (2020). Differences between Men and Women in Treatment and Outcome after Traumatic Brain Injury. Journal of Neurotrauma. ISSN 0897-7151. 38(2), p. 235–251. doi: 10.1089/neu.2020.7228. Full text in Research Archive
• Mikolic, Ana; Polinder, Suzanne; Steyerberg, Ewout W; Retel Helmrich, Isabel; Giacino, Joseph T. & Maas, Andrew I.R. [Show all 51 contributors for this article] (2020). Prediction of Global Functional Outcome and Post-Concussive Symptoms after Mild Traumatic Brain Injury: External Validation of Prognostic Models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study. Journal of Neurotrauma. ISSN 0897-7151. 38(2), p. 196–209. doi: 10.1089/neu.2020.7074. Full text in Research Archive
• Mathieu, Francois; Güting, Helge; Gravesteijn, Benjamin; Monteiro, Miguel; Glocker, Ben & Kornaropoulos, Evgenios [Show all 51 contributors for this article] (2020). Impact of Antithrombotic Agents on Radiological Lesion Progression in Acute Traumatic Brain Injury: A CENTER-TBI Propensity-Matched Cohort Analysis. Journal of Neurotrauma. ISSN 0897-7151. 37(19), p. 2069–2080. doi: 10.1089/neu.2019.6911.
• Gravesteijn, BY; Sewalt, Charlie; Stocchetti, Nino; Citerio, Giuseppe; Ercole, Ari & Lingsma, Hester F [Show all 54 contributors for this article] (2020). Prehospital Management of Traumatic Brain Injury across Europe: A CENTER-TBI Study. Prehospital Emergency Care. ISSN 1090-3127. doi: 10.1080/10903127.2020.1817210. Full text in Research Archive
• Dijkland, Simone; Retel Helmrich, Isabel; Nieboer, Daan; van der Jagt, Mathieu; Dippel, Diederik W.J. & Menon, David K [Show all 50 contributors for this article] (2020). Outcome Prediction after Moderate and Severe Traumatic Brain Injury: External Validation of Two Established Prognostic Models in 1742 European Patients. Journal of Neurotrauma. ISSN 0897-7151. doi: 10.1089/neu.2020.7300.
• Vande Vyvere, Thijs; De La Rosa, Ezequiel; Wilms, Guido; Nieboer, Daan; Steyerberg, Ewout & Maas, Andrew I.R. [Show all 51 contributors for this article] (2020). Prognostic Validation of the NINDS Common Data Elements for the Radiologic Reporting of Acute Traumatic Brain Injuries: A CENTER-TBI Study. Journal of Neurotrauma. ISSN 0897-7151. 37(11), p. 1269–1282. doi: 10.1089/neu.2019.6710.
• Huijbers, Jilske; Wiegers, E; Lingsma, Hester F; Citerio, Giuseppe; Maas, Andrew I.R. & Menon, David K [Show all 51 contributors for this article] (2020). Changing care pathways and between-center practice variations in intensive care for traumatic brain injury across Europe: a CENTER-TBI analysis. Intensive Care Medicine. ISSN 0342-4642. 46(5), p. 995–1004. doi: 10.1007/s00134-020-05965-z. Full text in Research Archive Show summary

  Purpose: To describe ICU stay, selected management aspects, and outcome of Intensive Care Unit (ICU) patients with traumatic brain injury (TBI) in Europe, and to quantify variation across centers. Methods: This is a prospective observational multicenter study conducted across 18 countries in Europe and Israel. Admission characteristics, clinical data, and outcome were described at patient- and center levels. Between-center variation in the total ICU population was quantified with the median odds ratio (MOR), with correction for case-mix and random variation between centers. Results: A total of 2138 patients were admitted to the ICU, with median age of 49 years; 36% of which were mild TBI (Glasgow Coma Scale; GCS 13–15). Within, 72 h 636 (30%) were discharged and 128 (6%) died. Early deaths and long-stay patients (> 72 h) had more severe injuries based on the GCS and neuroimaging characteristics, compared with short-stay patients. Long-stay patients received more monitoring and were treated at higher intensity, and experienced worse 6-month outcome compared to short-stay patients. Between-center variations were prominent in the proportion of short-stay patients (MOR = 2.3, p < 0.001), use of intracranial pressure (ICP) monitoring (MOR = 2.5, p < 0.001) and aggressive treatments (MOR = 2.9, p < 0.001); and smaller in 6-month outcome (MOR = 1.2, p = 0.01). Conclusions: Half of contemporary TBI patients at the ICU have mild to moderate head injury. Substantial between-center variations exist in ICU stay and treatment policies, and less so in outcome. It remains unclear whether admission of short-stay patients represents appropriate prudence or inappropriate use of clinical resources.

• Czeiter, Endre; Amrein, Krisztina; Gravesteijn, BY; Lecky, Fiona; Menon, David K & Mondello, Stefania [Show all 50 contributors for this article] (2020). Blood biomarkers on admission in acute traumatic brain injury: Relations to severity, CT findings and care path in the CENTER-TBI study. EBioMedicine. ISSN 2352-3964. 56. doi: 10.1016/j.ebiom.2020.102785. Full text in Research Archive Show summary

  Background: Serum biomarkers may inform and improve care in traumatic brain injury (TBI). We aimed to correlate serum biomarkers with clinical severity, care path and imaging abnormalities in TBI, and explore their incremental value over clinical characteristics in predicting computed tomographic (CT) abnormalities. Methods: We analyzed six serum biomarkers (S100B, NSE, GFAP, UCH-L1, NFL and t-tau) obtained <24 h post-injury from 2867 patients with any severity of TBI in the Collaborative European NeuroTrauma Effectiveness Research (CENTER-TBI) Core Study, a prospective, multicenter, cohort study. Univariable and multivariable logistic regression analyses were performed. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC) with 95% confidence intervals. Findings: All biomarkers scaled with clinical severity and care path (ER only, ward admission, or ICU), and with presence of CT abnormalities. GFAP achieved the highest discrimination for predicting CT abnormalities (AUC 0•89 [95%CI: 0•87-0•90]), with a 99% likelihood of better discriminating CT-positive patients than clinical characteristics used in contemporary decision rules. In patients with mild TBI, GFAP also showed incremental diagnostic value: discrimination increased from 0•84 [95%CI: 0•83-0•86] to 0•89 [95%CI: 0•87-0•90] when GFAP was included. Results were consistent across strata, and injury severity. Combinations of biomarkers did not improve discrimination compared to GFAP alone. Interpretation: Currently available biomarkers reflect injury severity, and serum GFAP, measured within 24 h after injury, outperforms clinical characteristics in predicting CT abnormalities. Our results support the further development of serum GFAP assays towards implementation in clinical practice, for which robust clinical assay platforms are required.

• van Wijk, Roel P J; van Dijck, Jeroen T. J. M.; Timmers, Marjolein; van Veen, Ernest; Citerio, Giuseppe & Lingsma, Hester F [Show all 50 contributors for this article] (2020). Informed consent procedures in patients with an acute inability to provide informed consent: Policy and practice in the CENTER-TBI study. Journal of critical care. ISSN 0883-9441. 59(15), p. 6–15. doi: 10.1016/j.jcrc.2020.05.004. Show summary

  Purpose: Enrolling traumatic brain injury (TBI) patients with an inability to provide informed consent in research is challenging. Alternatives to patient consent are not sufficiently embedded in European and national legislation, which allows procedural variation and bias. We aimed to quantify variations in informed consent policy and practice. Methods: Variation was explored in the CENTER-TBI study. Policies were reported by using a questionnaire and national legislation. Data on used informed consent procedures were available for 4498 patients from 57 centres across 17 European countries. Results: Variation in the use of informed consent procedures was found between and within EU member states. Proxy informed consent (N = 1377;64%) was the most frequently used type of consent in the ICU, followed by patient informed consent (N = 426;20%) and deferred consent (N = 334;16%). Deferred consent was only actively used in 15 centres (26%), although it was considered valid in 47 centres (82%). Conclusions: Alternatives to patient consent are essential for TBI research. While there seems to be concordance amongst national legislations, there is regional variability in institutional practices with respect to the use of different informed consent procedures. Variation could be caused by several reasons, including inconsistencies in clear legislation or knowledge of such legislation amongst researchers.

• Riemann, Lennart; Zweckberger, Klaus; Unterberg, Andreas; El Damaty,, Ahmed; Younsi, Alexander & Andelic, Nada [Show all 50 contributors for this article] (2020). Injury Causes and Severity in Pediatric Traumatic Brain Injury Patients Admitted to the Ward or Intensive Care Unit: A Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study. Frontiers in Neurology. ISSN 1664-2295. 11. doi: 10.3389/fneur.2020.00345. Full text in Research Archive Show summary

  Background: Traumatic brain injury (TBI) is the leading cause of death and disability in children. It includes a range of different pathologies that differ considerably from adult TBI. Analyzing and understanding injury patterns of pediatric TBI is essential to establishing new preventive efforts as well as to improve clinical management. Methods: The multi-center, prospectively collected CENTER-TBI core and registry databases were screened and patients were included when younger than 18 years at enrollment and admitted to the regular ward (admission stratum) or intensive care unit (ICU stratum) following TBI. Patient demographics, injury causes, clinical findings, brain CT imaging details, and outcome (GOSE at 6 months follow-up) were retrieved and analyzed. Injury characteristics were compared between patients admitted to the regular ward and ICU and multivariate analysis of factors predicting an unfavorable outcome (GOSE 1-4) was performed. Results from the core study were compared to the registry dataset which includes larger patient numbers but no follow-up data. Results: Two hundred and twenty seven patients in the core dataset and 687 patients in the registry dataset were included in this study. In the core dataset, road-traffic incidents were the most common cause of injury overall and in the ICU stratum, while incidental falls were most common in the admission stratum. Brain injury was considered serious to severe in the majority of patients and concurrent injuries in other body parts were very common. Intracranial abnormalities were detected in 60% of initial brain CTs. Intra- and extracranial surgical interventions were performed in one-fifth of patients. The overall mortality rate was 3% and the rate of unfavorable outcome 10%, with those numbers being considerably higher among ICU patients. GCS and the occurrence of secondary insults could be identified as independent predictors for an unfavorable outcome. Injury characteristics from the core study could be confirmed in the registry dataset. Conclusion: Our study displays the most common injury causes and characteristics of pediatric TBI patients that are treated in the regular ward or ICU in Europe. Road-traffic incidents were especially common in ICU patients, indicating that preventive efforts could be effective in decreasing the incidence of severe TBI in children.

• Wilson, Lindsay; Horton, Lindsay; Kunzmann, Kevin; Sahakian, Barbara J.; Newcombe, Virginia & Stamatakis, E [Show all 50 contributors for this article] (2020). Understanding the relationship between cognitive performance and function in daily life after traumatic brain injury . Journal of Neurology, Neurosurgery and Psychiatry. ISSN 0022-3050. doi: 10.1136/jnnp-2020-324492. Full text in Research Archive Show summary

  Objective: Cognitive impairment is a key cause of disability after traumatic brain injury (TBI) but relationships with overall functioning in daily life are often modest. The aim is to examine cognition at different levels of function and identify domains associated with disability. Methods: 1554 patients with mild-to-severe TBI were assessed at 6 months post injury on the Glasgow Outcome Scale—Extended (GOSE), the Short Form-12v2 and a battery of cognitive tests. Outcomes across GOSE categories were compared using analysis of covariance adjusting for age, sex and education. Results: Overall effect sizes were small to medium, and greatest for tests involving processing speed (ηp2 0.057–0.067) and learning and memory (ηp2 0.048–0.052). Deficits in cognitive performance were particularly evident in patients who were dependent (GOSE 3 or 4) or who were unable to participate in one or more major life activities (GOSE 5). At higher levels of function (GOSE 6–8), cognitive performance was surprisingly similar across categories. There were decreases in performance even in patients reporting complete recovery without significant symptoms. Medium to large effect sizes were present for summary measures of cognition (ηp2 0.111), mental health (ηp2 0.131) and physical health (ηp2 0.252). Conclusions: This large-scale study provides novel insights into cognitive performance at different levels of disability and highlights the importance of processing speed in function in daily life. At upper levels of outcome, any influence of cognition on overall function is markedly attenuated and differences in mental health are salient.

• Böhm, JK; Güting, Helge; Thorn, S; Schäfer, Nadine; Rambach, V & Schöchl, Herbert [Show all 50 contributors for this article] (2020). Global Characterisation of Coagulopathy in Isolated Traumatic Brain Injury (iTBI): A CENTER-TBI Analysis. Neurocritical Care. ISSN 1541-6933. doi: 10.1007/s12028-020-01151-7. Full text in Research Archive Show summary

  Background: Trauma-induced coagulopathy in patients with traumatic brain injury (TBI) is associated with high rates of complications, unfavourable outcomes and mortality. The mechanism of the development of TBI-associated coagulopathy is poorly understood. Methods: This analysis, embedded in the prospective, multi-centred, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, aimed to characterise the coagulopathy of TBI. Emphasis was placed on the acute phase following TBI, primary on subgroups of patients with abnormal coagulation profile within 4 h of admission, and the impact of pre-injury anticoagulant and/or antiplatelet therapy. In order to minimise confounding factors, patients with isolated TBI (iTBI) (n = 598) were selected for this analysis. Results: Haemostatic disorders were observed in approximately 20% of iTBI patients. In a subgroup analysis, patients with pre-injury anticoagulant and/or antiplatelet therapy had a twice exacerbated coagulation profile as likely as those without premedication. This was in turn associated with increased rates of mortality and unfavourable outcome post-injury. A multivariate analysis of iTBI patients without pre-injury anticoagulant therapy identified several independent risk factors for coagulopathy which were present at hospital admission. Glasgow Coma Scale (GCS) less than or equal to 8, base excess (BE) less than or equal to − 6, hypothermia and hypotension increased risk significantly. Conclusion: Consideration of these factors enables early prediction and risk stratification of acute coagulopathy after TBI, thus guiding clinical management.

• Glette, Malin Knutsen; Kringeland, Tone Åslaug; Røise, Olav & Wiig, Siri (2020). Would you be interested in participating in a study about hospital readmissions…? Experiences with methodological strategies and techniques for recruiting GPs to participate in qualitative research. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 6(2), p. 178–183. doi: 10.18261/issn.2387-5984-2020-02-14. Full text in Research Archive
• Cuevas-Østrem, Mathias; Røise, Olav; Wisborg, Torben & Jeppesen, Elisabeth (2020). Epidemiology of geriatric trauma patients in Norway: A nationwide analysis of Norwegian Trauma Registry data, 2015-2018. A retrospective cohort study. Injury. ISSN 0020-1383. doi: 10.1016/j.injury.2020.11.007. Full text in Research Archive
• Skansaar, Ola Fougner; Tverdal, Cathrine Buaas; Rønning, Pål André; Skogen, Karoline; Brommeland, Tor & Røise, Olav [Show all 9 contributors for this article] (2020). Traumatic brain injury—the effects of patient age on treatment intensity and mortality. BMC Neurology. ISSN 1471-2377. 20:376, p. 1–10. doi: 10.1186/s12883-020-01943-6. Full text in Research Archive
• Aase, Karina; Guise, Veslemøy; Billett, Stephen; Sollid, Stephen J. M.; Njå, Ove & Røise, Olav [Show all 9 contributors for this article] (2020). Resilience in healthcare (RiH): a longitudinal research programme protocol. BMJ Open. ISSN 2044-6055. 10(10). doi: 10.1136/bmjopen-2020-038779. Full text in Research Archive
• Robba, Chiara; Rebora, Paola; Banzato, Erika; Wiegers, E; Stocchetti, Nino & Menon, David [Show all 50 contributors for this article] (2020). Incidence, Risk Factors, and Effects on Outcome of Ventilator-Associated Pneumonia in Patients With Traumatic Brain Injury: Analysis of a Large, Multicenter, Prospective, Observational Longitudinal Study . Chest. ISSN 0012-3692. 158(6), p. 2292–2303. doi: 10.1016/j.chest.2020.06.064.
• Huie, Russel J; Mondello, Stefania; Lindsell, Christopher J.; Antiga, L; Yuh, Esther & Zanier, Elisa [Show all 50 contributors for this article] (2020). Biomarkers for Traumatic Brain Injury: Data Standards and Statistical Considerations . Journal of Neurotrauma. ISSN 0897-7151. 38(18), p. 2514–2529. doi: 10.1089/neu.2019.6762. Show summary

  Recent biomarker innovations hold potential for transforming diagnosis, prognostic modeling, and precision therapeutic targeting of traumatic brain injury (TBI). However, many biomarkers, including brain imaging, genomics, and proteomics, involve vast quantities of high-throughput and high-content data. Management, curation, analysis, and evidence synthesis of these data are not trivial tasks. In this review, we discuss data management concepts and statistical and data sharing strategies when dealing with biomarker data in the context of TBI research. We propose that application of biomarkers involves three distinct steps—discovery, evaluation, and evidence synthesis. First, complex/big data has to be reduced to useful data elements at the stage of biomarker discovery. Second, inferential statistical approaches must be applied to these biomarker data elements for assessment of biomarker clinical utility and validity. Last, synthesis of relevant research is required to support practice guidelines and enable health decisions informed by the highest quality, up-to-date evidence available. We focus our discussion around recent experiences from the International Traumatic Brain Injury Research (InTBIR) initiative, with a specific focus on four major clinical projects (Transforming Research and Clinical Knowledge in TBI, Collaborative European NeuroTrauma Effectiveness Research in TBI, Collaborative Research on Acute Traumatic Brain Injury in Intensive Care Medicine in Europe, and Approaches and Decisions in Acute Pediatric TBI Trial), which are currently enrolling subjects in North America and Europe. We discuss common data elements, data collection efforts, data-sharing opportunities, and challenges, as well as examine the statistical techniques required to realize successful adoption and use of biomarkers in the clinic as a foundation for precision medicine in TBI.

• Gravesteijn, BY; Nieboer, Daan; Ercole, Ari; Lingsma, Hester F; Nelson, David & Van Calster, Ben [Show all 50 contributors for this article] (2020). Machine learning algorithms performed no better than regression models for prognostication in traumatic brain injury. Journal of Clinical Epidemiology. ISSN 0895-4356. 122, p. 95–107. doi: 10.1016/j.jclinepi.2020.03.005. Full text in Research Archive
• Feng, Junfeng; van Veen, Ernest; Chun, Yang; Huijben, Jilske A.; Lingsma, Hester F & Gao, Guoyi [Show all 50 contributors for this article] (2020). Comparison of Care System and Treatment Approaches for Patients with Traumatic Brain Injury in China versus Europe: A CENTER-TBI Survey Study . Journal of Neurotrauma. ISSN 0897-7151. 37, p. 1806–1817. doi: 10.1089/neu.2019.6900.
• Huijben, Jilske A.; Wiegers, E; Ercole, Ari; de Keizer, Nicolette; Maas, Andrew I. R. & Steyerberg, Ewout W. [Show all 50 contributors for this article] (2020). Quality indicators for patients with traumatic brain injury in European intensive care units: a CENTER-TBI study . Critical Care. ISSN 1364-8535. doi: 10.1186/s13054-020-2791-0. Full text in Research Archive
• Robba, Chiara; Galimberti, Stefania; Graziano, Francesca; Wiegers, E; Lingsma, Hester F & Iaquaniello, Carolina [Show all 50 contributors for this article] (2020). Tracheostomy practice and timing in traumatic brain-injured patients: a CENTER-TBI study . Intensive Care Medicine. ISSN 0342-4642. 46, p. 983–994. doi: 10.1007/s00134-020-05935-5.
• Gravesteijn, BY; Sewalt, Charlie; Ercole, Ari; Akerlund, Cecilia; Nelson, David & Maas, Andrew IR [Show all 50 contributors for this article] (2020). Toward a New Multi-Dimensional Classification of Traumatic Brain Injury: A Collaborative European NeuroTrauma Effectiveness Research for Traumatic Brain Injury Study . Journal of Neurotrauma. ISSN 0897-7151. 37(7). doi: 10.1089/neu.2019.6764.
• Gravesteijn, BY; Sewalt, Charlie; Nieboer, D.; Menon, David K.; Maas, Andrew I. R. & Lecky, Fiona E. [Show all 50 contributors for this article] (2020). Tracheal intubation in traumatic brain injury: a multicentre prospective observational study . British Journal of Anaesthesia. ISSN 0007-0912. 125(4), p. 505–517. doi: 10.1016/j.bja.2020.05.067. Full text in Research Archive Show summary

  Background: We aimed to study the associations between pre- and in-hospital tracheal intubation and outcomes in traumatic brain injury (TBI), and whether the association varied according to injury severity. Methods: Data from the international prospective pan-European cohort study, Collaborative European NeuroTrauma Effectiveness Research for TBI (CENTER-TBI), were used (n=4509). For prehospital intubation, we excluded self-presenters. For in-hospital intubation, patients whose tracheas were intubated on-scene were excluded. The association between intubation and outcome was analysed with ordinal regression with adjustment for the International Mission for Prognosis and Analysis of Clinical Trials in TBI variables and extracranial injury. We assessed whether the effect of intubation varied by injury severity by testing the added value of an interaction term with likelihood ratio tests. Results: In the prehospital analysis, 890/3736 (24%) patients had their tracheas intubated at scene. In the in-hospital analysis, 460/2930 (16%) patients had their tracheas intubated in the emergency department. There was no adjusted overall effect on functional outcome of prehospital intubation (odds ratio=1.01; 95% confidence interval, 0.79–1.28; P=0.96), and the adjusted overall effect of in-hospital intubation was not significant (odds ratio=0.86; 95% confidence interval, 0.65–1.13; P=0.28). However, prehospital intubation was associated with better functional outcome in patients with higher thorax and abdominal Abbreviated Injury Scale scores (P=0.009 and P=0.02, respectively), whereas in-hospital intubation was associated with better outcome in patients with lower Glasgow Coma Scale scores (P=0.01): in-hospital intubation was associated with better functional outcome in patients with Glasgow Coma Scale scores of 10 or lower. Conclusion: The benefits and harms of tracheal intubation should be carefully evaluated in patients with TBI to optimise benefit. This study suggests that extracranial injury should influence the decision in the prehospital setting, and level of consciousness in the in-hospital setting.

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• Uleberg, Oddvar; Majeed, Waleed Mohammed; Hoås, Einar Frigstad & Røise, Olav (2023). Compliance to national trauma triage criteria in Norway - a cross-sectional study.
• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2023). Exploring managers` role in resilient healthcare during the COVID-19 pandemic in Norwegian homecare services. A- multiple embedded case study.
• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2023). The role of local context for managers` strategies when adapting to the COVID-19 pandemic. Managerial strategies across system levels in Norwegian homecare services.
• Nortvedt, Per; Røise, Olav; Rostoft, Siri & Pedersen, Reidar (2022). Man bryr seg mindre jo mer man gjør det. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 142(18), p. 1538–1538. doi: 10.4045/tidsskr.22.0667.
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• Dahlhaug, Marianne; Uleberg, Oddvar & Røise, Olav (2022). Bruk av pasientrapporterte data fra Nasjonalt Traumeregister.
• Rasmussen, Anders; Stenehjem, Jo Steinson; Røise, Olav; Gran, Jon Michael; Kristiansen, Thomas & Uleberg, Oddvar [Show all 8 contributors for this article] (2022). Standardised mortality rates for non-traumatic deaths among survivors of trauma in Norway (2015-2018).
• Uleberg, Oddvar; Naberezhneva, Natalia; Dahlhaug, Marianne; Giil-Jensen, Vigdis; Ringdal, Kjetil G. & Røise, Olav (2022). Excellent agreement of Norwegian Trauma Registry data compared to corresponding data in electronic patient records.
• Andersen, Nina Gjerde; Dahlhaug, Marianne; Røise, Olav; Nordseth, Trond; Rosseland, Leiv Arne & Uleberg, Oddvar (2022). Patient reported outcomes from the Norwegian Trauma Registry.
• Cuevas-Østrem, Mathias; Wisborg, Torben; Røise, Olav & Jeppesen, Elisabeth (2022). Older trauma patients are less likely to receive advanced prehospital care: A study from the Norwegian Trauma Registry.
• Seljemo, Camilla; Wiig, Siri; Røise, Olav & Ree, Eline (2022). The role of local context for managers` experiences and strategies applied when adapting to the COVID-19 pandemic in Norwegian homecare services - A multiple case study in four Norwegian municipalities.
• Uleberg, Oddvar; Kristiansen, Thomas; Nordseth, Trond; Stenehjem, Jo S.; Gran, Jon Michael & Clausen, Thomas [Show all 8 contributors for this article] (2022). Skader etter vold og ulykker - den glemte pandemi? Tidsskrift for Den norske legeforening. ISSN 0029-2001. 142(8), p. 678–679. doi: 10.4045/tidsskr.22.0261.
• Søberg, Helene L.; Moksnes, Håkon Øgreid; Anke, Audny Gabriele Wagner; Røise, Olav; Røe, Cecilie & Aas, Eline [Show all 20 contributors for this article] (2022). Erratum: Rehabilitation Needs, Service Provision, and Costs in the First Year following Traumatic Injuries: Protocol for a Prospective Cohort Study ((JMIR Res Protoc (2021) 10: 4 (e25980) DOI: 10.2196/25980). JMIR Research Protocols. ISSN 1929-0748. 11(3). doi: 10.2196/37723.
• Glette, Malin Knutsen; Kringeland, Tone Åslaug; Røise, Olav & Wiig, Siri (2022). Helsepersonells erfaringer med reinnleggelser fra primærhelsetjenesten – en oppsummering av en casestudie. Tidsskrift for omsorgsforskning. ISSN 2387-5976. p. 1–10. doi: 10.18261/tfo.8.1.4.
• Uleberg, Oddvar; Stenehjem, Jo S.; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Show all 12 contributors for this article] (2022). The injury prevention and outcomes following trauma (IPOT) project: is a nationwide registry-based study in Norway feasible?
• Cuevas-Østrem, Mathias; Røise, Olav; Wisborg, Torben & Jeppesen, Elisabeth (2021). Røntgenundersøkelser av bekkenet hos eldre traumepasienter. En studie fra Nasjonalt Traumeregister.
• Cuevas-Østrem, Mathias; Wisborg, Torben; Røise, Olav & Jeppesen, Elisabeth (2021). Geriatric trauma patients are less likely to receive advanced prehospital care. A study from the Norwegian Trauma Registry.
• Stenehjem, Jo S.; Røise, Olav; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Show all 12 contributors for this article] (2021). Injury Prevention and long-term Outcomes following Trauma - the IPOT project: a protocol for prospective nationwide registry-based studies in Norway.
• Rosseland, Leiv Arne; Stenehjem, Jo S.; Nordseth, Trond; Clausen, Thomas; Natvig, Bård & Skurtveit, Svetlana Ondrasova [Show all 12 contributors for this article] (2021). The Injury Prevention and Outcomes following Trauma project: a prospective nationwide registry-based study in Norway.
• Nordseth, Trond; Stenehjem, Jo S.; Uleberg, Oddvar; Røise, Olav & Rosseland, Leiv Arne (2021). The Injury Prevention and Outcomes after Trauma project: differences in survival between health trusts.
• Andelic, Nada; Røe, Cecilie; Brunborg, Cathrine; Zeldovich, Marina; Løvstad, Marianne & Løke, Daniel [Show all 19 contributors for this article] (2020). Correction to: Frequency of fatigue and its changes in the first 6 months after traumatic brain injury: results from the CENTER-TBI study (Journal of Neurology, (2020), 10.1007/s00415-020-10022-2). Journal of Neurology. ISSN 0340-5354. 268, p. 74–76. doi: 10.1007/s00415-020-10174-1.
• Glette, Malin Knutsen; Wiig, Siri; Røise, Olav & Kringeland, Tone Åslaug (2020). Exploring hospital readmissions from the primary healthcare service - A multiple Case Study. Universitetet i Stavanger. ISSN 978-82-7644-932-7.

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