{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:56:44Z","timestamp":1790197004871,"version":"4.1.0"},"reference-count":32,"publisher":"SAGE Publications","issue":"11-12","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n                    Traumatic brain injury (TBI) is a leading global cause of morbidity and mortality. Intracranial hypertension following moderate-to-severe TBI (m-sTBI) is a potentially modifiable secondary cerebral insult and one of the central therapeutic targets of contemporary neurocritical care. External ventricular drain (EVD) insertion is a common therapeutic intervention used to control intracranial hypertension and attenuate secondary brain injury. However, the optimal timing of EVD insertion in the setting of m-sTBI is uncertain and practice variation is widespread. Therefore, we aimed to assess if there is an association between timing of EVD placement and functional neurological outcome at 6 months post m-sTBI. We pooled individual patient data for all relevant harmonizable variables from the Erythropoietin in Traumatic Brain Injury (EPO-TBI) and Prophylactic Hypothermia Trial to Lessen Traumatic Brain Injury (POLAR) randomized control trials, and the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) Core Study version 3.0 and Australia-Europe NeuroTrauma Effectiveness Research in TBI (Oz-ENTER) prospective observational studies to create a combined dataset. The Glasgow Coma Scale (GCS) score was used to define TBI severity and we included all patients admitted to an intensive care unit with a GCS \u226412, who were 15 years or older and underwent EVD placement within 7 days of injury. We used hierarchical multi-variable logistic regression models to study the association between EVD insertion within 24\u2009h of injury (early) compared with EVD insertion more than 24\u2009h after injury (late) and 6-month functional neurological outcome measured using the Glasgow Outcome Score Extended (GOSE). In total, 2536 patients were assessed. Of these, 502 (20%) underwent early EVD insertion and 145 (6%) underwent late EVD insertion. Following adjustment for the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials in TBI) score extended (Core + CT), sex, injury severity score, study and treatment site, patients receiving a late EVD had higher odds of death or severe disability (GOSE 1-4) at 6 months follow-up than those receiving an early EVD adjusted odds ratio; 95% confidence interval, 2.14; 1.22-3.76;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.008. Our study suggests that in patients with m-sTBI where an EVD is needed, early (\u2264 24\u2009h post-injury) insertion may result in better long-term functional outcomes. This finding supports future prospective investigation in this area.\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0493","type":"journal-article","created":{"date-parts":[[2024,1,27]],"date-time":"2024-01-27T07:46:55Z","timestamp":1706341615000},"page":"1364-1374","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Association Between Early External Ventricular Drain Insertion and Functional Outcomes 6 Months Following Moderate-to-Severe Traumatic Brain Injury"],"prefix":"10.1177","volume":"41","author":[{"given":"Jonathon D.","family":"Taylor","sequence":"first","affiliation":[{"name":"Department of Critical Care Medicine, Auckland City Hospital, Grafton, Auckland, New Zealand."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Bailey","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Center, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. James","family":"Cooper","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Center, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia."},{"name":"The Alfred, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig","family":"French","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Center, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia."},{"name":"Western Health, Melbourne, Victoria, Australia."},{"name":"Department of Intensive Care, University of Melbourne, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Menon","sequence":"additional","affiliation":[{"name":"Division of Anesthesia, University of Cambridge, Addenbrooke's, Cambridge, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair D.","family":"Nichol","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Center, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia."},{"name":"The Alfred, Melbourne, Victoria, Australia."},{"name":"University College Dublin Clinical Research Center, St. Vincent's University Hospital, Dublin, Ireland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Pisic\u0103","sequence":"additional","affiliation":[{"name":"Center for Medical Decision Making, Department of Public Health, Erasmus MC\u2014University Medical Center Rotterdam, Rotterdam, the Netherlands."},{"name":"Department of Neurosurgery, Erasmus MC\u2014University Medical Center Rotterdam, Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Udy","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Center, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia."},{"name":"The Alfred, Melbourne, Victoria, Australia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Volovici","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Erasmus MC\u2014University Medical Center Rotterdam, Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa M.","family":"Higgins","sequence":"additional","affiliation":[{"name":"Australian and New Zealand Intensive Care Research Center, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, 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