{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T04:50:24Z","timestamp":1793163024175,"version":"4.5.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"The European Union FP 7th Framework program","award":["602150"],"award-info":[{"award-number":["602150"]}]},{"name":"Funding of additional elements has been provided by the Hannelore Kohl Foundation (Germany) and by the non-profit organization One Mind For Research"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Haemoglobin (Hb) thresholds and red blood cells (RBC) transfusion strategies in traumatic brain injury (TBI) are controversial. Our objective was to assess the association of Hb values with long-term outcomes in critically ill TBI patients. We conducted a secondary analysis of CENTER-TBI, a large multicentre, prospective, observational study of European TBI patients. All patients admitted to the Intensive Care Unit (ICU) with available haemoglobin data on admission and during the first week were included. During the first seven days, daily lowest haemoglobin values were considered either a continous variable or categorised as &lt;\u20097.5\u00a0g\/dL, between 7.5\u20139.5 and &gt;\u20099.5\u00a0g\/dL. Anaemia was defined as haemoglobin value &lt;\u20099.5\u00a0g\/dL. Transfusion practices were described as \u201crestrictive\u201d or \u201cliberal\u201d based on haemoglobin values before transfusion (e.g. &lt;\u20097.5\u00a0g\/dL or 7.5\u20139.5\u00a0g\/dL). Our primary outcome was the Glasgow outcome scale extended (GOSE) at six months, defined as being unfavourable when &lt;\u20095. Of 1590 included, 1231 had haemoglobin values available on admission. A mean Injury Severity Score (ISS) of 33 (SD 16), isolated TBI in 502 (40.7%) and a mean Hb value at ICU admission of 12.6 (SD 2.2) g\/dL was observed. 121 (9.8%) patients had Hb\u2009&lt;\u20099.5\u00a0g\/dL, of whom 15 (1.2%) had Hb\u2009&lt;\u20097.5\u00a0g\/dL. 292 (18.4%) received at least one RBC transfusion with a median haemoglobin value before transfusion of 8.4 (IQR 7.7\u20138.5) g\/dL. Considerable heterogeneity regarding threshold transfusion was observed among centres. In the multivariable logistic regression analysis, the increase of haemoglobin value was independently associated with the decrease in the occurrence of unfavourable neurological outcomes (OR 0.78; 95% CI 0.70\u20130.87). Congruous results were observed in patients with the lowest haemoglobin values within the first 7\u00a0days &lt;\u20097.5\u00a0g\/dL (OR 2.09; 95% CI 1.15\u20133.81) and those between 7.5 and 9.5\u00a0g\/dL (OR 1.61; 95% CI 1.07\u20132.42) compared to haemoglobin values &gt;\u20099.5\u00a0g\/dL. Results were consistent when considering\u00a0mortality at 6 months\u00a0as an\u00a0outcome. The increase of hemoglobin value was associated with the\u00a0decrease of mortality (OR 0.88; 95% CI 0.76\u20131.00);\u00a0haemoglobin values less than\u20097.5\u00a0g\/dL\u00a0was associated with an increase of mortality (OR 3.21; 95% CI 1.59\u20136.49). Anaemia was independently associated with long-term unfavourable neurological outcomes and mortality in critically ill TBI patients.<\/jats:p><jats:p>Trial registration: CENTER-TBI is registered at ClinicalTrials.gov, NCT02210221, last update 2022\u201311\u201307.<\/jats:p>","DOI":"10.1186\/s13054-024-04980-6","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T07:02:48Z","timestamp":1718348568000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Haemoglobin values, transfusion practices, and long-term outcomes in critically ill patients with traumatic brain injury: a secondary analysis of CENTER-TBI"],"prefix":"10.1186","volume":"28","author":[{"given":"Angelo","family":"Guglielmi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Graziano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa Gouv\u00eaa","family":"Bogossian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis F.","family":"Turgeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio Silvio","family":"Taccone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Citerio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CENTER-TBI Participants and Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"4980_CR1","doi-asserted-by":"publisher","first-page":"1004","DOI":"10.1016\/S1474-4422(22)00309-X","volume":"21","author":"AIR Maas","year":"2022","unstructured":"Maas AIR, Menon DK, Manley GT, Abrams M, \u00c5kerlund C, Andelic N, et al. Traumatic brain injury: progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022;21:1004\u201360.","journal-title":"Lancet Neurol"},{"key":"4980_CR2","doi-asserted-by":"publisher","first-page":"1834","DOI":"10.1089\/neu.2014.3352","volume":"32","author":"HM Bramlett","year":"2015","unstructured":"Bramlett HM, Dietrich WD. Long-term consequences of traumatic brain injury: current status of potential mechanisms of injury and neurological outcomes. J Neurotrauma. 2015;32:1834\u201348.","journal-title":"J Neurotrauma"},{"key":"4980_CR3","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s13054-020-2825-7","volume":"24","author":"FS Taccone","year":"2020","unstructured":"Taccone FS, Manoel ALDO, Robba C, Vincent J-L. Use a \u201cGHOST-CAP\u201d in acute brain injury. Crit Care. 2020;24:89.","journal-title":"Crit Care"},{"key":"4980_CR4","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s12873-018-0197-y","volume":"18","author":"PC Volpi","year":"2018","unstructured":"Volpi PC, Robba C, Rota M, Vargiolu A, Citerio G. Trajectories of early secondary insults correlate to outcomes of traumatic brain injury: results from a large, single centre, observational study. BMC Emerg Medicine. 2018;18:52.","journal-title":"BMC Emerg Medicine"},{"key":"4980_CR5","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.wneu.2016.02.076","volume":"90","author":"NS Litofsky","year":"2016","unstructured":"Litofsky NS, Martin S, Diaz J, Ge B, Petroski G, Miller DC, et al. The negative impact of anemia in outcome from traumatic brain injury. World Neurosurg. 2016;90:82\u201390.","journal-title":"World Neurosurg"},{"key":"4980_CR6","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s13054-016-1321-6","volume":"20","author":"C Lelubre","year":"2016","unstructured":"Lelubre C, Bouzat P, Crippa IA, Taccone FS. Anemia management after acute brain injury. Crit Care. 2016;20:152.","journal-title":"Crit Care"},{"key":"4980_CR7","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1007\/s12028-014-0096-3","volume":"23","author":"DE Griesdale","year":"2015","unstructured":"Griesdale DE, Sekhon MS, Menon DK, Lavinio A, Donnelly J, Robba C, et al. Hemoglobin area and time index above 90 g\/L are associated with improved 6-month functional outcomes in patients with severe traumatic brain injury. Neurocrit Care. 2015;23:78\u201384.","journal-title":"Neurocrit Care"},{"key":"4980_CR8","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s12028-016-0273-7","volume":"25","author":"KR Carr","year":"2016","unstructured":"Carr KR, Rodriguez M, Ottesen A, Michalek J, Son C, Patel V, et al. Association between relative anemia and early functional recovery after severe traumatic brain injury (TBI). Neurocrit Care. 2016;25:185\u201392.","journal-title":"Neurocrit Care"},{"key":"4980_CR9","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1001\/jama.2014.6490","volume":"312","author":"CS Robertson","year":"2014","unstructured":"Robertson CS, Hannay HJ, Yamal J-M, Gopinath S, Goodman JC, Tilley BC, et al. Effect of erythropoietin and transfusion threshold on neurological recovery after traumatic brain injury: a randomized clinical trial. JAMA. 2014;312:36\u201347.","journal-title":"JAMA"},{"key":"4980_CR10","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s12028-015-0220-z","volume":"24","author":"SR Leal-Noval","year":"2016","unstructured":"Leal-Noval SR, Mu\u00f1oz-Serrano \u00c1, Arellano-Orden V, Cayuela A, Mu\u00f1oz-G\u00f3mez M, Recio A, et al. Effects of red blood cell transfusion on long-term disability of patients with traumatic brain injury. Neurocrit Care. 2016;24:371\u201380.","journal-title":"Neurocrit Care"},{"key":"4980_CR11","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1016\/S1474-4422(19)30232-7","volume":"18","author":"EW Steyerberg","year":"2019","unstructured":"Steyerberg EW, Wiegers E, Sewalt C, Buki A, Citerio G, Keyser VD, et al. Case-mix, care pathways, and outcomes in patients with traumatic brain injury in CENTER-TBI: a European prospective, multicentre, longitudinal, cohort study. Lancet Neurol. 2019;18:923\u201334.","journal-title":"Lancet Neurol"},{"key":"4980_CR12","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1227\/NEU.0000000000000575","volume":"76","author":"AIR Maas","year":"2015","unstructured":"Maas AIR, Menon DK, Steyerberg EW, Citerio G, Lecky F, Manley GT, et al. Collaborative European neurotrauma effectiveness research in traumatic brain injury (CENTER-TBI): a prospective longitudinal observational study. Neurosurgery. 2015;76:67\u201380.","journal-title":"Neurosurgery"},{"key":"4980_CR13","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1089\/neu.1998.15.573","volume":"15","author":"JTL Wilson","year":"1998","unstructured":"Wilson JTL, Pettigrew LEL, Teasdale GM. Structured interviews for the Glasgow outcome scale and the extended Glasgow outcome scale: guidelines for their use. J Neurotraum. 1998;15:573\u201385.","journal-title":"J Neurotraum"},{"key":"4980_CR14","doi-asserted-by":"publisher","first-page":"1372","DOI":"10.1093\/ije\/dyx180","volume":"46","author":"D Doiron","year":"2017","unstructured":"Doiron D, Marcon Y, Fortier I, Burton P, Ferretti V. Software application profile: opal and mica: open-source software solutions for epidemiological data management, harmonization and dissemination. Int J Epidemiol. 2017;46:1372\u20138.","journal-title":"Int J Epidemiol"},{"issue":"Suppl 1","key":"4980_CR15","first-page":"S287","volume":"9","author":"LF Marshall","year":"1992","unstructured":"Marshall LF, Marshall SB, Klauber MR, Clark MVB, Eisenberg H, Jane JA, et al. The diagnosis of head injury requires a classification based on computed axial tomography. J Neurotrauma. 1992;9(Suppl 1):S287\u201392.","journal-title":"J Neurotrauma"},{"key":"4980_CR16","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1097\/00005373-198501000-00010","volume":"25","author":"L Greenspan","year":"1985","unstructured":"Greenspan L, McLellan BA, Greig H. Abbreviated injury scale and injury severity score. J Trauma Inj Infect Crit Care. 1985;25:60\u20134.","journal-title":"J Trauma Inj Infect Crit Care"},{"key":"4980_CR17","doi-asserted-by":"publisher","first-page":"1768","DOI":"10.1089\/neu.2015.4266","volume":"33","author":"P Zuercher","year":"2016","unstructured":"Zuercher P, Groen JL, Aries MJH, Steyerberg EW, Maas AIR, Ercole A, et al. Reliability and validity of the therapy intensity level scale: analysis of clinimetric properties of a novel approach to assess management of intracranial pressure in traumatic brain injury. J Neurotraum. 2016;33:1768\u201374.","journal-title":"J Neurotraum"},{"key":"4980_CR18","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1385\/NCC:5:1:4","volume":"5","author":"LA McIntyre","year":"2006","unstructured":"McIntyre LA, Fergusson DA, Hutchison JS, Pagliarello G, Marshall JC, Yetisir E, et al. Effect of a liberal versus restrictive transfusion strategy on mortality in patients with moderate to severe head injury. Neurocrit Care. 2006;5:4\u20139.","journal-title":"Neurocrit Care"},{"key":"4980_CR19","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1007\/s00134-019-05884-8","volume":"46","author":"AP Vlaar","year":"2020","unstructured":"Vlaar AP, Oczkowski S, de Bruin S, Wijnberge M, Antonelli M, Aubron C, et al. Transfusion strategies in non-bleeding critically ill adults: a clinical practice guideline from the European Society of Intensive Care Medicine. Intens Care Med. 2020;46:673\u201396.","journal-title":"Intens Care Med"},{"key":"4980_CR20","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s13054-018-2273-9","volume":"23","author":"ALN Gobatto","year":"2019","unstructured":"Gobatto ALN, Link MA, Solla DJ, Bassi E, Tierno PF, Paiva W, et al. Transfusion requirements after head trauma: a randomized feasibility controlled trial. Crit Care. 2019;23:89.","journal-title":"Crit Care"},{"key":"4980_CR21","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1097\/01.ta.0000231768.44727.a2","volume":"61","author":"AP Carlson","year":"2006","unstructured":"Carlson AP, Schermer CR, Lu SW. Retrospective evaluation of anemia and transfusion in traumatic brain injury. J Trauma Inj Infect Crit Care. 2006;61:567\u201371.","journal-title":"J Trauma Inj Infect Crit Care"},{"key":"4980_CR22","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1007\/s12028-022-01561-9","volume":"37","author":"H Vanhala","year":"2022","unstructured":"Vanhala H, Junttila E, Kataja A, Huhtala H, Luostarinen T, Luoto T. Incidence and associated factors of anemia in patients with acute moderate and severe traumatic brain injury. Neurocrit Care. 2022;37:629\u201337.","journal-title":"Neurocrit Care"},{"key":"4980_CR23","doi-asserted-by":"publisher","first-page":"e067117","DOI":"10.1136\/bmjopen-2022-067117","volume":"12","author":"AF Turgeon","year":"2022","unstructured":"Turgeon AF, Fergusson DA, Clayton L, Patton M-P, Zarychanski R, English S, et al. Haemoglobin transfusion threshold in traumatic brain injury optimisation (HEMOTION): a multicentre, randomised, clinical trial protocol. BMJ Open. 2022;12:e067117.","journal-title":"BMJ Open"},{"key":"4980_CR24","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1089\/neur.2022.0056","volume":"3","author":"EY Montgomery","year":"2022","unstructured":"Montgomery EY, Barrie U, Kenfack YJ, Edukugho D, Caruso JP, Rail B, et al. Transfusion guidelines in traumatic brain injury: a systematic review and meta-analysis of the currently available evidence. Neurotrauma Rep. 2022;3:554\u201368.","journal-title":"Neurotrauma Rep"},{"key":"4980_CR25","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1093\/oxfordjournals.ndt.a027970","volume":"15","author":"F Metivier","year":"2000","unstructured":"Metivier F, Marchais SJ, Guerin AP, Pannier B, London GM. Pathophysiology of anaemia: focus on the heart and blood vessels. Nephrol Dial Transpl. 2000;15:14\u20138.","journal-title":"Nephrol Dial Transpl"},{"key":"4980_CR26","doi-asserted-by":"publisher","first-page":"682054","DOI":"10.1155\/2015\/682054","volume":"2015","author":"I Mozos","year":"2015","unstructured":"Mozos I. Mechanisms linking red blood cell disorders and cardiovascular diseases. BioMed Res Int. 2015;2015:682054.","journal-title":"BioMed Res Int"},{"key":"4980_CR27","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/0378-3782(92)90070-W","volume":"30","author":"VTh Ramaekers","year":"1992","unstructured":"Ramaekers VTh, Casaer P, Daniels H, Marchal G. The influence of blood transfusion on brain blood flow autoregulation among stable preterm infants. Early Hum Dev. 1992;30:211\u201320.","journal-title":"Early Hum Dev"},{"key":"4980_CR28","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1056\/NEJMra1705649","volume":"378","author":"JW Cannon","year":"2018","unstructured":"Cannon JW. Hemorrhagic shock. N Engl J Med. 2018;378:370\u20139.","journal-title":"N Engl J Med"},{"key":"4980_CR29","unstructured":"Writing Committee for the REMAP-CAP Investigators; Higgins AM, Berry LR, Lorenzi E, Murthy S, McQuilten Z, Mouncey PR et al. Long-term (180-Day) outcomes in critically ill patients with COVID-19 in the REMAP-CAP randomized clinical trial. Jama. 2023;329:39\u201351."},{"key":"4980_CR30","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.jamcollsurg.2008.03.013","volume":"207","author":"A Salim","year":"2008","unstructured":"Salim A, Hadjizacharia P, DuBose J, Brown C, Inaba K, Chan L, et al. Role of anemia in traumatic brain injury. J Am Coll Surgeons. 2008;207:398\u2013406.","journal-title":"J Am Coll Surgeons"},{"key":"4980_CR31","doi-asserted-by":"publisher","first-page":"R128","DOI":"10.1186\/cc11431","volume":"16","author":"MS Sekhon","year":"2012","unstructured":"Sekhon MS, McLean N, Henderson WR, Chittock DR, Griesdale DE. Association of hemoglobin concentration and mortality in critically ill patients with severe traumatic brain injury. Crit Care. 2012;16:R128.","journal-title":"Crit Care"},{"key":"4980_CR32","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/TA.0b013e318298492e","volume":"75","author":"J Elterman","year":"2013","unstructured":"Elterman J, Brasel K, Brown S, Bulger E, Christenson J, Kerby JD, et al. Transfusion of red blood cells in patients with a prehospital Glasgow Coma Scale score of 8 or less and no evidence of shock is associated with worse outcomes. J Trauma Acute Care Surg. 2013;75:8\u201314.","journal-title":"J Trauma Acute Care Surg"},{"key":"4980_CR33","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1016\/j.tmrv.2015.08.004","volume":"30","author":"A Boutin","year":"2016","unstructured":"Boutin A, Chass\u00e9 M, Shemilt M, Lauzier F, Moore L, Zarychanski R, et al. Red blood cell transfusion in patients with traumatic brain injury: a systematic review and meta-analysis. Transfus Med Rev. 2016;30:15\u201324.","journal-title":"Transfus Med Rev"},{"key":"4980_CR34","doi-asserted-by":"publisher","first-page":"1852","DOI":"10.1001\/jama.2023.20737","volume":"330","author":"SJ Raasveld","year":"2023","unstructured":"Raasveld SJ, de Bruin S, Reuland MC, van den Oord C, Schenk J, Aubron C, et al. Red blood cell transfusion in the intensive care unit. JAMA. 2023;330:1852\u201361.","journal-title":"JAMA"},{"key":"4980_CR35","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1186\/s13054-017-1748-4","volume":"21","author":"R Badenes","year":"2017","unstructured":"Badenes R, Oddo M, Suarez JI, Antonelli M, Lipman J, Citerio G, et al. Hemoglobin concentrations and RBC transfusion thresholds in patients with acute brain injury: an international survey. Crit Care. 2017;21:159.","journal-title":"Crit Care"},{"key":"4980_CR36","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1089\/neu.2017.5194","volume":"35","author":"JA Huijben","year":"2018","unstructured":"Huijben JA, van der Jagt M, Cnossen MC, Kruip MJHA, Haitsma IK, Stocchetti N, et al. Variation in blood transfusion and coagulation management in traumatic brain injury at the intensive care unit: a survey in 66 neurotrauma centers participating in the collaborative European neurotrauma effectiveness research in traumatic brain injury study. J Neurotrauma. 2018;35:323\u201332.","journal-title":"J Neurotrauma"},{"key":"4980_CR37","doi-asserted-by":"publisher","first-page":"1038","DOI":"10.1007\/s12630-019-01369-w","volume":"66","author":"PL Bonaventure","year":"2019","unstructured":"Bonaventure PL, Lauzier F, Zarychanski R, Boutin A, Shemilt M, Saxena M, et al. Red blood cell transfusion in critically ill patients with traumatic brain injury: an international survey of physicians\u2019 attitudes. Can J Anesthesia. 2019;66:1038\u201348.","journal-title":"Can J Anesthesia"},{"key":"4980_CR38","doi-asserted-by":"publisher","first-page":"1530","DOI":"10.3171\/2017.1.JNS162234","volume":"128","author":"LB Ngwenya","year":"2018","unstructured":"Ngwenya LB, Suen CG, Tarapore PE, Manley GT, Huang MC. Safety and cost efficiency of a restrictive transfusion protocol in patients with traumatic brain injury. J Neurosurg. 2018;128:1530\u20137.","journal-title":"J Neurosurg"},{"key":"4980_CR39","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1186\/s13063-022-07061-7","volume":"24","author":"FS Taccone","year":"2023","unstructured":"Taccone FS, Badenes R, Rynkowski CB, Bouzat P, Caricato A, Kurtz P, et al. TRansfusion strategies in Acute brain INjured patients (TRAIN): a prospective multicenter randomized interventional trial protocol. Trials. 2023;24:20.","journal-title":"Trials"}],"container-title":["Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-024-04980-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13054-024-04980-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13054-024-04980-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T07:11:32Z","timestamp":1718349092000},"score":1,"resource":{"primary":{"URL":"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/s13054-024-04980-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,14]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["4980"],"URL":"https:\/\/doi.org\/10.1186\/s13054-024-04980-6","relation":{},"ISSN":["1364-8535"],"issn-type":[{"value":"1364-8535","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,14]]},"assertion":[{"value":"26 March 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The CENTER-TBI study was performed according to the Helsinki Declaration and the International Conference on Harmonization for Good Clinical Practice. Since comatose patients could not provide informed consent during study recruitment, each center referred to local\/national law on the lack of capacity. If the patients regained capacity at the follow-up visit, they had to either provide informed consent to use the acute and follow-up data or refuse to participate in the research. Ethical approval for the study was obtained from the Medical Ethics Committees of each participating center, and informed consent was obtained from all participants following local regulations (). For this sub-analysis, no further ethical approval was required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Written informed consent for the publication of these data has been previously obtained.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"GC reports grants personal fees as Speakers' Bureau Member and Advisory Board Member from Integra and Neuroptics, all outside the submitted work. The other authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"199"}}