Characteristics, management and outcomes of patients with severe traumatic brain injury in Victoria, Australia compared to United Kingdom and Europe: A comparison between two harmonised prospective cohort studies

ObjectiveThe aim of this manuscript is to compare characteristics, management, and outcomes patients with severe Traumatic Brain Injury (TBI) between Australia, the United Kingdom (UK) Europe.MethodsWe enrolled TBI in Victoria, Australia (OzENTER-TBI), UK Europe (CENTER-TBI) from 2015 2017. Main outcome measures were mortality unfavourable (Glasgow Outcome Scale Extended <5) 6 months after injury. Expected compared according IMPACT-CT prognostic model, observed expected (O/E) ratios 95% confidence intervals.ResultsWe included 107 171 UK, 596 Europe. Compared Europe, younger (median 32 vs 44 years), a larger proportion had secondary brain insults including hypotension (30% 17% 21%) received ICP monitoring (75% 74% 58%). Hospital length stay was shorter than (median: 17 23 16 days), higher discharged rehabilitation unit (64% 26% 28%). Mortality overall lower (27% 35%, O/E ratio 0.77 [95% CI: 0.64 – 0.87]. comparable regions for 0.86 0.49–1.23] 0.82 [0.51–1.15] 0.76 [0.60–0.87]). Unfavourable rates line historic expectations (O/E 1.32 [0.96-1.68] 1.13 [0.84-1.42] 0.96 [0.85-1.09]).ConclusionsThere are major differences case-mix Europe; Australian have rate insults. Despite some management discharge policies, less overall, did not differ regions. Functional similar regions, but worse expected, emphasizing need improve treatment TBI.