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Article summary:
1. This study aimed to describe the existing care for patients with traumatic brain injury (TBI) and the outcomes in China.
2. 13,627 patients from 56 neurosurgical centres across China were enrolled in the registry. Most patients were male, with a median age of 48 years and a median Glasgow Coma Scale (GCS) score of 13. The leading cause of injury was road-traffic incident.
3. Age, GCS score, injury severity score, pupillary light reflex, CT findings, presence of hypoxia, systemic hypotension, altitude higher than >500 m, and GDP per capita were significantly associated with survival in all patients with TBI. Variation in mortality existed between centres and regions.
Article analysis:
The article is generally reliable and trustworthy as it provides detailed information on the clinical characteristics and outcomes of traumatic brain injury (TBI) in China through a prospective multicentre longitudinal observational study conducted across 56 neurosurgical centres in 22 provinces of China. The primary endpoint was survival on discharge which was compared with expected mortality estimated using the CRASH basic model. The study also identified predictors of mortality such as age, GCS score, injury severity score etc., which can be used to develop benchmarks for assessing quality of care for TBI patients in China.
However, there are some potential biases that should be noted when interpreting the results of this study. Firstly, since this is an observational study rather than a randomized controlled trial (RCT), there may be confounding factors that could affect the results such as differences in patient characteristics or treatment approaches between different hospitals or regions that could lead to bias in the results. Secondly, since this is a single-centre study conducted only in China it may not be generalizable to other countries or settings where TBI management may differ significantly from that observed in this study due to differences in healthcare systems or resources available for TBI management. Finally, since this is an observational study it does not provide any evidence regarding causality between predictor variables and outcome measures which limits its utility for developing evidence-based treatment guidelines for TBI management.