Citicoline in severe traumatic brain injury: indications for improved outcome : A retrospective matched pair analysis from 14 Austrian trauma centers
| Autor: | Andrea Wodak, Helmut Trimmel, Guenther Herzer, Marek Majdan, Daniel Csomor, Alexandra Brazinova |
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| Rok vydání: | 2017 |
| Předmět: |
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medicine.medical_specialty Cytidine Diphosphate Choline Traumatic brain injury Matched-Pair Analysis Subgroup analysis 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Quality of life Randomized controlled trial Trauma Centers law Brain Injuries Traumatic Medicine Humans Glasgow Coma Scale Prospective Studies Retrospective Studies business.industry General Medicine Middle Aged medicine.disease Intensive care unit Clinical trial Austria Emergency medicine Physical therapy Quality of Life Female business 030217 neurology & neurosurgery Citicoline medicine.drug |
| Zdroj: | Wiener klinische Wochenschrift. 130(1-2) |
| ISSN: | 1613-7671 |
| Popis: | Goal-oriented management of traumatic brain injury (TBI) can save the lives and/or improve the long-term outcome of millions of affected patients worldwide. Additionally, enhancing quality of life will save enormous socio-economic costs; however, promising TBI treatment strategies with neuroprotective agents, such as citicoline (CDP-choline), lacked evidence or produced contradictory results in clinical trials. During a prehospital TBI project to optimize early TBI care within 14 Austrian trauma centers, data on 778 TBI patients were prospectively collected. As preceding evaluations suggested a beneficial outcome in TBI patients treated at the Wiener Neustadt Hospital (WNH), we aimed to investigate the potential role of citicoline administration, solely applied in WNH, in those patients. In a retrospective subgroup analysis we compared 67 patients from WNH with citicoline administration and 67 matched patients from other Austrian centers without citicoline use. Patients with Glasgow Coma Scale score13 on site and/or Abbreviated Injury Scale of the region "head"2 were included. Our analysis revealed significantly reduced rates of intensive care unit (ICU) mortality (5% vs. 24%, p 0.01), in-hospital mortality (9% vs. 24%, p = 0.035) and 6‑month mortality (13% vs. 28%, p = 0.031), as well as of unfavorable outcome (34% vs. 57%, p = 0.015) and observed vs. expected ratio for mortality (0.42 vs. 0.84) in the WNH (citicoline receivers) group. Despite the limitations of a retrospective subgroup analysis our findings suggest a possible correlation between early and consequent citicoline administration and beneficial outcomes. Therefore, we aim to set up an initiative for a prospective, multicenter randomized controlled trial with citicoline in sTBI (severe TBI) patients. |
| Databáze: | OpenAIRE |
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