“ Beholders ” or patients and families?

LITFL • Life in the Fast Lane Medical Blog LITFL • Life in the Fast Lane Medical Blog - Emergency medicine and critical care medical education blog This is a guest post by Dr Peter Hutchinson, Professor of Neurosurgery; Dr Angelos Kolias, Clinical Lecturer in Neurosurgery; and Dr David Menon, Professor of Anaesthesia – all at the University of Cambridge and Addenbrooke’s Hospital, Cambridge, UK. It is a response to the recent LITFL post by Dr Alistair Nichol titled RESCUEicp and the Eye of the Beholder. * beholder NOUN literary, archaic  A person who sees or observes someone or something. We welcome the ongoing discussion which is centred on the “acceptable” degree of disability and the choice of dichotomisation points for the extended Glasgow Outcome Scale (GOS-E) in trials in traumatic brain injury (TBI). We discussed some of these issues in the correspondence published in the NEJM1 and we provide the relevant excerpts below: “The DECRA trial, as compared with the RESCUEicp trial, enrolled patients with a lower intracranial-pressure threshold (20 mm Hg vs. 25 mm Hg) for shorter intervals (15 minutes vs. 1 to 12 hours), after lower intensities of therapy (stage 1 interventions vs. stage 1 and 2 interventions), and within a shorter interval after injury (all patients enrolled within 72 hours after injury vs. 44% of patients enrolled >72 hours after injury). At enrolment, the populations also differed with respect to expected outcome; the requirement...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Intensive Care Neurosurgery angelos kolias david menon Decompressive craniectomy peter hutchinson RESCUEicp TBI traumatic brain injury Source Type: blogs