Is management of acute traumatic brain injury effective?
【Abstract】 Objective: To evaluate all the possible therapeutic measures concerning the acute management of traumatic brain injury (TBI) mentioned in Cochrane System-atic Reviews published in the Cochrane Database of Sys-tematic Reviews (CDSR). Methods: An exhausted literature search for all...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2012-04-01
|
| Series: | Chinese Journal of Traumatology |
| Online Access: | http://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/192 |
| _version_ | 1819060657893408768 |
|---|---|
| author | LEI Jin GAO Guo-yi JIANG Ji-yao |
| author_facet | LEI Jin GAO Guo-yi JIANG Ji-yao |
| author_sort | LEI Jin |
| collection | DOAJ |
| description | 【Abstract】 Objective: To evaluate all the possible
therapeutic measures concerning the acute management of
traumatic brain injury (TBI) mentioned in Cochrane System-atic Reviews published in the Cochrane Database of Sys-tematic Reviews (CDSR).
Methods: An exhausted literature search for all pub-lished Cochrane Systematic Reviews discussing therapeu-tic rather than prevention or rehabilitative interventions of
TBI was conducted. We retrieved such databases as CDSR
and Cochrane Injury Group, excluded the duplications, and
eventually obtained 20 results, which stand for critical ap-praisal for as many as 20 different measures for TBI patients.
The important data of each systematic review, including
total population, intervention, outcome, etc, were collected
and presented in a designed table. Besides, we also tried to
find out the possible weakness of these clinical trials in-cluded in each review.
Results: Analysis of these reviews yielded meanfuling
observations: (1) The effectiveness of most ordinary treat-ments in TBI is inconclusive except that corticosteroids are
likely to be ineffective or harmful, and tranexamic acid,
nimodipine and progesterone show a promising effect in
bleeding trauma, traumatic subarachnoid hemorrhage, TBI
or severe TBI. (2) A majority of the systematic reviews in-clude a small number of clinical trials and the modest num-bers of patients, largely due to the uncertainty of the
effectiveness. (3) The quality of most trials reported in the
systematic reviews is more or less questionable. (4) In
addition, lots of other complex factors together may lead to
the inconclusive results demonstrated in the Cochrane Sys-tematic Reviews.
Conclusions: For clinical physicians, to translate these
conclusions into practice with caution is essential. Basic
medication and nursing care deserve additional attention
as well and can be beneficial. For researchers, high quality
trials with perfect design and comprehensive consideration
of various factors are urgently required.
Key words: Brain injuries; Meta-analysis; Review;
Acute management |
| first_indexed | 2024-12-21T14:30:29Z |
| format | Article |
| id | doaj.art-ceb244ad3a694cddb75463978628bc6d |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-12-21T14:30:29Z |
| publishDate | 2012-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-ceb244ad3a694cddb75463978628bc6d2022-12-21T19:00:31ZengElsevierChinese Journal of Traumatology1008-12752012-04-011511722113Is management of acute traumatic brain injury effective?LEI JinGAO Guo-yiJIANG Ji-yao【Abstract】 Objective: To evaluate all the possible therapeutic measures concerning the acute management of traumatic brain injury (TBI) mentioned in Cochrane System-atic Reviews published in the Cochrane Database of Sys-tematic Reviews (CDSR). Methods: An exhausted literature search for all pub-lished Cochrane Systematic Reviews discussing therapeu-tic rather than prevention or rehabilitative interventions of TBI was conducted. We retrieved such databases as CDSR and Cochrane Injury Group, excluded the duplications, and eventually obtained 20 results, which stand for critical ap-praisal for as many as 20 different measures for TBI patients. The important data of each systematic review, including total population, intervention, outcome, etc, were collected and presented in a designed table. Besides, we also tried to find out the possible weakness of these clinical trials in-cluded in each review. Results: Analysis of these reviews yielded meanfuling observations: (1) The effectiveness of most ordinary treat-ments in TBI is inconclusive except that corticosteroids are likely to be ineffective or harmful, and tranexamic acid, nimodipine and progesterone show a promising effect in bleeding trauma, traumatic subarachnoid hemorrhage, TBI or severe TBI. (2) A majority of the systematic reviews in-clude a small number of clinical trials and the modest num-bers of patients, largely due to the uncertainty of the effectiveness. (3) The quality of most trials reported in the systematic reviews is more or less questionable. (4) In addition, lots of other complex factors together may lead to the inconclusive results demonstrated in the Cochrane Sys-tematic Reviews. Conclusions: For clinical physicians, to translate these conclusions into practice with caution is essential. Basic medication and nursing care deserve additional attention as well and can be beneficial. For researchers, high quality trials with perfect design and comprehensive consideration of various factors are urgently required. Key words: Brain injuries; Meta-analysis; Review; Acute managementhttp://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/192 |
| spellingShingle | LEI Jin GAO Guo-yi JIANG Ji-yao Is management of acute traumatic brain injury effective? Chinese Journal of Traumatology |
| title | Is management of acute traumatic brain injury effective? |
| title_full | Is management of acute traumatic brain injury effective? |
| title_fullStr | Is management of acute traumatic brain injury effective? |
| title_full_unstemmed | Is management of acute traumatic brain injury effective? |
| title_short | Is management of acute traumatic brain injury effective? |
| title_sort | is management of acute traumatic brain injury effective |
| url | http://www.cjtrauma.com/apps/ojs/index.php/cjt/article/view/192 |
| work_keys_str_mv | AT leijin ismanagementofacutetraumaticbraininjuryeffective AT gaoguoyi ismanagementofacutetraumaticbraininjuryeffective AT jiangjiyao ismanagementofacutetraumaticbraininjuryeffective |