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. 2021 Feb 23;25:78. doi: 10.1186/s13054-020-03370-y

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 3 — Definitions of aggressiveness. This figure illustrates the concordance between two definitions to identify aggressiveness of centers. On the x-axis is the definition of aggressiveness according to previous studies: the percentage of patients receiving ICP monitoring according to the BTF guidelines (GCS < 8 and abnormal CT, or normal CT and 2 or more of the following: hypotension, age > 40 years, unilateral or bilateral motor posturing, or systolic blood pressure (BP) < 90 mmHg). This percentage ICP monitoring was calculated in the ICU database (including all patients). On the y-axis is the definition of aggressiveness according to our study: the random effects of high TIL treatment per centers (log odds of receiving high TIL treatment). The upper right quadrant shows the centers that are both identified as aggressive by the previous definition (threshold 50% ICP monitoring) and the definition in our study (threshold random effect of zero).The lower left quadrant shows the centers that are identified as non-aggressive centers by both definitions. The two other quadrants show a discrepancy between the definitions of aggressiveness. Overall, there is no relationship between aggressiveness defined using ICP monitoring rates and actual use of aggressive therapies for ICP control