Table 1: Study characteristics.
Overview of all studies included in the statistical analysis
| Study Type | n | Study population | Early vs late, cutoff | Duration of follow-up | Relevant outcome measures | Study Quality (NOS) | |
|---|---|---|---|---|---|---|---|
|
Ahmed 2007 USA 2002–2005 |
Single center, retrospective cohort study | 55 | Severe TBI (GCS≤8), expected to survive > 3 days | Yes, ≤7d vs >7d | dc hospital | Mortality at dc Cost of Hospitalization |
5 |
|
Alali 2014 Canada 2009–2011 |
Multicenter, retrospective cohort study | 1142 | TBI (AIS 3 or greater) | Yes, ≤8d vs >8d | dc hospital | Mortality at dc | 6 |
|
Baron 2016 Austria 1998–2010 |
Multicenter, retrospective cohort study | 553 | Moderate-severe isolated TBI (GCS ≤ 12, AIS 2–5) |
No | dc hospital | ICU mortality Mortality at dc |
6 |
|
Bösel 2013 Germany 2009–2011 |
Single Center, prospective RCT | 60 | Stroke (AIS, ICH, SAH) admitted to the ICU, intubated on admission | Yes, 1–3d vs 7–10d |
6 months | Neurological outcome (mRS) at dc ICU and 6 months ICU mortality Mortality at 6 months Decannulation rates Cost of Hospitalization |
7 |
|
Bouderka 2004 Morocco (no time period defined) |
Single Center, prospective RCT | 31 | Severe TBI (GCS≤8 on hospital day 1 and 5), plus contusion on CT | Yes, day 5 or 6 * | dc hospital | Mortality at dc | 5 |
|
Gandia-Martinez 2010 Spain 2004–2007 |
Single Center, prospective observational study | 118 | ‘Severe’ TBI [no GCS limit] (60.2%) or stroke (39.8%), all pts intubated on admission | Yes, ≤9d vs >9d | dc hospital | ICU mortality Mortality at dc |
5 |
|
Gessler 2015 Germany 2006–2011 |
Multicenter, retrospective observational cohort study | 148 | Aneurysmal SAH, HH3–5 | Yes, ≤7d vs >7d | 6 months | Neurological outcome (mRS) at 6 months ICU mortality Mortality at 6 months |
6 |
|
Khalili 2017 Iran 2014–2015 |
Single Center, prospective cohort study | 152 | Severe TBI (GCS≤8) | Yes, ≤6d vs >6d | dc hospital | Mortality at dc | 5 |
|
Lahiri 2015 USA 2005–2012 |
Multicenter, retrospective review of administrative state data | 16,264 | Stroke (AIS, ICH and SAH) | No | dc hospital | Discharge home | 5 |
|
Rabinstein 2004 USA 1976–2000 |
Single Center, retrospective chart review | 97 | Stroke (AIS, ICH and SAH) | No | At dc hospital and at 1 year | Neurological outcome (GOS) at 1yr Mortality at dc Mortality at 1 year Decannulation |
7 |
|
Rizk 2011 USA 1990–2005 |
Multicenter (trauma registry), retrospective observational cohort study | 3104 | Severe TBI (GCS≤8), excluded isolated head injury | Yes, ≤7d vs >7d | dc hospital | Mortality at dc | 6 |
|
Roch 2003 USA 1997–2000 |
Single Center, retrospective chart review; prospective follow-up | 50 | ICH | No | 27+/− 14 mo | Decannulation rate** | 7 |
|
Schneider 2017 Germany 2014–2015 |
Single Center, prospective observational cohort study | 53 | Stroke (AIS, ICH and SAH) | No | 1 year | Neurological outcome (mRS) at 10 days, 3 months and 1 year Mortality at 10 days, 3 months and 1 year Decannluation rate Discharge destination |
6 |
|
Shibahashi 2017 Japan 2010–2014 |
Single center, retrospective review | 91 | Severe TBI (AIS ≥4****) | Yes, 2–3 vs 4–6 days | dc hospital | Mortality at dc | 6 |
|
Siddiqui 2015 Pakistan 2002–2009 |
Single center, both retro-and prospective data | 49 | Isolated severe TBI (GCS<8) | Yes, ≤7d* | dc hospital | Mortality at dc*** Cost of Care |
4 |
|
Sugarman 1997 USA (no time period defined) |
Multicenter, prospective cohort study | 35 | Severe TBI (GCS≤8), as part of cohort (other are NTBI) | Yes, 3–5d vs 10–14d |
dc hospital | Mortality at dc | 5 |
|
Villwock 2014 USA 2008–2010 |
Multicenter, retrospective review of NIS registry data | 13,165 | Stroke (AIS, ICH, SAH) | Yes, ≤10d vs >10d | dc hospital | Mortality at discharge Discharge destination Cost of Care |
4 |
|
Wabl 2018 USA 2008–2013 |
Single center, both retro-and prospective data | 129 | Severe TBI (GCS≤8), AIS, ICH< SAH | No | 36 months | Neurological outcome | 7 |
| Wang 2011 Taiwan 2005–2008 |
Single center, retrospective review | 66 | Severe TBI (GCS≤8) | Yes, ≤10d vs >10d | 1 year | Mortality at 1 month and 1 year | 6 |
NOS= Newcastle-Ottawa Scale, RCT = randomized controlled trial, dc = discharge, NIS = National Inpatient Service
*
compared to group with prolonged MV, the latter was not included as not specified whether the whole group was tracheotomized
**
Mortality not analyzed due to selection bias
***
long-term neurological outcome not reported due to time interval (average)
****
study excluded patients that died
*****
severe chest injury with AIS≥4 excluded