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Erschienen in: Wiener klinische Wochenschrift 1-2/2018

27.07.2017 | original article

Citicoline in severe traumatic brain injury: indications for improved outcome

A retrospective matched pair analysis from 14 Austrian trauma centers

verfasst von: Helmut Trimmel, Marek Majdan, Andrea Wodak, Guenther Herzer, Daniel Csomor, Alexandra Brazinova

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 1-2/2018

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Summary

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 score <13 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.
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Metadaten
Titel
Citicoline in severe traumatic brain injury: indications for improved outcome
A retrospective matched pair analysis from 14 Austrian trauma centers
verfasst von
Helmut Trimmel
Marek Majdan
Andrea Wodak
Guenther Herzer
Daniel Csomor
Alexandra Brazinova
Publikationsdatum
27.07.2017
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 1-2/2018
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-017-1240-9

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