Neuroanesthesia & neurocritical care
Staircase strategy, tier-three therapies, and effects on outcome in traumatic brain injured patients: the Triple-T traumatic brain injury (TBI) study
Authors' conclusion
The staircase approach before the use of TTT was not often utilized after severe TBI. Secondary DC was performed more often than other treatments and its use was associated with improved mortality and neurological outcome.
Study context
- Population
- Adult TBI patients requiring at least one tier-three therapy for control of intracranial hypertension during intensive care unit (ICU) stay, 16 ICUs
- Participants
- 408 patients · 16 ICUs
- Exposure
- Tier-three therapies and their association with outcome
- Secondary decompressive craniectomy (DC)n = 297
- Outcome
- ICU mortality and neurological outcome
- Follow-up
- 3 months (neurological outcome)
Methodological detailsinternational, multicentre, observational
- International
- Multicentre
- Observational
Main finding
As reported in the abstract
ICU mortality
Odds ratio (95% CI)P value
Secondary DC
0.34(0.14–0.78)
P = 0.012Barbiturates
3.05(1.43–6.49)
P = 0.004Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Neurological outcome · 3 monthsSecondary DC · better neurological outcome | P = 0.047 |
| Neurological outcome · 3 monthsBarbiturates · worse neurological outcome | P = 0.032 |
Interventions in adherence to guidelines
- Patients treated in adherence to guidelines
- 224 (55%)
- Non-significant trend towards better outcomes with adherence
Original publication
Staircase strategy, tier-three therapies, and effects on outcome in traumatic brain injured patients: the Triple-T TBI study. Intensive Care Med. Published 14 April 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →