Determining the global outcomes of traumatic brain injury in low-, middle- and high- income countries: a prospective, global neurosurgery, multicenter cohort study (Global NeuroSurg 1 Study Protocol)

Globally, traumatic brain injury (TBI) affects 69 million individuals every year. However, there are wide variations in the management of TBI across low-, middle- and high-income countries which reflects on the outcomes of TBI worldwide. This study aims to provide a comprehensive global picture of the surgical and nonsurgical management and outcomes of TBI. The Global NeuroSurg 1 study is a prospective international multicentre cohort study conducted in self-selected registered centers. Any hospital receiving and managing TBI patients is eligible to participate (registration through www.globalneurosurg.org). After obtaining institutional ethical approvals, collaborator teams collect consecutive TBI patient data within any 2 weeks from the 1 June 2019 to the 30 September 2021 with 90 days of follow-up for every patient. Data items include (1) patient demographics, (2) TBI timing, severity and mechanism, (3) clinical status of the patient, (4) radiographic findings, (5) surgical and nonsurgical management and (6) patient survival and Glasgow outcome score. All data are submitted to the secure RedCap system of Oregon Health and Science University, OR. Binary logistic regression analysis will be conducted to evaluate the predictors of 30-day mortality. The odds ratios and the corresponding 95% confidence intervals will be calculated for each variable. Then variables that are independently contributing to the mortality will be selected and examined. Study ethical approvals or ethical approval waivers are obtained from all participating centers. All collected data are kept confidential and will be used only for the purpose of this study.