Evidence map›Paper›PMID 40933835›Full record

ArticleNeurotrauma reports2025

Redirection of Care after Traumatic Brain Injury in Intensive Care: Sex and Social Determinants of Health.

Simone Unseld, Alessandra Nadja Herzog, Federica Stretti, Tanja Krones, Caroline Hertler, Giovanna Brandi, Stefan Yu Bögli

Abstract read
In one paragraph

Article in Neurotrauma reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Simone UnseldInstitute of Intensive Care Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Alessandra Nadja HerzogInstitute of Intensive Care Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Federica StrettiInstitute of Intensive Care Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Tanja KronesInstitute of Biomedical Ethics and History of Medicine, Clinical Ethics, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Caroline HertlerDepartment of Radiation Oncology and Competence Center for Palliative Care, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Giovanna BrandiInstitute of Intensive Care Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
Stefan Yu BögliInstitute of Intensive Care Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0001-5386-0811

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Traumatic brain injury (TBI) impairs a patient's capacity for informed decision-making, necessitating surrogate decision-makers to decide whether to continue life-sustaining therapies. Patient sex and social determinants of health (SDH)-for example, economic stability, education, and health care access-possibly affect such decisions. We aimed to explore interactions between sex, SDH, and redirection of care in a cohort of patients with TBI from a high-income, high-resource country. Adult patients with consecutive TBI admitted to intensive care were included. Data on demographics, TBI characteristics, advance directives, and SDH (civil status, living situation, dependence for daily activities, income, employment, religion, nationality) were extracted. The primary end-point was redirection of care, followed by in-hospital mortality. Differences were analyzed univariably, after prognostic score matching, and through random forest models to assess the importance of each factor. Seven hundred and twelve patients (26.4% female, median age 56) were included. Women were older, more often widowed, and more frequently dependent on help, while men had higher income and education levels. Redirection of care and mortality were more common in women, even after prognostic score matching, though the difference disappeared after adjusting for redirection of care. Random forest models identified employment status and dependence on support as key factors associated with redirection of care, while sex did not improve model performance. Our results underline the importance of SDH for prognostication of patients with TBI and suggest that it is not sex

Indexed as

end of lifesex differencessocial determinants of healthtraumatic brain injury

Identifiers

PMID40933835
PMCPMC12419443

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.