ArticleFrontiers in neurology
Neurosurgical intervention versus conservative management in older adults with traumatic brain injury: a protocol for a systematic review and meta-analysis.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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.
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Who cites it
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Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Traumatic brain injury in older adults represents a serious public health challenge with complex management decisions. The aging population exhibits distinct pathophysiological responses to brain injury, altered recovery trajectories, and increased vulnerability to both surgical and medical complications. Decision-making regarding neurosurgical intervention versus conservative management remains contentious, with limited high-quality evidence specific to older populations. Existing guidelines predominantly derive from younger cohorts, potentially misaligning with the unique risk-benefit profiles of older adults. Objectives: This systematic review and meta-analysis protocol aims to synthesize evidence comparing neurosurgical intervention with conservative management for older adults with traumatic brain injury, examining functional outcomes, mortality, quality of life, and complications to inform evidence-based clinical decision-making. Methods: Following PRISMA-P guidelines, we will search PubMed, MEDLINE, Embase, Scopus, Cochrane Library, Web of Science, CINAHL, PsycINFO, and PEDro from inception to December 2025. Eligibility criteria include adults aged 65 years and older with traumatic brain injury comparing neurosurgical intervention with conservative management. Two reviewers will independently screen studies and extract data using standardized forms. Risk of bias assessment will employ the Cochrane RoB 2 tool for randomized trials and ROBINS-I for non-randomized studies. Random-effects meta-analysis will be conducted where appropriate, with heterogeneity assessed using I Discussion: This protocol establishes rigorous methodology for synthesizing comparative effectiveness evidence on neurosurgical versus conservative management in older adults with traumatic brain injury. Findings will address critical evidence gaps, informing clinical guidelines, shared decision-making frameworks, and research priorities for optimizing outcomes in this vulnerable population. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261376172, identifier PROSPERO (CRD420261376172).
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