Page 70 - DECISION-MAKING IN SEVERE TRAUMATIC BRAIN INJURY PATIENT OUTCOME, HOSPITAL COSTS, AND RESEARCH PRACTICE

Chapter 3
In this systematic review, we have therefore focussed on: (1) providing a detailed insight in the reported in-hospital costs for patients with s-TBI and (2) assessing the (quality of) study methodology.
METHODS
This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. 23 The study protocol was registered in the PROSPERO International Prospective Register of Systematic Review with registration number CRD42018081131.
Literature search
A final systematic literature search was performed on the 8th of August 2018 using the following databases: PubMed, MEDLINE, Embase, Web of Science, Cochrane library, CENTRAL, Emcare, PsychINFO, Academic Search Premier and Google Scholar. The search strategy was developed and conducted with the assistance of a trained clinical librarian. All relevant information on the literature search can be found in S1 Appendix. In addition to the search, the reference lists of all included articles were manually checked for additional relevant studies.
Inclusion/exclusion criteria
Studies were included when the in-hospital costs or in-hospital charges of a cohort of >10 patients with s-TBI were reported. Because the appellation “severe TBI” encompassed a range of brain injuries considered to be too varied for appropriate comparison the two most widely used classifications for s-TBI were applied: Glasgow Coma Scale (GCS) ≤8 and/or Abbreviated Injury Scale (AIS) ≥4. 24-26 We excluded reviews, commentaries, editorials, conference and meeting abstracts, unpublished data, non-English studies and studies that could not be found or retrieved in full text. Studies were also excluded when in-hospital costs related to acute care were not distinguishable from other costs like indirect non-healthcare related costs (e.g. loss of productivity), (in-hospital) rehabilitation or long-term costs. There were no restrictions on publication date or patient characteristics.
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