Translational Research of Traumatic Brain Injuries, Establishment of a Spinal Surgery Registry

Traumatic brain injury (TBI) is a major public health issue, being the primary cause of mortality and long-term disability during the active years of life. Each year, tens of thousands of people suffer from head injuries of varying severity, many resulting in permanent brain damage, highlighting the importance of this healthcare area in reducing preventable healthy life years lost and healthcare costs. Although research on the management of head injuries provides a solid foundation for general care strategies, outcome data have not improved in recent decades. The primary reason for this is that managing the complex injury of our most intricate organ can only be successful through high-level, multimodal monitoring of brain functions, rapid evaluation of results, and immediate integration into therapeutic decision-making.

The rapid expansion of digital medicine raises a fundamental question in neurotraumatology: how can vast amounts of multimodal data be integrated and analyzed in real time to support personalized therapeutic decision-making?

At the Department of Neurosurgery of the University of Pécs, a unique infrastructure has been established in recent years for the treatment of critically ill patients requiring intensive care. Using a globally recognized clinical neuromonitoring system, we can obtain real-time data on pathological brain states. However, the various pathological variables detected by different sensors and their conversion into electrical signals are not currently integrated into a unified platform, making it impossible to examine correlations between individual parameters.

Our goal is to develop a platform (software) capable of comprehensively collecting and algorithmically analyzing these parameters. In addition to invasively collected data, it will integrate the patient's previous medical history and imaging information. Furthermore, the platform will objectively assess therapeutic decisions in the acute phase for hospitalized head injury patients and provide early predictions of long-term cognitive decline.

We aim to develop a unique, integrated clinical platform in Europe with high added value, enabling fully personalized care for patients with traumatic brain injuries, enhancing existing therapies, and facilitating the development of new ones. Through its application, a real-world data-based database will be created, enabling the identification of the most effective therapeutic practices while providing real-time decision-support recommendations. Expanding this network could lay the foundation for a clinical system that supports both drug trials and the introduction of therapeutic best practices, serving personalized patient care and research internationally.

Diseases and traumatic injuries affecting the spine pose a significant public health burden. It is crucial that the data generated during patient care is recorded in a structured, searchable, comparable, and analyzable format. This way, it can be utilized not only in daily healthcare but also in clinical research. To this end, we have developed a data collection form and database (spinal registry) specifically designed for spinal patients.

One of the main advantages of using these forms is that both ambulatory and inpatient spinal patients—whether awaiting acute or elective intervention—receive standardized care upon admission. This ensures that patients belonging to similar groups receive the same professional quality of care regardless of the attending physician. During our work, we selected the most frequently used, validated algorithms from the literature.

During data collection, the system provides patient-specific therapeutic recommendations to the physician. These easily and quickly usable "score" systems aid in selecting the appropriate therapy for patients with spinal tumors, spinal fractures, osteoporosis-related conditions, and inflammatory spinal diseases. Additionally, the detailed data collection allows for the prospective assessment of patients' medical history, the precise characterization of their pain, neurological status, and quality of life, as well as the examination of surgical specifications. This type of data collection is particularly important for clinical practice as it enables the objective measurement of therapeutic effectiveness and helps identify patients who respond less favorably to treatment. By analyzing such cases, we can continue to refine our care system.

By using structured data forms, each patient receives the most appropriate care, and the effectiveness of our therapeutic interventions becomes measurable, providing essential support for clinical research as well.