Rabie Adel El Arab, Rita Urbanavice, Agne Jakavonyte-Akstiniene, Marija Skvarcevskaja, Donatas Austys, Erica Briones-Vozmediano, Esther Rubinat-Arnaldo, Natalja Istomina
"We want our freedom back, that's our only need": a qualitative study of health and social needs among asylum seekers and undocumented migrants crossing the borders from Belarus to Lithuania
Frontiers in public health
background objective timely palliative care involvement offers demonstrable benefits traumatic brain injury tbi patients however palliative care consultations pccs used inconsistently tbi management study aimed employ advanced machine learning techniques elucidate primary drivers pcc timing variability tbi patients methods data admission hospital course outcomes collected cohort 232 tbi patients received pccs neurosurgical consultations hospitalization principal component analysis pca kmeans clustering used identify patient phenotypes compared using kaplanmeier analysis extreme gradient boosting model xgboost employed determine drivers pcc timing model interpretation performed using shapley additive explanations shap results cluster n 86 consisted mainly older median iqr 87 78 94 years white females mild tbis demonstrated shortest timetopcc 25 10 70 days cluster b n 108 also sustained mild tbis comprised moderately younger 81 75 86 years married white males later pcc 50 30 108 days cluster c n 38 represented much younger 465 295 598 years severely injured nonwhite patients latest pcc initiation 90 42 170 days clusters differ discharge disposition p 04 frequency inpatient mortality p 09 however kaplanmeier analysis revealed significant difference time admission pcc p 0001 despite differences time admission mortality p 018 shap analysis xgboost model identified age sex race influential drivers pcc timing conclusions study highlights crucial disparities pcc timing tbi patients underscores need targeted strategies ensure timely equitable palliative care integration vulnerable population