Global Neurotrauma Outcomes Study 1 (GNOS‐1)

The GNOS‐1 study aims, for the first time, to provide a comprehensive picture of the management and outcomes of patients undergoing emergency cranial surgery after a traumatic brain injury (TBI) worldwide. Our aim is to include as many hospitals from as many countries as possible. Additionally, the study will form the basis of a future TBI registry supported by the World Federation of Neurosurgical Societies (WFNS).
The provisional start date for this project is September 2018.

For more information about the study please visit:

To register your interest and to stay up to date, please email



  1. Describe patient demographics, baseline clinical characteristics, indications for surgery, choice of procedure, perioperative care in emergency cranial surgery for TBI worldwide.
  2. Describe outcomes from emergency cranial surgery for TBI worldwide.
  3. Identify modifiable factors associated with a favourable outcome.


As part of the registration process for the GNOS study we will be asking all participants to fill out a short provider profile survey on Emergency Neurosurgical Practice in their institution to give context to the entered data.


  • Multi-centre, prospective observational study.
  • Any hospital in the world performing emergency cranial surgery following TBI can participate.
  • Each hospital will have a lead investigator.

a) A team of up to 4 collaborators (including lead investigator) will identify patients and collect data.

 b) Lead investigators will also be responsible for gaining local approvals and creating clear methods for collecting all required data on all eligible patients.

c) The participation of residents / registrars / trainees is encouraged.


  • Every patient receiving emergency surgery for TBI in any consecutive 30-day period between June and December 2018.
    • This wide period has been chosen in order to maximise flexibility.
    • Each local team of investigators should select the most convenient consecutive 30-day period.


  • Patients undergoing only insertion of external ventricular drain or ICP monitor cannot be included.
  • The index procedure should not be a revision procedure (e.g. re-evacuation of haematoma).
  • Planned or semi-elective (where the patient was initially admitted as an emergency, then discharged from hospital, and re-admitted at later time for surgery) procedures cannot be included.


  • 14-day mortality
  • Return to operating theatre for cranial surgery
  • Length of stay in hospital
  • GCS at discharge
  • Discharge destination