Methodological Considerations on the Retrospective Cohort Study of Remifentanil-Propofol versus Propofol Alone in Severe Traumatic Brain Injury [Letter]

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To address methodological concerns regarding the efficacy of remifentanil-propofol versus propofol alone in severe traumatic brain injury outcomes.
Analysis of a retrospective cohort study involving 113 patients undergoing severe TBI surgery.
Comparison of Good Recovery rates as measured by the Glasgow Outcome Scale at three months post-surgery.
Evaluation of baseline characteristics and potential confounding factors in patient allocation.
The remifentanil-propofol group reported a Good Recovery rate of 54.39% compared to 25.00% in the propofol-alone group (P = 0.001).
Concerns raised about the biological plausibility of outcome differences and the lack of clarity in group allocation.
Differences in extubation and awakening times reported, though considered pharmacokinetically expected.

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Letter critiques a retrospective cohort study comparing anesthetic approaches in severe traumatic brain injury, suggesting methodological flaws.

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ŞİMŞEK et al. (2026) studied this question.

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