Increasing incidence of ED-visits and admissions due to traumatic brain injury among elderly patients in the Netherlands, 2011–2020

Santing, Juliette A.L.; Brand, Crispijn L.Van Den; Panneman, Martien J.M.; Asscheman, J.Susanne; van der Naalt, Joukje; Jellema, Korné

doi:10.1016/j.injury.2023.110902

Cited by 6 publications

(1 citation statement)

References 31 publications

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“…There is little hard scientific evidence for many aspects of the acute evaluation of these patients, but a strong clinical experience and consensus [10]. There is still insufficient evidence to show how some existing recommendations (such as using head computed tomography [CT] rules or biomarkers) apply for elderly people [11][12][13][14], frequently presenting with comorbidities and polypharmacy, including drugs affecting bleeding risk. We focus on a practical everyday approach to acute TBIs not in obvious need of immediate in-hospital care, without delineating these injuries as 'mild' or 'moderate', which is often impossible in the ED.…”

Section: Introductionmentioning

confidence: 99%

Consensus paper on the assessment of adult patients with traumatic brain injury with Glasgow Coma Scale 13–15 at the emergency department: A multidisciplinary overview

Backus,

Moustafa,

Skogen

et al. 2024

European Journal of Emergency Medicine

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Traumatic brain injury (TBI) is a common reason for presenting to emergency departments (EDs). The assessment of these patients is frequently hampered by various confounders, and diagnostics is still often based on nonspecific clinical signs. Throughout Europe, there is wide variation in clinical practices, including the follow-up of those discharged from the ED. The objective is to present a practical recommendation for the assessment of adult patients with an acute TBI, focusing on milder cases not requiring in-hospital care. The aim is to advise on and harmonize practices for European settings. A multiprofessional expert panel, giving consensus recommendations based on recent scientific literature and clinical practices, is employed. The focus is on patients with a preserved consciousness (Glasgow Coma Scale 13–15) not requiring in-hospital care after ED assessment. The main results of this paper contain practical, clinically usable recommendations for acute clinical assessment, decision-making on acute head computerized tomography (CT), use of biomarkers, discharge options, and needs for follow-up, as well as a discussion of the main features and risk factors for prolonged recovery. In conclusion, this consensus paper provides a practical stepwise approach for the clinical assessment of patients with an acute TBI at the ED. Recommendations are given for the performance of acute head CT, use of brain biomarkers and disposition after ED care including careful patient information and organization of follow-up for those discharged.

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