Mortality rates of severe traumatic brain injury patients: impact of direct versus nondirect transfers

Prabhakaran, Kartik; Petrone, Patrizio; Lombardo, Gary; Stoller, Christy; Policastro, A.J.; Marini, Corrado P.

doi:10.1016/j.jss.2017.05.103

Cited by 34 publications

(25 citation statements)

References 17 publications

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“…The regular assessment of the risk of deterioration through EWS is a standard procedure in multiple clinical context the use of which is more than contrasted [14,15,28] and which can help to detect patients with TBI and a high risk [49,50]. Determining which patients may be subsidiaries of advanced procedures and rapid transportation to a useful center must be a priority for the EMS [51].…”

Section: Early Warning Scores (Ews) and Prehospital Tbimentioning

confidence: 99%

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Martin-Rodríguez

López-Izquierdo

Mohedano-Moriano

et al. 2020

IJERPH

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Traumatic brain injuries are complex situations in which the emergency medical services must quickly determine the risk of deterioration using minimal diagnostic methods. The aim of this study is to analyze whether the use of early warning scores can help with decision-making in these dynamic situations by determining the patients who need the intensive care unit. A prospective, multicentric cohort study without intervention was carried out on traumatic brain injury patients aged over 18 given advanced life support and taken to the hospital. Our study included a total of 209 cases. The total number of intensive-care unit admissions was 50 cases (23.9%). Of the scores analyzed, the National Early Warning Score2 was the best result presented with an area under the curve of 0.888 (0.81–0.94; p < 0.001) and an odds ratio of 25.4 (95% confidence interval (CI):11.2–57.5). The use of early warning scores (and specifically National Early Warning Score2) can help the emergency medical services to differentiate traumatic brain injury patients with a high risk of deterioration. The emergency medical services should use the early warning scores routinely in all cases for the early detection of high-risk situations.

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Section: Early Warning Scores (Ews) and Prehospital Tbimentioning

confidence: 99%

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Martin-Rodríguez

López-Izquierdo

Mohedano-Moriano

et al. 2020

IJERPH

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“…However, this effect on mortality was only seen in patients with severe TBI. The overall mortality of patients with mild and moderate TBI did not differ if admitted directly or after transfer from a non-trauma center [33].…”

Section: Prehospital and Emergency Carementioning

confidence: 99%

Prehospital and Emergency Care in Adult Patients with Acute Traumatic Brain Injury

2019

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Traumatic brain injury (TBI) is a major healthcare problem and a major burden to society. The identification of a TBI can be challenging in the prehospital setting, particularly in elderly patients with unobserved falls. Errors in triage on scene cannot be ruled out based on limited clinical diagnostics. Potential new mobile diagnostics may decrease these errors. Prehospital care includes decision-making in clinical pathways, means of transport, and the degree of prehospital treatment. Emergency care at hospital admission includes the definitive diagnosis of TBI with, or without extracranial lesions, and triage to the appropriate receiving structure for definitive care. Early risk factors for an unfavorable outcome includes the severity of TBI, pupil reaction and age. These three variables are core variables, included in most predictive models for TBI, to predict short-term mortality. Additional early risk factors of mortality after severe TBI are hypotension and hypothermia. The extent and duration of these two risk factors may be decreased with optimal prehospital and emergency care. Potential new avenues of treatment are the early use of drugs with the capacity to decrease bleeding, and brain edema after TBI. There are still many uncertainties in prehospital and emergency care for TBI patients related to the complexity of TBI patterns.

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“… 6) Additionally, following the established guidelines, when managing neurotrauma, will lead to decreased mortality rates. 22) …”

Section: Discussionmentioning

confidence: 99%

Brain Trauma Mortality Rate Score Scale (BTMRSS): Postmortem Evaluation of the Events

Nikova

Dimitrov²

2020

Korean J Neurotrauma

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Objective Brain trauma and its burden is becoming a significant cause of permanent damage and deterioration. Prioritization at the place of the incident and calculation of mortality are leading factors for the final management, but all of them are obtained from living patients. When the autopsies are made there is no actual score system to guide the forensic scientists in their conclusions. Should all of the cadavers with traumatic brain injury (TBI) have been dead? Therefore, we aim to present a score system—brain trauma mortality score scale (BTMSS), aiming to evaluate postmortem the actual risk of mortality. Methods We established a score scale, which could be used on cadavers for the evaluation of the events. Afterwards, we applied this score scale on the reports of the cadavers who suffered blunt force TBI for a 10-year period of time between 2007 and 2016. Thereafter, the results were processed with SPSS version 25. Results The outcome showed that there is a significant difference between the scores of the cadavers who died at the place of the incident and those who died in hospital thus approving that the BTMSS works well, as well as the importance of level I trauma center. Conclusion Every score system could show something useful for the management of the TBIs. The solution and improvement in the outcome of the current study would be a level I trauma center with a qualified neurosurgical department.

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Mortality rates of severe traumatic brain injury patients: impact of direct versus nondirect transfers

Cited by 34 publications

References 17 publications

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Identification of Serious Adverse Events in Patients with Traumatic Brain Injuries, from Prehospital Care to Intensive-Care Unit, Using Early Warning Scores

Prehospital and Emergency Care in Adult Patients with Acute Traumatic Brain Injury

Brain Trauma Mortality Rate Score Scale (BTMRSS): Postmortem Evaluation of the Events

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