Identification and management of low-risk isolated traumatic brain injury patients initially treated at a rural level IV trauma center.
Am J Emerg Med
; 78: 127-131, 2024 Apr.
Article
en En
| MEDLINE
| ID: mdl-38266433
ABSTRACT
STUDY OBJECTIVE:
Our goal was to determine if low-risk, isolated mild traumatic brain injury (TBI) patients who were initially treated at a rural emergency department may have been safely managed without transfer to the tertiary referral trauma center.METHODS:
This was a retrospective observational analysis of isolated mild TBI patients who were transferred from a rural Level IV Trauma Center to a regional Level I Trauma Center between 2018 and 2022. Patients were risk-stratified according to the modified Brain Injury Guidelines (mBIG). Data abstracted from the electronic medical record included patient presentation, management, and outcomes.RESULTS:
250 patients with isolated mild TBI were transferred out to the Level I Trauma Center. Fall was the most common mechanism of injury (69.2%). 28 patients (11.2%) were categorized as low-risk (mBIG1). No mBIG1 patients suffered a progression of neurological injury, had worsening of intracranial hemorrhage on repeat head CT, or required neurosurgical intervention. 12/28 (42.9%) of mBIG1 patients had a hospital length of stay of 2 days or less, typically for observation. Those with longer lengths of stay were due to medical complications, such as sepsis, or difficulty in arranging disposition.CONCLUSION:
We propose that patients who meet mBIG1 criteria may be safely observed without transfer to a referral Level I Trauma Center. This would be of considerable benefit to patients, who would not need to leave their community, and would improve resource utilization in the region.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Conmoción Encefálica
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Lesiones Encefálicas
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Lesiones Traumáticas del Encéfalo
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
Am J Emerg Med
Año:
2024
Tipo del documento:
Article