Not every trauma patient with a radiographic head injury requires transfer for neurosurgical evaluation: Application of the brain injury guidelines to patients transferred to a level 1 trauma center.

Abstract:

BACKGROUND:Patients with radiographically-identified traumatic brain injury are often transferred to our regional trauma center for neurosurgical evaluation, yet few injuries require neurosurgical intervention. Transfer is costly, inconvenient, and potentially risky in inclement weather. We propose that previously-published brain injury guidelines (BIG)1 can help to determine which patients could avoid mandatory transfer. METHODS:Retrospective chart review of patients transferred between January 2012 and December 2013 was performed. Patients were classified as having minor (BIG 1), moderate (BIG 2), or severe (BIG 3) head injuries based on previously-published guidelines. Patient characteristics and outcomes were compared. RESULTS:No BIG 1 patients deteriorated or required surgical intervention. One BIG 2 patient required a non-emergent operation and another was readmitted with a worsened injury. In the BIG 3 group, 11.9% required neurosurgical procedures and 20% died. CONCLUSIONS:The BIG classification can help stratify patients for whom transfer is considered.

journal_name

Am J Surg

authors

Capron GK,Voights MB,Moore HR 3rd,Wall DB

doi

10.1016/j.amjsurg.2017.09.002

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

1182-1185

issue

6

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(17)30375-6

journal_volume

214

pub_type

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