Moderate and severe traumatic brain injury in general hospitals: a ten-year population-based retrospective cohort study in central Norway

Background Patients with moderate and severe traumatic brain injury (TBI) are admitted to general hospitals (GHs) without neurosurgical services, but few studies have addressed the management of these patients. This study aimed to describe these patients, the rate of and reasons for managing patient...

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Main Authors: Rahim, Shavin, Laugsand, Eivor Alette, Fyllingen, Even Hovig, Rao, Vidar, Pantelatos, Rabea Iris, Müller, Tomm Brostrup, Vik, Anne, Skandsen, Toril
Format: Article
Language:English
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Summary:Background Patients with moderate and severe traumatic brain injury (TBI) are admitted to general hospitals (GHs) without neurosurgical services, but few studies have addressed the management of these patients. This study aimed to describe these patients, the rate of and reasons for managing patients entirely at the GH, and differences between patients managed entirely at the GH (GH group) and patients transferred to the regional trauma centre (RTC group). We specifically examined the characteristics of elderly patients. Methods Patients with moderate (Glasgow Coma Scale score 9–13) and severe (score ≤ 8) TBIs who were admitted to one of the seven GHs without neurosurgical services in central Norway between 01.10.2004 and 01.10.2014 were retrospectively identified. Demographic, injury-related and outcome data were collected from medical records. Head CT scans were reviewed. Results Among 274 patients admitted to GHs, 137 (50%) were in the GH group. The transferral rate was 58% for severe TBI and 40% for moderate TBI. Compared to the RTC group, patients in the GH group were older (median age: 78 years vs. 54 years, p