Implementation of a Traumatic Brain Injury Guideline at A Department of Defense Level 1 Trauma Center

Traumatic brain injury (TBI) is one of the most prevalent diagnoses among trauma populations and places significant strain on valuable rural hospital resources. Limited studies show safety and efficacy of implementation of a Brain Injury Guideline (BIG) protocol at a Department of Defense (DoD) Leve...

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Bibliographic Details
Published in:The Journal of surgical research 2022-04, Vol.272, p.117-124
Main Authors: Vitale, Dominick, Bohan, Phillip Kemp, How, Remealle, Arnold-Lloyd, Travis, Aden, James K., Sams, Valerie
Format: Article
Language:English
Subjects:
Acute Care Surgery
Brain Injuries
Brain Injuries, Traumatic - diagnosis
Brain Injuries, Traumatic - epidemiology
Brain Injuries, Traumatic - therapy
Brain Injury Guidelines
Hospital Mortality
Humans
Neurosurgical Intervention
Resource Utilization
Retrospective Studies
Trauma Centers
Traumatic Brain Injury
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Summary:Traumatic brain injury (TBI) is one of the most prevalent diagnoses among trauma populations and places significant strain on valuable rural hospital resources. Limited studies show safety and efficacy of implementation of a Brain Injury Guideline (BIG) protocol at a Department of Defense (DoD) Level 1 trauma center. Data from patients diagnosed with traumatic brain injury during the study period were collected from our institutional trauma database. A retrospective review was performed on patients identified in the database to collect demographic and injury related data. All primary and secondary outcome data were analyzed using two-tailed Fischer's exact tests, Pearson Chi-square tests, and non-parametric Mann Whitney U tests. A total of 354 patients were included in the study, 189 pre-implementation and 165 post-implementation. Demographics, head injury severity, initial HCT findings, and BIG classification distributions were well-matched. There was a significant reduction in neurosurgical consultations (NSC) (98.4% pre- to 77.0% post-implementation, P
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2021.10.028