Abstract
AbstractFast acquisition of a first computed tomography (CT) scan after traumatic brain injury (TBI) is recommended. This study is aimed at investigating whether the length of the period preceding initial CT scan influences mortality in patients with leading TBI. A retrospective cohort analysis of patients registered in the TraumaRegister DGU® was conducted including adult patients with TBI, defined as Abbreviated Injury ScaleHead ≥ 3 and GCS ≤ 13 who had been treated in level 1 or 2 trauma centers from 2007–2016. Patients were grouped according to time intervals either from trauma or from admission to CT. A total of 6904 patients met the inclusion criteria. Mean time period from trauma to hospital admission was 68.8 min. From admission to first CT, a mean of 19.0 min elapsed. Trauma severity was higher in groups with a longer duration from trauma to CT as represented by a mean (± standard deviation) Injury Severity Score (ISS) of 19.8 ± 9.0, 20.7 ± 9.3, and 21.4 ± 7.5 and similar distribution of mortality of 24.9%, 29.9%, and 36.3% in the ≤ 60-min, 61–120-min, and ≥ 121-min groups, respectively. An adjusted multivariable logistic regression model showed a significant influence of the level of the trauma center (p = 0.037) but not for interval from admission to CT (p = 0.528). TBI patients with a longer time span from trauma to first CT were more severely injured and demonstrated a worse prognosis, but received a CT scan faster when duration from admission is observed. The duration until the CT scan was obtained showed no significant impact on the mortality.
Publisher
Springer Science and Business Media LLC
Subject
Clinical Neurology,General Medicine,Surgery
Reference20 articles.
1. Baker SP, O'Neill B, Haddon W Jr, Long WB (1974) The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 14(3):187–196
2. Brazinova A, Majdan M, Leitgeb J, Trimmel H, Mauritz W (2015) Austrian Working Group on Improvement of Early TBI Care. Factors that may improve outcomes of early traumatic brain injury care: prospective multicenter study in Austria. Scand J Trauma Resusc Emerg Med 23:53. https://doi.org/10.1186/s13049-015-0133-z
3. DGU Weißbuch Schwerverletztenversorgung, 3. Erweiterte Auflage 2019 (Vorabdruck) https://www.dgu-online.de/fileadmin/published_content/5.Qualitaet_und_Sicherheit/PDF/2019_DGU_Weissbuch_Schwerverletztenversorgung_Vorabdruck.pdf [in German, accessed Mar 10 2020]
4. Fainardi E, Chieregato A, Antonelli V, Fagioli L, Servadei F (2004) Time course of CT evolution in traumatic subarachnoid haemorrhage: a study of 141 patients. Acta Neurochir 146(3):257–263. https://doi.org/10.1007/s00701-003-0207-y
5. Fakhry SM, Trask AL, Waller MA, Watts DD, IRTC Neurotrauma Task Force (2004) Management of brain-injured patients by an evidence-based medicine protocol improves outcomes and decreases hospital charges. J Trauma 56(3):492–500. https://doi.org/10.1097/01.ta.0000115650.07193.66
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