BACKGROUND: Critical pathways for the management of patients with severe traumatic brain injury (STBI) may contribute to reducing the incidence of hospital complications, length of hospitalization stay, and cost of care. Such pathways have previously been developed for departments with significant resource availability. In Mexico, STBI is the most important cause of complications and length of stay in neurotrauma services at public hospitals. Although current treatment is designed basically in accordance with the Brain Trauma Foundation guidelines, shortfalls in the availability of local resources make it difficult to comply with these standards, and no critical pathway is available that accords with the resources of public hospitals. The purpose of the present study was to design and to validate a critical pathway for managing STBI patients that would be suitable for implementation in neurotrauma departments of middle-income level countries. METHODS: The study comprised two phases: design (through literature review and design plan) and validation (content, construct, and appearance) of the critical pathway. RESULTS: The validated critical pathway for managing STBI patients entails four sequential subprocesses summarizing the hospital's care procedures, and includes three components: (1) nodes and criteria (in some cases, indicators are also included); (2) health team members in charge of the patient; (3) maximum estimated time for compliance with recommendations. CONCLUSIONS: This validated critical pathway is based on the current scientific evidence and accords with the availability of resources of middle-income countries.
BACKGROUND: Critical pathways for the management of patients with severe traumatic brain injury (STBI) may contribute to reducing the incidence of hospital complications, length of hospitalization stay, and cost of care. Such pathways have previously been developed for departments with significant resource availability. In Mexico, STBI is the most important cause of complications and length of stay in neurotrauma services at public hospitals. Although current treatment is designed basically in accordance with the Brain Trauma Foundation guidelines, shortfalls in the availability of local resources make it difficult to comply with these standards, and no critical pathway is available that accords with the resources of public hospitals. The purpose of the present study was to design and to validate a critical pathway for managing STBI patients that would be suitable for implementation in neurotrauma departments of middle-income level countries. METHODS: The study comprised two phases: design (through literature review and design plan) and validation (content, construct, and appearance) of the critical pathway. RESULTS: The validated critical pathway for managing STBI patients entails four sequential subprocesses summarizing the hospital's care procedures, and includes three components: (1) nodes and criteria (in some cases, indicators are also included); (2) health team members in charge of the patient; (3) maximum estimated time for compliance with recommendations. CONCLUSIONS: This validated critical pathway is based on the current scientific evidence and accords with the availability of resources of middle-income countries.
Authors: Randall M Chesnut; Nancy Temkin; Walter Videtta; Gustavo Petroni; Silvia Lujan; Jim Pridgeon; Sureyya Dikmen; Kelley Chaddock; Jason Barber; Joan Machamer; Nahuel Guadagnoli; Peter Hendrickson; Sergio Aguilera; Victor Alanis; Manuel Enrique Bello Quezada; Ermitaño Bautista Coronel; Luis Alberto Bustamante; Armando C Cacciatori; Carlos Javier Carricondo; Felipe Carvajal; Rafael Davila; Mario Dominguez; Jairo Antonio Figueroa Melgarejo; Maria Martha Fillipi; Daniel A Godoy; Delia Cristina Gomez; Angel J Lacerda Gallardo; Juan Antonio Guerra Garcia; Gustavo la Fuente Zerain; Luis Arturo Lavadenz Cuientas; Cecilio Lequipe; Gerardo Vicente Grajales Yuca; Manuel Jibaja Vega; Michael Eduardo Kessler; Hubiel J López Delgado; Freddy Sandi Lora; Ana Maria Mazzola; Roberto Merida Maldonado; Natascha Mezquia de Pedro; J Ricardo Martínez Zubieta; Julio C Mijangos Méndez; Jacobo Mora; Johnny Marcelo Ochoa Parra; Perla B Pahnke; Jorge Paranhos; Gustavo R Piñero; Francisco A Rivadeneira Pilacuán; Mario Napoleon Mendez Rivera; Ricardo Luis Romero Figueroa; Andres M Rubiano; Alexandra Matilde Saraguro Orozco; Juan Ignacio Silesky Jiménez; Luis Silva Naranjo; Caridad Soler Morejon; Zulma Urbina Journal: J Neurotrauma Date: 2020-03-04 Impact factor: 5.269
Authors: Jin Hoan Kim; Ha Young Byun; Seungnam Son; Joong Hoon Lee; Chul Ho Yoon; Eun Shin Lee; Heesuk Shin; Min-Kyun Oh Journal: Ann Rehabil Med Date: 2014-10-30