Gweniviere Kayla Capron1, Mary Beth Voights1, Henry R Moore1, Derek B Wall2. 1. Division of Trauma, Department of Surgery, Carle Foundation Hospital, Urbana, IL, USA. 2. Division of Trauma, Department of Surgery, Carle Foundation Hospital, Urbana, IL, USA. Electronic address: dwall@northshore.org.
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.
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 1patients deteriorated or required surgical intervention. One BIG 2patient 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.
Authors: Nima Alan; Song Kim; Nitin Agarwal; Jamie Clarke; Donald M Yealy; Aaron A Cohen-Gadol; Raymond F Sekula Journal: J Clin Neurosci Date: 2020-10-15 Impact factor: 1.961