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

2022 ◽  
Vol 272 ◽  
pp. 117-124
Author(s):  
Dominick Vitale ◽  
Phillip Kemp Bohan ◽  
Remealle How ◽  
Travis Arnold-Lloyd ◽  
James K Aden ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Trauma Center ◽  
Level 1 ◽  
Level 1 Trauma Center

scholarly journals Detection of S-100β Protein in Plasma and Urine After a Mild Traumatic Brain Injury

2019 ◽  
Vol 46 (5) ◽  
pp. 599-602 ◽  
Author(s):  
Natalie Le Sage ◽  
Pier-Alexandre Tardif ◽  
Jérôme Frenette ◽  
Marcel Émond ◽  
Jean-Marc Chauny ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Trauma Center ◽  
Invasive Procedure ◽  
Urine Samples ◽  
Non Invasive ◽  
Plasma And Urine Samples ◽  
Level 1 ◽  
Level 1 Trauma Center

ABSTRACT:This study assessed whether S-100β protein could be measured in urine when detectable in plasma after a mild traumatic brain injury (mTBI). Clinical data, plasma and urine samples were collected for the 46 adult patients prospectively enrolled in the emergency department (ED) of a Level 1 trauma center. S-100β protein concentrations were analysed using ELISA. S-100β protein was detectable in 91% and 71% of plasma and urine samples, but values were not correlated (r = 0.002). Urine sampling would have been a non-invasive procedure, but it does not appear to be useful in the ED during the acute phase after an mTBI.

Early Prognostication after Traumatic Brain Injury: Specific Validation of the IMPACT Prognostic Calculator in a Level 1 Trauma Center

2019 ◽  
Vol 80 (06) ◽  
pp. 423-429
Author(s):  
Anna Jung ◽  
Felix Arlt ◽  
Maciej Rosolowski ◽  
Jürgen Meixensberger
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Trauma Center ◽  
Roc Analysis ◽  
Time Frame ◽  
Extended Model ◽  
Severe Tbi ◽  
Level 1 ◽  
The Impact ◽  
Level 1 Trauma Center

AbstractThe present study evaluated the usefulness of the IMPACT prognostic calculator (IPC) for patients receiving acute neurointensive care at a level 1 trauma center in Germany. A total of 139 patients with traumatic brain injury (TBI) were assessed. One day after trauma, the extended model of the IPC was found to provide the most valid prediction of 6-month mortality/unfavorable outcome. Different time frames within the first day could be determined by analyzing mild, moderate, and severe TBI cohorts. The CORE + CT model at time frame Z2 (<6 h from the point of first documentation) for mild TBI exhibited the highest values in the receiver operating characteristic (ROC) analysis (area under the curve [AUC], 0.9; sensitivity, 1; specificity, 0.7). For patients with moderate head injury at time frame Z2/3 (<6–12 h from point of first documentation), the extended model fit best. For patients with severe TBI, the extended model at time frame Z6 (48–72 h from point of first documentation) best predicted 6-month mortality and unfavorable outcome (ROC analysis: AUC, 0.542/0.445; sensitivity, 0.167/0.364; specificity, 0.575/0.444). Center-specific validation demonstrated the validity of the IPC in the early phase after TBI. These findings support the usefulness of the IPC for predicting the prognosis of patients with TBI. However, further prospective validation using a larger TBI cohort is needed.

Ethnicity/race and service-connected disability disparities in civilian traumatic brain injury mechanism of injury and VHA health services costs in military veterans: Evidence from a Level 1 Trauma Center and VA Medical Center

Trauma ◽  
2020 ◽  
pp. 146040862091443
Author(s):  
CE Dismuke-Greer ◽  
SM Fakhry ◽  
MD Horner ◽  
TK Pogoda ◽  
MJ Pugh ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
African American ◽  
Brain Injury ◽  
Military Service ◽  
Trauma Center ◽  
Mechanism Of Injury ◽  
Level 1 ◽  
Level 1 Trauma Center ◽  
African American Race ◽  
Hispanic White

Introduction The objective of this study was to examine the association of military veteran socio-demographics and service-connected disability with civilian mechanism of traumatic brain injury and long-term Veterans Health Administration (VHA) costs. Methods We conducted a 17-year retrospective longitudinal cohort study of veterans with a civilian-related traumatic brain injury from a Level 1 Trauma Center between 1999 and 2013, with VHA follow-up through 2016. We merged trauma center VHA data, and used logit to model mechanism of injury, and generalized linear model to model VHA costs. Results African American race or Hispanic ethnicity veterans had a higher unadjusted rate of civilian assault/gun as mechanism of injury (15.38%) relative to non-Hispanic White (7.19%). African American race or Hispanic veterans who were discharged from the trauma center with traumatic brain injury and followed in VHA had more than twice the odds of assault/gun (OR 2.47; 95% CI 1.16:5.26), after adjusting for sex, age, and military service-connected disability. Veterans with service-connected disability ≥50% had more than twice the odds of assault/gun (OR 2.48; 95% CI 0.97:6.31). Assault/gun was associated with significantly higher annual VHA costs post-discharge ($16,807; 95% CI 672:32,941) among non-Hispanic White veterans. Military service-connected disability ≥50% was associated with higher VHA costs among both non-Hispanic White ($44,987; 95% CI $17,159:$72,816) and African American race or Hispanic ($37,901; 95% CI $4,543:$71,258) veterans. Conclusions We found that African American race or Hispanic veterans had higher adjusted likelihood of assault/gun mechanism of traumatic brain injury, and non-Hispanic White veterans had higher adjusted annual VHA resource costs associated with assault/gun, post trauma center discharge. Veterans with higher than 50% service-connected disability had higher likelihood of assault/gun and higher adjusted annual VHA resource costs. Assault/gun prevention efforts may be indicated within the VHA, especially in minority and service-connected disability veterans. More data from Level 1 Trauma Centers are needed to assess the generalizability of these findings.

scholarly journals Results of delayed follow-up imaging in traumatic brain injury

2016 ◽  
Vol 124 (3) ◽  
pp. 703-709 ◽  
Author(s):  
Adam Ross Befeler ◽  
William Gordon ◽  
Nickalus Khan ◽  
Julius Fernandez ◽  
Michael Scott Muhlbauer ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Trauma Center ◽  
Demographic Data ◽  
Data Types ◽  
Surgical Interventions ◽  
Imaging Results ◽  
Level 1 ◽  
Level 1 Trauma Center

OBJECT There is a paucity of scientific evidence available about the benefits of outpatient follow-up imaging for traumatic brain injury patients. In this study, 1 year of consecutive patients at a Level 1 trauma center were analyzed to determine if there is any benefit to routinely obtaining CT of the head at the outpatient follow-up visit. METHODS This single-institution retrospective review was performed on all patients with a traumatic brain injury seen at a Level 1 trauma center in 2013. Demographic data, types of injuries, surgical interventions, radiographic imaging in inpatient and outpatient settings, and outcomes were assessed through a review of the institution’s trauma registry, patient charts, and imaging. RESULTS Five hundred twenty-five patients were seen for traumatic brain injury in 2013 at Regional One Health in Memphis, Tennessee. One hundred eighty-five patients (35%) presented for outpatient follow-up, all with CT scans of the head. Seven of these patients (4%) showed worsening of their intracranial injuries on outpatient imaging studies; however, surgical intervention was recommended for only 3 of these patients (2%). All patients requiring an intervention had neurological deterioration prior to their follow-up appointment. CONCLUSIONS These experiences suggest that outpatient follow-up imaging for traumatic brain injury should be done selectively, as it was not helpful for patients who did not exhibit worsening of neurological signs or symptoms. Furthermore, routine outpatient imaging results in unnecessary resource utilization and radiation exposure.

scholarly journals Epidemiology, clinical characteristics and outcomes of traumatic brain injury: Evidences from integrated level 1 trauma center in India

2016 ◽  
Vol 7 (04) ◽  
pp. 515-525 ◽  
Author(s):  
Vineet Kumar Kamal ◽  
Deepak Agrawal ◽  
Ravindra Mohan Pandey
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Trauma Center ◽  
Clinical Characteristics ◽  
Indian Subcontinent ◽  
Unfavorable Outcome ◽  
High Rate ◽  
Severe Tbi ◽  
Level 1 ◽  
Level 1 Trauma Center

ABSTRACT Introduction: Traumatic brain injury (TBI) is a leading cause of mortality, morbidity, disability, and socioeconomic losses in the Indian subcontinent. However, for policymaking and research, there is a lack of reliable and larger data in our settings. Aims and Objectives: To evaluate and describe the epidemiological, clinical characteristics, and outcomes of patients with TBI in a Level 1 Trauma Center in India. Materials and Methods: In this retrospective study, all patients with moderate or severe TBI, based on emergency department Glasgow Coma Scale, admitted to neurosurgery Intensive Care Unit (ICU) during May 2010–July 2012 were evaluated to provide detailed information on TBI-related variables and outcomes using descriptive statistics. Results: Among the 1527 patients with moderate or severe TBI patients with mean age 32.15 ± 16.76 years (range: 1–90) and male:female ratio 6.5:1, 1281 (83.89%) had severe TBI. The majority of cases took place in the age group of 21–40 years (50.24%) with the most common mode of injury as road traffic accidents (RTAs) (64.96%). Surgical intervention (craniotomy) was done in 49.12% of patients. About 34.58% (n = 528) patients died in hospital, and 67.21% (n = 701) had unfavorable outcome at 6 months. Conclusions: This is the first study of its kind from the Indian subcontinent that gives data on the admission characteristics, mortality, and 6 months outcome of such patients. Most of the injuries occurred due to RTAs, more common among the economic productive age groups and mostly in males with a high rate of mortality and unfavorable outcome.

Opportunity to reduce transfer of patients with mild traumatic brain injury and intracranial hemorrhage to a Level 1 trauma center

2017 ◽  
Vol 35 (9) ◽  
pp. 1281-1284 ◽  
Author(s):  
Brian J. Yun ◽  
Benjamin A. White ◽  
H. Benjamin Harvey ◽  
Anand M. Prabhakar ◽  
Jonathan D. Sonis ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Intracranial Hemorrhage ◽  
Trauma Center ◽  
Level 1 ◽  
Level 1 Trauma Center
Sign in / Sign up

Export Citation Format

Share Document