EMBARGOED UNTIL 12:00 AM ET JANUARY 25, 2022
Newswise — Charlottesville, VA (January 25, 2022). A new study shows that the updated Brain Injury Guidelines (uBIG) can reduce the unnecessary costs and burden associated with transferring patients with complicated mild traumatic brain injury (TBI). In a retrospective study of patients receiving care at level I trauma centers in Canada, at least 65% of patients categorized as having the mildest form of complicated mild TBI (uBIG-1) could be safely treated at their local hospital. The paper was published today in the Journal of Neurosurgery and is available at https://thejns.org/doi/abs/10.3171/2021.10.JNS211794.
Updated in 2018, the uBIG are designed to help local clinicians assess whether the care of patients with complicated mild TBI requires transfer to a trauma center. The uBIG combine multiple variables from a physical examination and medication history to classify patients into one of three tiers ranging from uBIG-1 (the mildest form of injury) to uBIG-3 (the most severe). To determine if implementing the uBIG could reduce the need for patient transfers without affecting patient outcomes, Mr. Jean-Nicolas Tourigny of the Université Laval in Québec City, Canada, and colleagues conducted a retrospective review of 477 patients who presented or were transferred to one of three level I trauma centers in Québec.
Of the 40 patients classified with the mildest form of complicated TBI (uBIG-1), at least 65% of patients could have been treated at their local hospital without the need for transfer or a neurosurgical consultation. Additionally, 5.4% of repeat head CT scans and 4.9% of hospitalizations could have been avoided for all patients. Like all clinical guidelines, uBIG has some important limitations, principally that the guidelines do not account for additional non-head injuries sustained by the patient. Recognizing this limitation, Mr. Tourigny and colleagues concluded that uBIGs’ adoption could potentially reduce the number of transfers to centers with a higher level of trauma designation by 6% to 25%.
“Further refinement of the uBIG criteria could improve specificity and efficiency at a system level,” said Mr. Tourigny. “This is really a game changer for emergency medicine, especially now with the competing demands for health services in the era of the COVID-19 pandemic.”
The article—External validation of the updated Brain Injury Guidelines for complicated mild traumatic brain injuries: a retrospective cohort study—by Mr. Tourigny and colleagues is available at the Journal of Neurosurgery (https://thejns.org/doi/abs/10.3171/2021.10.JNS211794).
Disclosures: The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.
Funding: Mr. Tourigny was supported by a research grant from the VITAM—Centre de recherche en santé durable de l’Université Laval.
###
For more than 75 years, the Journal of Neurosurgery has been recognized by neurosurgeons and other medical specialists the world over for its authoritative clinical articles, cutting-edge laboratory research papers, renowned case reports, expert technical notes, and more. Each article is rigorously peer reviewed. The Journal of Neurosurgery is published monthly by the JNS Publishing Group, the scholarly journal division of the American Association of Neurological Surgeons. Other peer-reviewed journals published by the JNS Publishing Group each month include Neurosurgical Focus, the Journal of Neurosurgery: Spine, and the Journal of Neurosurgery: Pediatrics. All four journals can be accessed at www.thejns.org.
Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 12,000 members worldwide. Fellows of the AANS are board-certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons of Canada, or the Mexican Council of Neurological Surgery, A.C. Neurosurgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the spinal column, spinal cord, brain, nervous system and peripheral nerves. For more information, visit www.AANS.org.
RSS