Document Type
Article
Publication Date
7-2024
Abstract
Background
Traumatic brain injury (TBI) due to single-level falls (SLF) are frequent and often require interhospital transfer. This retrospective cohort study aimed to assess the safety of a criteria for non-transfer among a subset of TBI patients who could be observed at their local hospital, vs mandatory transfer to a level 1 trauma center (L1TC).
Methods
We conducted a 7-year review of patients with TBI due to SLF at a rural L1TC. Patients were classified as transfer/non-transfer according to the Brain Injuries in Greater East Texas (BIGTEX) criteria. The primary outcome measure was the occurrence of a critical event defined as deteriorating repeat head computed tomography (CT) scan or neurological status, neurosurgical intervention, or death.
Results
Of the 689 included patients, 63 (9.1%) were classified as non-transfer. Although there were 4 cases with a neurological change and one with a head CT change among the non-transfer group, there were no neurosurgical procedures or deaths. The Cox Proportional Hazard model showed a near 3-fold increased risk of experiencing a critical event if classified as a non-transfer. The multivariable regression model showed patients with an Abbreviated Injury Scale (AIS) of 3 was twice as likely to experience a critical event, with an AIS of 4, three times, and 3 times more likely to be classified to transfer.
Discussion
The BIGTEX criteria identify a subset of patients who can safely be observed at their local hospital. To confirm the safety and efficacy of this transfer criteria recommendation, a prospective study is warranted.
Persistant Identifier
http://hdl.handle.net/10950/4765
Publisher
SAGE
Permanent Email Address
rswindall@uttyler.edu
Recommended Citation
Murry, Jason; Cook, Alan D.; Swindall, Rebecca J.; Kanazawa, Hirofumi; Wadle, Carly R.; Mohiuddin, Musharaf; Nalbach, Stephen V.; Le, Tuan D.; Pero, Brandi N.; and Norwood, Scott H., "A Criteria to Reduce Interhospital Transfer of Traumatic Brain Injuries in Greater East Texas" (2024). School of Medicine Faculty Publications and Presentations. Paper 23.
Description
© The Author(s) 2024.
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