Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities

Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without...

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Detalles Bibliográficos
Autores: Picetti, Edoardo, Catena, Fausto|||0000-0001-5558-9965, Abu-Zidan, Fikri, Ansaloni, Luca|||0000-0001-6427-0307, Armonda, Rocco A., Bala, Miklosh|||0000-0002-1504-6162, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M.|||0000-0001-6377-3666, Citerio, Giuseppe|||0000-0002-5374-3161, Coccolini, Federico|||0000-0001-6364-4186, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawrylux, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo Barris, Juan|||0000-0003-0713-5875, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio Silvio, Udy, Andrew A.|||0000-0002-6284-2022, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda|||0000-0002-7956-3097, Kluger, Yoram, Martino, Costanza, Moore, Ernest, Sartelli, Massimo|||0000-0003-3202-7542, Weber, Dieter, Robba, Chiara|||0000-0003-1628-3845
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:281584
Acceso en línea:https://ddd.uab.cat/record/281584
https://dx.doi.org/urn:doi:10.1186/s13017-022-00468-2
Access Level:acceso abierto
Palabra clave:Hub
Management
Spoke
Transfer
Traumatic brain injury
Descripción
Sumario:Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. This consensus provides practical recommendations to support clinician's decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center. The online version contains supplementary material available at 10.1186/s13017-022-00468-2.

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