Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey

Purpose: Clinical guidelines have been developed to standardize the management of mild traumatic brain injury (mTBI) in the emergency room, in particular the indication of brain CT scan and the use of blood biomarkers. The objective of this study was to determine the degree of adherence to guideline...

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Autores: Lagares Gómez-Abascal, Alfonso, Castaño León, Ana María, Richard, Marion, Tsitsopoulos, Parmenion Philip, Morales, Julian, Mihai, Podaru, Pavlov, Vladislav, Mejan, Odile, Cruz, Javier de la, Payen, Jean François, Maignan, Maxime, Jacquin, Laurent, Douplat, Marion, Laribi, Said, Pes, Philippe, Ray, Patrick, Guenezan, Jérémy, Sebbane, Mustapha, Balen, Frédéric, Durand, Guillaume, Abric, Cordelia, Lorca, María Teresa, Ponce, Mariana Garcia, Cuesta, Maite, Alén, Jose A. F.
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universidad Complutense de Madrid (UCM)
Repositorio:Docta Complutense
Idioma:inglés
OAI Identifier:oai:docta.ucm.es:20.500.14352/71553
Acceso en línea:https://hdl.handle.net/20.500.14352/71553
Access Level:acceso abierto
Palabra clave:Mild traumatic brain injury
Adult
Computed tomography
Clinical guidelines
Survey
Neurociencias (Medicina)
2490 Neurociencias
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spelling Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational surveyLagares Gómez-Abascal, AlfonsoCastaño León, Ana MaríaRichard, MarionTsitsopoulos, Parmenion PhilipMorales, JulianMihai, PodaruPavlov, VladislavMejan, OdileCruz, Javier de laPayen, Jean FrançoisMaignan, MaximeJacquin, LaurentDouplat, MarionLaribi, SaidPes, PhilippeRay, PatrickGuenezan, JérémySebbane, MustaphaBalen, FrédéricDurand, GuillaumeAbric, CordeliaLorca, María TeresaPonce, Mariana GarciaCuesta, MaiteAlén, Jose A. F.Mild traumatic brain injuryAdultComputed tomographyClinical guidelinesSurveyNeurociencias (Medicina)2490 NeurocienciasPurpose: Clinical guidelines have been developed to standardize the management of mild traumatic brain injury (mTBI) in the emergency room, in particular the indication of brain CT scan and the use of blood biomarkers. The objective of this study was to determine the degree of adherence to guidelines in the management of these patients across four countries of Southern Europe. Methods: An electronic survey including structural and general management of mTBI patients and six clinical vignettes was conducted. In-charge physicians from France, Spain, Greece and Portugal were contacted by telephone and email. Diferences among countries were searched using an unconditional approach test on contingency tables. Results: One hundred and eighty eight physicians from 131 Hospitals (78 Spain, 36 France, 12 Greece and 5 Portugal) completed the questionnaire. There were diferences regarding the in-charge specialist across these countries. There was variability in the use of guidelines and their adherence. Spain was the country with the least guideline adherence. There was a global agreement in ordering a brain CT for patients receiving anticoagulation or platelet inhibitors, and for patients with seizures, altered consciousness, neurological defcit, clinical signs of skull fracture or signs of facial fracture. Aging was not an indication for CT in French centres. Loss of consciousness and posttraumatic amnesia were considered as indications for CT more frequently in Spain than in France. These fndings were in line with the data from the 6 clinical vignettes. The estimated use of CT reached around 50% of mTBI cases. The use of S100B is restricted to fve French centres. Conclusions: There were large variations in the guideline adherence, especially in the situations considered to order brain CT after mTBI.Springer NatureUniversidad Complutense de Madrid20222022-02-1820222022-02-18journal articlehttp://purl.org/coar/resource_type/c_6501info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.14352/71553reponame:Docta Complutenseinstname:Universidad Complutense de Madrid (UCM)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Atribución 3.0 Españahttps://creativecommons.org/licenses/by/3.0/es/info:eu-repo/semantics/openAccessoai:docta.ucm.es:20.500.14352/715532026-06-02T12:44:21Z
dc.title.none.fl_str_mv Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
title Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
spellingShingle Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
Lagares Gómez-Abascal, Alfonso
Mild traumatic brain injury
Adult
Computed tomography
Clinical guidelines
Survey
Neurociencias (Medicina)
2490 Neurociencias
title_short Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
title_full Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
title_fullStr Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
title_full_unstemmed Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
title_sort Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
dc.creator.none.fl_str_mv Lagares Gómez-Abascal, Alfonso
Castaño León, Ana María
Richard, Marion
Tsitsopoulos, Parmenion Philip
Morales, Julian
Mihai, Podaru
Pavlov, Vladislav
Mejan, Odile
Cruz, Javier de la
Payen, Jean François
Maignan, Maxime
Jacquin, Laurent
Douplat, Marion
Laribi, Said
Pes, Philippe
Ray, Patrick
Guenezan, Jérémy
Sebbane, Mustapha
Balen, Frédéric
Durand, Guillaume
Abric, Cordelia
Lorca, María Teresa
Ponce, Mariana Garcia
Cuesta, Maite
Alén, Jose A. F.
author Lagares Gómez-Abascal, Alfonso
author_facet Lagares Gómez-Abascal, Alfonso
Castaño León, Ana María
Richard, Marion
Tsitsopoulos, Parmenion Philip
Morales, Julian
Mihai, Podaru
Pavlov, Vladislav
Mejan, Odile
Cruz, Javier de la
Payen, Jean François
Maignan, Maxime
Jacquin, Laurent
Douplat, Marion
Laribi, Said
Pes, Philippe
Ray, Patrick
Guenezan, Jérémy
Sebbane, Mustapha
Balen, Frédéric
Durand, Guillaume
Abric, Cordelia
Lorca, María Teresa
Ponce, Mariana Garcia
Cuesta, Maite
Alén, Jose A. F.
author_role author
author2 Castaño León, Ana María
Richard, Marion
Tsitsopoulos, Parmenion Philip
Morales, Julian
Mihai, Podaru
Pavlov, Vladislav
Mejan, Odile
Cruz, Javier de la
Payen, Jean François
Maignan, Maxime
Jacquin, Laurent
Douplat, Marion
Laribi, Said
Pes, Philippe
Ray, Patrick
Guenezan, Jérémy
Sebbane, Mustapha
Balen, Frédéric
Durand, Guillaume
Abric, Cordelia
Lorca, María Teresa
Ponce, Mariana Garcia
Cuesta, Maite
Alén, Jose A. F.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universidad Complutense de Madrid
dc.subject.none.fl_str_mv Mild traumatic brain injury
Adult
Computed tomography
Clinical guidelines
Survey
Neurociencias (Medicina)
2490 Neurociencias
topic Mild traumatic brain injury
Adult
Computed tomography
Clinical guidelines
Survey
Neurociencias (Medicina)
2490 Neurociencias
description Purpose: Clinical guidelines have been developed to standardize the management of mild traumatic brain injury (mTBI) in the emergency room, in particular the indication of brain CT scan and the use of blood biomarkers. The objective of this study was to determine the degree of adherence to guidelines in the management of these patients across four countries of Southern Europe. Methods: An electronic survey including structural and general management of mTBI patients and six clinical vignettes was conducted. In-charge physicians from France, Spain, Greece and Portugal were contacted by telephone and email. Diferences among countries were searched using an unconditional approach test on contingency tables. Results: One hundred and eighty eight physicians from 131 Hospitals (78 Spain, 36 France, 12 Greece and 5 Portugal) completed the questionnaire. There were diferences regarding the in-charge specialist across these countries. There was variability in the use of guidelines and their adherence. Spain was the country with the least guideline adherence. There was a global agreement in ordering a brain CT for patients receiving anticoagulation or platelet inhibitors, and for patients with seizures, altered consciousness, neurological defcit, clinical signs of skull fracture or signs of facial fracture. Aging was not an indication for CT in French centres. Loss of consciousness and posttraumatic amnesia were considered as indications for CT more frequently in Spain than in France. These fndings were in line with the data from the 6 clinical vignettes. The estimated use of CT reached around 50% of mTBI cases. The use of S100B is restricted to fve French centres. Conclusions: There were large variations in the guideline adherence, especially in the situations considered to order brain CT after mTBI.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022-02-18
2022
2022-02-18
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.14352/71553
url https://hdl.handle.net/20.500.14352/71553
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 3.0 España
https://creativecommons.org/licenses/by/3.0/es/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer Nature
publisher.none.fl_str_mv Springer Nature
dc.source.none.fl_str_mv reponame:Docta Complutense
instname:Universidad Complutense de Madrid (UCM)
instname_str Universidad Complutense de Madrid (UCM)
reponame_str Docta Complutense
collection Docta Complutense
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,300719

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