Comparison of the predictive value of two international guidelines for safe discharge of patients with mild traumatic brain injuries and associated intracranial pathology
(2022) In European Journal of Trauma and Emergency Surgery 48(6). p.4489-4497- Abstract
Purpose: To determine and compare the sensitivity, specificity, and proportion of patients eligible for discharge by the Brain Injury Guidelines and the Mild TBI Risk Score in patients with mild traumatic brain injury and concomitant intracranial injury. Methods: Retrospective review of the medical records of adult patients with traumatic intracranial injuries and an initial Glasgow Coma Scale score of 14–15, who sought care at Helsingborg Hospital between 2014/01/01 and 2019/12/31. Both guidelines were theoretically applied. The sensitivity, specificity, and percentage of the cohort that theoretically could have been discharged by either guideline were calculated. The outcome was defined as death, in-hospital intervention, admission to... (More)
Purpose: To determine and compare the sensitivity, specificity, and proportion of patients eligible for discharge by the Brain Injury Guidelines and the Mild TBI Risk Score in patients with mild traumatic brain injury and concomitant intracranial injury. Methods: Retrospective review of the medical records of adult patients with traumatic intracranial injuries and an initial Glasgow Coma Scale score of 14–15, who sought care at Helsingborg Hospital between 2014/01/01 and 2019/12/31. Both guidelines were theoretically applied. The sensitivity, specificity, and percentage of the cohort that theoretically could have been discharged by either guideline were calculated. The outcome was defined as death, in-hospital intervention, admission to the intensive care unit, requiring emergency intubation due to intracranial injury, decreased consciousness, or seizure within 30 days of presentation. Results: Of the 538 patients included, 8 (1.5%) and 10 (1.9%) were eligible for discharge according to the Brain Injury Guidelines and the Mild TBI Risk Score, respectively. Both guidelines had a sensitivity of 100%. The Brain Injury Guidelines had a specificity of 2.3% and the Mild TBI Risk Score had a specificity of 2.9%. Conclusion: There was no difference between the two guidelines in sensitivity, specificity, or proportion of the cohort eligible for discharge. Specificity and proportion of cohort eligible for discharge were lower than each guideline’s original study. At present, neither guideline can be recommended for implementation in the current or similar settings.
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- author
- Vestlund, Sebastian LU ; Tryggmo, Sebastian ; Vedin, Tomas LU ; Larsson, Per Anders LU and Edelhamre, Marcus LU
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Brain injuries, Intracranial hemorrhage, Practice guideline, Skull fractures, Traumatic
- in
- European Journal of Trauma and Emergency Surgery
- volume
- 48
- issue
- 6
- pages
- 4489 - 4497
- publisher
- Urban & Vogel
- external identifiers
-
- scopus:85120411796
- pmid:34859266
- ISSN
- 1863-9933
- DOI
- 10.1007/s00068-021-01842-6
- language
- English
- LU publication?
- yes
- id
- 75b669da-b911-417a-98c1-f48e9246ce9c
- date added to LUP
- 2022-01-17 11:56:03
- date last changed
- 2024-06-01 23:16:57
@article{75b669da-b911-417a-98c1-f48e9246ce9c,
abstract = {{<p>Purpose: To determine and compare the sensitivity, specificity, and proportion of patients eligible for discharge by the Brain Injury Guidelines and the Mild TBI Risk Score in patients with mild traumatic brain injury and concomitant intracranial injury. Methods: Retrospective review of the medical records of adult patients with traumatic intracranial injuries and an initial Glasgow Coma Scale score of 14–15, who sought care at Helsingborg Hospital between 2014/01/01 and 2019/12/31. Both guidelines were theoretically applied. The sensitivity, specificity, and percentage of the cohort that theoretically could have been discharged by either guideline were calculated. The outcome was defined as death, in-hospital intervention, admission to the intensive care unit, requiring emergency intubation due to intracranial injury, decreased consciousness, or seizure within 30 days of presentation. Results: Of the 538 patients included, 8 (1.5%) and 10 (1.9%) were eligible for discharge according to the Brain Injury Guidelines and the Mild TBI Risk Score, respectively. Both guidelines had a sensitivity of 100%. The Brain Injury Guidelines had a specificity of 2.3% and the Mild TBI Risk Score had a specificity of 2.9%. Conclusion: There was no difference between the two guidelines in sensitivity, specificity, or proportion of the cohort eligible for discharge. Specificity and proportion of cohort eligible for discharge were lower than each guideline’s original study. At present, neither guideline can be recommended for implementation in the current or similar settings.</p>}},
author = {{Vestlund, Sebastian and Tryggmo, Sebastian and Vedin, Tomas and Larsson, Per Anders and Edelhamre, Marcus}},
issn = {{1863-9933}},
keywords = {{Brain injuries; Intracranial hemorrhage; Practice guideline; Skull fractures; Traumatic}},
language = {{eng}},
number = {{6}},
pages = {{4489--4497}},
publisher = {{Urban & Vogel}},
series = {{European Journal of Trauma and Emergency Surgery}},
title = {{Comparison of the predictive value of two international guidelines for safe discharge of patients with mild traumatic brain injuries and associated intracranial pathology}},
url = {{http://dx.doi.org/10.1007/s00068-021-01842-6}},
doi = {{10.1007/s00068-021-01842-6}},
volume = {{48}},
year = {{2022}},
}