Association Between Implementation of Clinical Practice Guidelines and Outcome for Traumatic Brain Injury

Keris, Valdis; Lavendelis, E.; Macane, I.

doi:10.1007/s00268-007-9002-x

Cited by 21 publications

(15 citation statements)

References 19 publications

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“…If this is true, the effect of mannitol on the outcome of the patients with EDH must be scrutinized carefully in the near future. Implementation of evidence-based recommendations by BTF is related with the improvements in mortality in TBI 9). Adoption and integration of the basic guideline to individual institutional protocols is a step forward to treating a diverse pool of patients with EDH 421)…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System

Jeong

Cho

2016

Korean J Neurotrauma

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ObjectiveThe aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS).MethodsOf 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. We subcategorized the patients into two groups with good and poor outcomes. Various clinical characteristics and the time intervals with regard to treatment course were investigated to determine the relationship between these parameters and the functional outcome.ResultsOf multiple parameters for this analysis, older age (p=0.0003), higher degree of brain injury (p<0.0001), cases of surgical EDH (p<0.0001), time interval from trauma to hospital before 6 hours, and the decreasing pattern of Glasgow Coma Scale (GCS) between and initial and final GCS were strongly associated with poor outcome. Use of prophylactic anticonvulsant did not affect the functional outcome. There was an interesting difference in the use of mannitol in treating EDH between the urban and rural regions (p<0.0001).ConclusionThis is the first multi-center analysis of etiology of injury, pre-hospital care, treatment, and functional outcome of EDH in Korea. The degree of brain injury and the GCS difference were notable factors that were significant in determining the functional outcome of EDH.

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Section: Discussionmentioning

confidence: 99%

Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System

Jeong

Cho

2016

Korean J Neurotrauma

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“…This case was elegantly demonstrated with the TBI-Trac program headed by Jamshid Ghajar and founded by the Soros Foundation in the late 1990s. The success of this program itself led to a change in the field of neurotrauma in Eastern Europe, facilitating the dissemination of guidelines, spreading the word against the hopelessness of head injury, and recruiting young neurosurgeons to make a difference in neurotrauma care [43,44].…”

Section: Traumatic Brain Injury In Eastern Europe: Neurotrauma Carementioning

confidence: 99%

“…In Latvia, the incidence of moderate TBI to severe TBI is about 8 per 10,000 inhabitants; these two groups constitute more than 30 % of all TBI cases [43].…”

Section: Traumatic Brain Injury In Eastern Europe: the Actual Carementioning

confidence: 99%

Geriatric Traumatic Brain Injury in Hungary and Eastern Europe

Büki

Czeiter

Kovács

et al. 2012

Curr Tran Geriatr Gerontol Rep

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While the incidence of traumatic brain injury (TBI) is decreasing in the young, active population, injuries are getting more frequent among the elderly; as the geriatric population is in a constant rise and the relative cost of care is particularly high in this group of patients, the economic burden of TBI does not decline. This review is aimed to identify predisposing factors and characteristic features of geriatric brain injury, primarily focusing on the comparison between Eastern and Western European countries. While economically each of these is a high-or middle-income country, the differences in mortality and morbidity, approaches, and policies applied by health care providers are substantial. On the basis of the disappointing outcome results in Eastern Europe, one may conclude that therapeutic guidelines defined on the basis of the "Western experience" should only be applied in conjunction with a systematic reorganization of health care in Eastern Europe.

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“…Evidence‐based clinical practice guidelines (CPGs) can facilitate physician decision‐making, improve patient outcomes, improve efficient use of health resources, and promote management consistency 9,10 . CPGs contain systematically developed statements that include recommendations, strategies, or information that help health care providers and patients make decisions about appropriate health care for specific clinical circumstances 11 .…”

mentioning

confidence: 99%

Quality and Consistency of Guidelines for the Management of Mild Traumatic Brain Injury in the Emergency Department

Tavender

Bosch

Green

et al. 2011

Academic Emergency Medicine

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Objectives: The objective was to provide an overview of the recommendations and quality of evidencebased clinical practice guidelines (CPGs) for the emergency management of mild traumatic brain injury (mTBI), with a view to informing best practice and improving the consistency of recommendations.Methods: Electronic searches of health databases (MEDLINE, EMBASE, The Cochrane Library, PsycINFO), CPG clearinghouse websites, CPG developer websites, and Internet search engines up to January 2010 were conducted. CPGs were included if 1) they were published in English and freely accessible, 2) their scope included the management of mTBI in the emergency department (ED), 3) the date of last search was within the past 10 years (2000 onward), 4) systematic methods were used to search for evidence, and 5) there was an explicit link between the recommendations and the supporting evidence. Four authors independently assessed the quality of the included CPGs using the Appraisal of Guidelines, Research and Evaluation (AGREE) Instrument. The authors extracted and categorized recommendations according to initial clinical assessment, imaging, management, observation, discharge planning, and patient information and follow-up.Results: The search identified 18 potential CPGs, of which six met the inclusion criteria. The included CPGs varied in scope, target population, size, and guideline development processes. Four CPGs were assessed as ''strongly recommended.'' The majority of CPGs did not provide information about the level of stakeholder involvement (mean AGREE standardized domain score = 57%, range = 25% to 81%), nor did they address the organizational ⁄ cost implications of applying the recommendations or provide criteria for monitoring and review of recommendations in practice (mean AGREE standardized domain score = 46.6%, range = 19% to 94%). Recommendations were mostly consistent in terms of the use of the Glasgow Coma Scale (GCS) score (adult and pediatric) to assess the level of consciousness, initial assessment criteria, the use of computed tomography (CT) scanning as imaging investigation of choice, and the provision of patient information. The CPGs defined mTBI in a variety of ways and described different rules to determine the need for CT scanning and therefore used different criteria to identify high-risk patients.Conclusions: Higher-quality CPGs for mTBI are consistent in their recommendations about assessment, imaging, and provision of patient information. There is not, however, an agreed definition of mTBI, and the quality of future CPGs could be improved with better reporting of stakeholder involvement, procedures for updating, and greater consideration of the applicability of the recommendations (cost implications, monitoring procedures). Nevertheless, guideline developers may benefit from adapting existing CPGs to their local context rather than investing in developing CPGs de novo.ACADEMIC EMERGENCY MEDICINE 2011; 18:880-889 ª

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Association Between Implementation of Clinical Practice Guidelines and Outcome for Traumatic Brain Injury

Abstract: Implementation of the Guidelines was associated with a statistically significant decrease of HCFR in TBI patients.

Cited by 21 publications

References 19 publications

Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System

Clinical Outcome of Acute Epidural Hematoma in Korea: Preliminary Report of 285 Cases Registered in the Korean Trauma Data Bank System

Geriatric Traumatic Brain Injury in Hungary and Eastern Europe

Quality and Consistency of Guidelines for the Management of Mild Traumatic Brain Injury in the Emergency Department

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