Time of admission and outcome in traumatic brain injury patients

Agrawal, Amit; Munivenkatappa, Ashok; Rustagi, Neeti; Rammohan, Pathapati; Subrahmanyam, B. V.

doi:10.4103/0975-2870.186064

Cited by 3 publications

(4 citation statements)

References 1 publication

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“…The current study findings revealed that the majority of the accidents took place in the morning or early morning and night, particularly at crossroads, service road junctions, nearby schools, and workplaces. A recent study reported that more accidents occurred between 9 PM to 7 AM 16 Our study findings emphasize the establishment of traffic signals and visible signboards at service roads and schools.…”

Section: Status Of Prehospital Caresupporting

confidence: 77%

“…Majority of the patients had met with an accident in the morning (6 a.m. to 9 a.m., 16 Besides, good Samaritans or general public 25 (55.7%), police 9 (20%), friends 6 (13.3%), and auto drivers 5 (11%) helped in terms of moving the patient to the safer side of the accident spot, calling 108 ambulance services, and shifting the TBI survivors to a nearby hospital. The study results described that the majority of 30 (67%) of the TBI survivors were shifted by 108 ambulances, private ambulance 10 (22%), and used bus /car /auto 5 (11%).…”

Section: Prehospital Carementioning

confidence: 99%

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Prehospital Impact on Family Members of Road Traffic Accident

Raju¹,

Kanmani

Konar

et al. 2021

JNRP

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Background Prehospital care is nonexistent in most rural and semiurban areas. The implementation of golden hour care is still unachieved. The psychosocial problems of family members who accompany the traumatic brain injury (TBI) survivors after road traffic accidents (RTA) are not given attention during prehospital care. Therefore, the current study was aimed to understand the prehospital psychosocial impact on family members. Methodology A cross-sectional study was conducted at the Emergency and Trauma Care Centre at National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru between July 2017 to April 2018. Forty-five (n = 45) referred family members providing care for trauma survivors were purposively recruited in the study. Structured checklists were administered to measure the psychological reactions and psychosocial problems experienced by the family members during prehospital care. Data analysis was analyzed using the R software 3.0.1 version. Results TBI survivor's mean age was found to be 33 years (33.09 ± 13.20), of which males were 23 (51.1%) and females were 22 (48.9%), respectively. The result depicted first aid was provided by unskilled people after an average of 41 minutes (41 ± 30). The results further showed that family members had experienced agitation (100%), shock (82.2%), fatigue and headache (75.6%), depression (66.7%), feeling of hopelessness (55.6%) helplessness, and lack of support from family and financial constraints (48.9%) during prehospital care. Conclusion Psychosocial interventions need to be provided during prehospital care by trained medical and psychiatric social work professionals to address the need of family members during the crisis.

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Section: Status Of Prehospital Caresupporting

confidence: 77%

Section: Prehospital Carementioning

confidence: 99%

Prehospital Impact on Family Members of Road Traffic Accident

Raju¹,

Kanmani

Konar

et al. 2021

JNRP

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“…Agrawal et al 1) categorized the timings based on traffic hours and reported that the highest number of accidents and deaths were reported at 21:00-07:00. They reported that TBI was the most common on Tuesday (17.8%) and Wednesday (16.6%), in January (13.9%) and December (12.8%), and post monsoon (fall) (28.5%), and only admission seasons were significantly related to patient outcome.…”

Section: Discussionmentioning

confidence: 99%

The Time-Related Trends in the Presenting of Traumatic Head Injury in a Single Institution

Eom

2020

Korean J Neurotrauma

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Objective: It is important to know the epidemiologic aspects of traumatic brain injury (TBI) for its rapid detection, appropriate treatment, and prevention. The purpose of this study is to classify the time of arrival of patients in the emergency room (ER) by time of day, day of the week, month, and season, and to analyze the relationship between the frequency of presentation at different times and TBI. Methods: The time of arrival of 327 patients with TBI between January 2016 to December 2017 at the ER was analyzed retrospectively. The trends regarding the frequency of presentation of patients with TBI were analyzed in relation to arrival time at the ER. Results: Patients with TBI were found to have the greatest number of hospitalizations at 13:00-18:00, on Saturdays, in December, and during the summer. Surgical treatment was not related to the temporal pattern of TBI patient admission. Patients with TBI in the severe group (GCS score <8) arrived at the ER mainly at 07:00-12:00 (p=0.015). Patients with TBI in the mild group (GCS score 13-15) mainly presented in the ER during the summer (p=0.003), while patients TBI in the moderate group (GCS score 9-12) presented mainly in the winter (p=0.244). The combination of the mild and moderate group presented more often in the winter (p=0.014). Conclusion: It is worthwhile understanding the temporal trends of TBI patients. These data may provide useful information in predicting the ER visits of TBI patients in advance and preparing for prompt and appropriate treatment.

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“…The after-hours presentation is a risk factor for patients with acute conditions such as stroke, traumatic brain injury, pulmonary embolism, myocardial infarction, cardiac arrest, and ruptured an aortic aneurysm. [293031323334] The factors speculated to increase the mortality in our study may be: reduction in staffing levels during off hours,[35] impairment in performance in emergency settings due to fatigue,[3637] disrupted circadian rhythms, and increased medical errors and complications. [3839] More research is needed to determine the contribution of each on mortality.…”

Section: Discussionmentioning

confidence: 99%

Do the care process and survival chances differ in patients arriving to a level 1 Indian trauma center, during-hours and after-hours?

Soni

Mahindrakar

Kaushik

et al. 2019

J Emerg Trauma Shock

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Introduction: Trauma systems vary in performance during different time periods and may affect the patient outcomes, especially in resource-limited settings. The present study was undertaken to study the pattern, epidemiological profile, processes of care variations of trauma victims presenting during-hours and after-hours in a level 1 trauma Center of a lower middle-income country. Methodology: Retrospective analyses of prospectively collected data registry at a single tertiary care center. Data collected from 2013 to 2015 were analyzed. Patients with a history of trauma and admission to the center or death between arrival and admission were included. Isolated limb injury and patients dead on arrival were excluded. Results: Of 4692, 1789 (38.1%) patients arrived and were admitted during-hours and 2903 (61.9%) after-hours. The overall in-hospital mortality was 14.9% in the cohort. Moreover, it was 16.10% during after-hours in comparison to 13.0% during-hours. The Revised Trauma Score was statistically different during-hours and after-hours suggesting patients with greater physiological derangement after-hours. The Kaplan–Meier survival curves for 7 days were comparable in two groups with the log-rank test of 078. The proportion of initial radiological investigations (chest X-ray, focused assessment sonography in trauma [FAST], and computerized tomography [CT] scans) was ranged from 84.9% for CT scans in the cohort to 99.3% for FAST. Conclusions: Processes of care do not differ significantly for the patients admitted at a level 1 trauma center irrespective of time of the day. Although survival probability for the initial 7 days of follow-up is comparable between two groups; however, for 30 and 90 days of follow-up they are significantly different between during-hours and after-hours, likely due to injury severity.

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Time of admission and outcome in traumatic brain injury patients

Cited by 3 publications

References 1 publication

Prehospital Impact on Family Members of Road Traffic Accident

Prehospital Impact on Family Members of Road Traffic Accident

The Time-Related Trends in the Presenting of Traumatic Head Injury in a Single Institution

Do the care process and survival chances differ in patients arriving to a level 1 Indian trauma center, during-hours and after-hours?

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