Citation

Khormi Y, Gosadi I, Campbell S, Senthilselvan A, O'kelly C, Zygun D. J. Neurotrauma 2018; 35(13): 1407-1418.

Affiliation

University of Alberta, Department of Critical Care Medicine, Edmonton, Alberta, Canada ; zygun@ualberta.ca.

Copyright

(Copyright © 2018, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2017.5345

PMID

29648976

Abstract

Traumatic brain injury (TBI) management based on Brain Trauma Foundation (BTF) guidelines is widely accepted and thought to improve outcome. The objectives of this study are to provide an overview of adherence to BTF guidelines and to explore which factors influence adherence. We conducted a search of relevant electronic bibliographic databases. Twenty articles met inclusion/exclusion criteria out of 666 papers screened. All were cohort studies. Wide variation in adherence to BTF guidelines was observed with a median of 66.2% (range 0-100%). The lowest median adherence was observed with surgical management (14%), while the highest was observed with oxygenation (100%), steroid (97.8%) and blood pressure recommendation (92.3%). Variability was primarily explained by the variation in strength of evidence of each recommendation. Treating patients with higher severity of injury and treatment in a level 1 trauma center positively influenced adherence. Overall, adherence to BTF guidelines varies. Further research is required to strengthen the current evidence and to identify factors related to adherence with guidelines from a professional prospective.

Language: en

Keywords

ADULT BRAIN INJURY; CLINICAL MANAGEMENT OF CNS INJURY; GUIDELINES; HEAD TRAUMA