@article{ref1,
title="Which factors influence the decision to transfer patients with traumatic brain injury to a neurosurgery unit in a major trauma network?",
journal="British journal of neurosurgery",
year="2020",
author="Rajwani, Kapil Mohan and Lavrador, José Pedro and Ansaripour, Ali and Tolias, Christos M.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="<b>Objectives:</b> Within the pan London Major Trauma System many patients with minor or non-life threatening traumatic brain injury (TBI) remain at their local hospital and are not transferred to a major trauma centre (MTC). Our aim was to identify factors that influence the decision to transfer patients with TBI to a neurosurgical centre.<b>Methods:</b> This is a single centre prospective cohort study of all patients with TBI referred to our neurosurgery unit from regional acute hospitals over a 4-month period (Sept 2016-Jan 2017). Our primary outcome was transferred to a neurosurgical centre. We identified the following factors that may predict decision to transfer: patient demographics, transfer distance, antithrombotic therapy and severity of TBI based on initial Glasgow Coma Scale (GCS) and Marshall CT score. A multivariable logistic regression analysis was performed.<b>Results:</b> A total of 339 patients were referred from regional hospitals with TBI and of these, 53 (15.6%) were transferred to our hospital. The mean age of patients referred was 70.6 years, 62.5% were men and 43% on antithrombotic drugs. Eighty-six percent of patients had mild TBI (GCS 13-15) on initial assessment and 79% had a Marshall CT score of 2. The adjusted analysis revealed only higher age, higher Marshall Score, the presence of chronic subdural haematoma (CSDH), the presence of contusion(s) and fracture(s) predicted transfer (<i>p</i><.05). Subgroup analysis consistently showed a higher Marshall score predicted transfer (<i>p</i><.05).<b>Conclusions:</b> In our cohort higher Marshall score consistently predicted transfer to our neurosurgical centre. Presenting GCS, transfer distance and antithrombotic therapy did not influence decision to transfer.<p /> <p>Language: en</p>",
language="en",
issn="0268-8697",
doi="10.1080/02688697.2020.1742289",
url="http://dx.doi.org/10.1080/02688697.2020.1742289"
}