First steps toward a BIG change: A pilot study to implement the Brain Injury Guidelines across a 24-hospital system - 22/11/23
, Samantha A. Malone a, ⁎ , Joseph R. Bledsoe b , Sarah Majercik a , David S. Morris a Abstract |
Introduction |
The modified Brain Injury Guidelines (mBIG) support a subset of low-risk patients to be managed without repeat head computed tomography (RHCT), neurosurgical consult (NSC), or hospital transfer/admission. This pilot aimed to assess mBIG implementation at a single facility to inform future systemwide implementation.
Methods |
Single cohort pilot trial at a level I trauma center, December 2021–August 2022. Adult patients included if tICH meeting BIG 1 or 2 criteria. BIG 3 patients excluded.
Results |
No patients required neurosurgical intervention. 72 RHCT and 83 NSC were prevented. 21 isolated BIG 1 were safely discharged home from the ED. No hospital readmissions for tICH. Protocol adherence rate was 92%.
Conclusion |
Implementation of the mBIG at a single trauma center is feasible and optimizes resource utilization. This pilot study will inform an implementation trial of the mBIG across a 24-hospital integrated health system.
Il testo completo di questo articolo è disponibile in PDF.Highlights |
• | Traumatic brain injury (TBI) is responsible for the utilization of significant healthcare, yet there is no widely accepted approach to management. |
• | In current practice, management of TBI with intracranial hemorrhage is resource intensive and often beyond what patients need. |
• | The modified Brain Injury Guideline allows management of low-risk TBI patients without repeat head CT, neurosurgical consult, or hospital admission. |
• | The mBIG can safely and effectively improve resource utilization in patients with traumatic intracranial hemorrhage (ICH). |
Mappa
Vol 226 - N° 6
P. 845-850 - dicembre 2023 Ritorno al numero
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