(HealthDay)—Implementation of prehospital traumatic brain injury (TBI) guidelines is associated with improvement in survival to hospital discharge for patients with severe TBI, according to a study published online May 8 in JAMA Surgery.
Daniel W. Spaite, M.D., from the University of Arizona in Phoenix, and colleagues conducted an intention-to-treat study using a before/after controlled design with patients with moderate to critically severe TBI. The correlation between implementing the nationally vetted, evidence-based prehospital treatment guidelines and outcomes was examined. A total of 21,852 patients met inclusion criteria for analysis.
The researchers found that the adjusted odds ratio (aOR) was 1.06 (95 percent confidence interval [CI], 0.93 to 1.21; P = 0.40) for survival to hospital discharge in the primary analysis. For survival to hospital admission, the aOR was 1.70 (95 percent CI, 1.38 to 2.09; P < 0.001). Guideline implementation was significantly associated with survival to discharge among the severe injury cohorts (Regional Severity Score-Head 3 to 4: aOR, 2.03 [95 percent CI, 1.52 to 2.72; P < 0.001]; Injury Severity Score 16 to 24: aOR, 1.61 [95 percent CI, 1.07 to 2.48; P = 0.02]). Among the severe, intubated subgroups, guideline implementation was also associated with significantly improved survival to discharge.
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