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Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey
PURPOSE: Clinical guidelines have been developed to standardize the management of mild traumatic brain injury (mTBI) in the emergency room, in particular the indication of brain CT scan and the use of blood biomarkers. The objective of this study was to determine the degree of adherence to guideline...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229664/ https://www.ncbi.nlm.nih.gov/pubmed/35178583 http://dx.doi.org/10.1007/s00068-022-01902-5 |
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author | Lagares, Alfonso Castaño-Leon, Ana María Richard, Marion Tsitsopoulos, Parmenion Philip Morales, Julian Mihai, Podaru Pavlov, Vladislav Mejan, Odile de la Cruz, Javier Payen, Jean François |
author_facet | Lagares, Alfonso Castaño-Leon, Ana María Richard, Marion Tsitsopoulos, Parmenion Philip Morales, Julian Mihai, Podaru Pavlov, Vladislav Mejan, Odile de la Cruz, Javier Payen, Jean François |
author_sort | Lagares, Alfonso |
collection | PubMed |
description | PURPOSE: Clinical guidelines have been developed to standardize the management of mild traumatic brain injury (mTBI) in the emergency room, in particular the indication of brain CT scan and the use of blood biomarkers. The objective of this study was to determine the degree of adherence to guidelines in the management of these patients across four countries of Southern Europe. METHODS: An electronic survey including structural and general management of mTBI patients and six clinical vignettes was conducted. In-charge physicians from France, Spain, Greece and Portugal were contacted by telephone and email. Differences among countries were searched using an unconditional approach test on contingency tables. RESULTS: One hundred and eighty eight physicians from 131 Hospitals (78 Spain, 36 France, 12 Greece and 5 Portugal) completed the questionnaire. There were differences regarding the in-charge specialist across these countries. There was variability in the use of guidelines and their adherence. Spain was the country with the least guideline adherence. There was a global agreement in ordering a brain CT for patients receiving anticoagulation or platelet inhibitors, and for patients with seizures, altered consciousness, neurological deficit, clinical signs of skull fracture or signs of facial fracture. Aging was not an indication for CT in French centres. Loss of consciousness and posttraumatic amnesia were considered as indications for CT more frequently in Spain than in France. These findings were in line with the data from the 6 clinical vignettes. The estimated use of CT reached around 50% of mTBI cases. The use of S100B is restricted to five French centres. CONCLUSIONS: There were large variations in the guideline adherence, especially in the situations considered to order brain CT after mTBI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-022-01902-5. |
format | Online Article Text |
id | pubmed-10229664 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-102296642023-06-01 Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey Lagares, Alfonso Castaño-Leon, Ana María Richard, Marion Tsitsopoulos, Parmenion Philip Morales, Julian Mihai, Podaru Pavlov, Vladislav Mejan, Odile de la Cruz, Javier Payen, Jean François Eur J Trauma Emerg Surg Original Article PURPOSE: Clinical guidelines have been developed to standardize the management of mild traumatic brain injury (mTBI) in the emergency room, in particular the indication of brain CT scan and the use of blood biomarkers. The objective of this study was to determine the degree of adherence to guidelines in the management of these patients across four countries of Southern Europe. METHODS: An electronic survey including structural and general management of mTBI patients and six clinical vignettes was conducted. In-charge physicians from France, Spain, Greece and Portugal were contacted by telephone and email. Differences among countries were searched using an unconditional approach test on contingency tables. RESULTS: One hundred and eighty eight physicians from 131 Hospitals (78 Spain, 36 France, 12 Greece and 5 Portugal) completed the questionnaire. There were differences regarding the in-charge specialist across these countries. There was variability in the use of guidelines and their adherence. Spain was the country with the least guideline adherence. There was a global agreement in ordering a brain CT for patients receiving anticoagulation or platelet inhibitors, and for patients with seizures, altered consciousness, neurological deficit, clinical signs of skull fracture or signs of facial fracture. Aging was not an indication for CT in French centres. Loss of consciousness and posttraumatic amnesia were considered as indications for CT more frequently in Spain than in France. These findings were in line with the data from the 6 clinical vignettes. The estimated use of CT reached around 50% of mTBI cases. The use of S100B is restricted to five French centres. CONCLUSIONS: There were large variations in the guideline adherence, especially in the situations considered to order brain CT after mTBI. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00068-022-01902-5. Springer Berlin Heidelberg 2022-02-18 2023 /pmc/articles/PMC10229664/ /pubmed/35178583 http://dx.doi.org/10.1007/s00068-022-01902-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Lagares, Alfonso Castaño-Leon, Ana María Richard, Marion Tsitsopoulos, Parmenion Philip Morales, Julian Mihai, Podaru Pavlov, Vladislav Mejan, Odile de la Cruz, Javier Payen, Jean François Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey |
title | Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey |
title_full | Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey |
title_fullStr | Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey |
title_full_unstemmed | Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey |
title_short | Variability in the indication of brain CT scan after mild traumatic brain injury. A transnational survey |
title_sort | variability in the indication of brain ct scan after mild traumatic brain injury. a transnational survey |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10229664/ https://www.ncbi.nlm.nih.gov/pubmed/35178583 http://dx.doi.org/10.1007/s00068-022-01902-5 |
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