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Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

BACKGROUND: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hosp...

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Autores principales: Picetti, Edoardo, Catena, Fausto, Abu-Zidan, Fikri, Ansaloni, Luca, Armonda, Rocco A., Bala, Miklosh, Balogh, Zsolt J., Bertuccio, Alessandro, Biffl, Walt L., Bouzat, Pierre, Buki, Andras, Cerasti, Davide, Chesnut, Randall M., Citerio, Giuseppe, Coccolini, Federico, Coimbra, Raul, Coniglio, Carlo, Fainardi, Enrico, Gupta, Deepak, Gurney, Jennifer M., Hawryluk, Gregory W. J., Helbok, Raimund, Hutchinson, Peter J. A., Iaccarino, Corrado, Kolias, Angelos, Maier, Ronald W., Martin, Matthew J., Meyfroidt, Geert, Okonkwo, David O., Rasulo, Frank, Rizoli, Sandro, Rubiano, Andres, Sahuquillo, Juan, Sams, Valerie G., Servadei, Franco, Sharma, Deepak, Shutter, Lori, Stahel, Philip F., Taccone, Fabio S., Udy, Andrew, Zoerle, Tommaso, Agnoletti, Vanni, Bravi, Francesca, De Simone, Belinda, Kluger, Yoram, Martino, Costanza, Moore, Ernest E., Sartelli, Massimo, Weber, Dieter, Robba, Chiara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9830860/
https://www.ncbi.nlm.nih.gov/pubmed/36624517
http://dx.doi.org/10.1186/s13017-022-00468-2
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author Picetti, Edoardo
Catena, Fausto
Abu-Zidan, Fikri
Ansaloni, Luca
Armonda, Rocco A.
Bala, Miklosh
Balogh, Zsolt J.
Bertuccio, Alessandro
Biffl, Walt L.
Bouzat, Pierre
Buki, Andras
Cerasti, Davide
Chesnut, Randall M.
Citerio, Giuseppe
Coccolini, Federico
Coimbra, Raul
Coniglio, Carlo
Fainardi, Enrico
Gupta, Deepak
Gurney, Jennifer M.
Hawryluk, Gregory W. J.
Helbok, Raimund
Hutchinson, Peter J. A.
Iaccarino, Corrado
Kolias, Angelos
Maier, Ronald W.
Martin, Matthew J.
Meyfroidt, Geert
Okonkwo, David O.
Rasulo, Frank
Rizoli, Sandro
Rubiano, Andres
Sahuquillo, Juan
Sams, Valerie G.
Servadei, Franco
Sharma, Deepak
Shutter, Lori
Stahel, Philip F.
Taccone, Fabio S.
Udy, Andrew
Zoerle, Tommaso
Agnoletti, Vanni
Bravi, Francesca
De Simone, Belinda
Kluger, Yoram
Martino, Costanza
Moore, Ernest E.
Sartelli, Massimo
Weber, Dieter
Robba, Chiara
author_facet Picetti, Edoardo
Catena, Fausto
Abu-Zidan, Fikri
Ansaloni, Luca
Armonda, Rocco A.
Bala, Miklosh
Balogh, Zsolt J.
Bertuccio, Alessandro
Biffl, Walt L.
Bouzat, Pierre
Buki, Andras
Cerasti, Davide
Chesnut, Randall M.
Citerio, Giuseppe
Coccolini, Federico
Coimbra, Raul
Coniglio, Carlo
Fainardi, Enrico
Gupta, Deepak
Gurney, Jennifer M.
Hawryluk, Gregory W. J.
Helbok, Raimund
Hutchinson, Peter J. A.
Iaccarino, Corrado
Kolias, Angelos
Maier, Ronald W.
Martin, Matthew J.
Meyfroidt, Geert
Okonkwo, David O.
Rasulo, Frank
Rizoli, Sandro
Rubiano, Andres
Sahuquillo, Juan
Sams, Valerie G.
Servadei, Franco
Sharma, Deepak
Shutter, Lori
Stahel, Philip F.
Taccone, Fabio S.
Udy, Andrew
Zoerle, Tommaso
Agnoletti, Vanni
Bravi, Francesca
De Simone, Belinda
Kluger, Yoram
Martino, Costanza
Moore, Ernest E.
Sartelli, Massimo
Weber, Dieter
Robba, Chiara
author_sort Picetti, Edoardo
collection PubMed
description BACKGROUND: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. METHODS: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. RESULTS: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. CONCLUSIONS: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13017-022-00468-2.
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spelling pubmed-98308602023-01-11 Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES) Picetti, Edoardo Catena, Fausto Abu-Zidan, Fikri Ansaloni, Luca Armonda, Rocco A. Bala, Miklosh Balogh, Zsolt J. Bertuccio, Alessandro Biffl, Walt L. Bouzat, Pierre Buki, Andras Cerasti, Davide Chesnut, Randall M. Citerio, Giuseppe Coccolini, Federico Coimbra, Raul Coniglio, Carlo Fainardi, Enrico Gupta, Deepak Gurney, Jennifer M. Hawryluk, Gregory W. J. Helbok, Raimund Hutchinson, Peter J. A. Iaccarino, Corrado Kolias, Angelos Maier, Ronald W. Martin, Matthew J. Meyfroidt, Geert Okonkwo, David O. Rasulo, Frank Rizoli, Sandro Rubiano, Andres Sahuquillo, Juan Sams, Valerie G. Servadei, Franco Sharma, Deepak Shutter, Lori Stahel, Philip F. Taccone, Fabio S. Udy, Andrew Zoerle, Tommaso Agnoletti, Vanni Bravi, Francesca De Simone, Belinda Kluger, Yoram Martino, Costanza Moore, Ernest E. Sartelli, Massimo Weber, Dieter Robba, Chiara World J Emerg Surg Research BACKGROUND: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. METHODS: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. RESULTS: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. CONCLUSIONS: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13017-022-00468-2. BioMed Central 2023-01-09 /pmc/articles/PMC9830860/ /pubmed/36624517 http://dx.doi.org/10.1186/s13017-022-00468-2 Text en © The Author(s) 2023, corrected publication 2023 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/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Picetti, Edoardo
Catena, Fausto
Abu-Zidan, Fikri
Ansaloni, Luca
Armonda, Rocco A.
Bala, Miklosh
Balogh, Zsolt J.
Bertuccio, Alessandro
Biffl, Walt L.
Bouzat, Pierre
Buki, Andras
Cerasti, Davide
Chesnut, Randall M.
Citerio, Giuseppe
Coccolini, Federico
Coimbra, Raul
Coniglio, Carlo
Fainardi, Enrico
Gupta, Deepak
Gurney, Jennifer M.
Hawryluk, Gregory W. J.
Helbok, Raimund
Hutchinson, Peter J. A.
Iaccarino, Corrado
Kolias, Angelos
Maier, Ronald W.
Martin, Matthew J.
Meyfroidt, Geert
Okonkwo, David O.
Rasulo, Frank
Rizoli, Sandro
Rubiano, Andres
Sahuquillo, Juan
Sams, Valerie G.
Servadei, Franco
Sharma, Deepak
Shutter, Lori
Stahel, Philip F.
Taccone, Fabio S.
Udy, Andrew
Zoerle, Tommaso
Agnoletti, Vanni
Bravi, Francesca
De Simone, Belinda
Kluger, Yoram
Martino, Costanza
Moore, Ernest E.
Sartelli, Massimo
Weber, Dieter
Robba, Chiara
Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)
title Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)
title_full Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)
title_fullStr Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)
title_full_unstemmed Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)
title_short Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)
title_sort early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the world society of emergency surgery (wses)
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9830860/
https://www.ncbi.nlm.nih.gov/pubmed/36624517
http://dx.doi.org/10.1186/s13017-022-00468-2
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