Prehospital management of traumatic brain injury across Europe: a CENTER-TBI study.

Prehospital management of traumatic brain injury across Europe: a CENTER-TBI study. Prehosp Emerg Care. 2020 Sep 02;:1-22 Authors: Gravesteijn B, Sewalt CA, Stocchetti N, Citerio G, Ercole A, Lingsma HF, von Steinbüchel N, Steyerberg EW, Wilson L, Maas AIR, Menon DK, Lecky FE, CENTER-TBI collaborators Abstract Prehospital care for traumatic brain injury (TBI) is important to prevent secondary brain injury. We aim to compare prehospital care systems within Europe and investigate the association of system characteristics with the stability of patients at hospital arrival. We studied TBI patients who were transported to CENTER-TBI centers, a pan-European, prospective TBI cohort study, by emergency medical services between 2014 and 2017. The association of demographic factors, injury severity, situational factors, and interventions associated with on-scene time was assessed using linear regression. We used mixed effects models to investigate the case mix adjusted variation between countries in prehospital times and interventions. The case mix adjusted impact of on-scene time and interventions on hypoxia (oxygen saturation <90%) and hypotension (systolic blood pressure <100mmHg) at hospital arrival was analysed with logistic regression. Among 3878 patients, the greatest driver of longer on-scene time was intubation (+8.3 min, 95% CI: 5.6 - 11.1). Secondary referral was associated with shorter on-scene time (-5.0 min 95% CI: -6....
Source: Prehospital Emergency Care - Category: Endocrinology Tags: Prehosp Emerg Care Source Type: research