Can trauma surgeons manage mild traumatic brain injuries?

Area of Science:

• Neurosurgery
• Trauma Surgery
• Neurology

Background:

• Current practice involves neurosurgical consultations for mild traumatic brain injuries (MTBI), despite less than 1% requiring intervention.
• A selective consultation policy was implemented to evaluate trauma surgeons' ability to manage MTBI independently.

Purpose of the Study:

• To assess the impact of a selective neurosurgical consultation policy on patient outcomes for mild traumatic brain injuries.
• To determine if trauma surgeons can manage MTBI patients without compromising neurologic outcomes.

Main Methods:

• Analysis of data from a level I trauma registry for patients with MTBI.
• Inclusion criteria: intracranial hemorrhage ≤1 cm and Glasgow Coma Score ≥13, excluding other intracranial injuries.
• Multivariate regression used to correlate neurosurgical management with neurologic outcomes, controlling for confounders.

Main Results:

• The selective policy significantly reduced neurosurgical consultations from 94% to 65% (P < .002).
• Multivariate analysis indicated no association between neurosurgical consultation and patient neurologic outcomes.

Conclusions:

• A selective neurosurgical consultation policy for MTBI effectively reduces consultations.
• Trauma surgeons can manage MTBI patients, demonstrating no adverse effect on patient outcomes.