Articles: traumatic-brain-injuries.
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Emerg Med Australas · Feb 2025
The determinants for death in hospital following moderate to severe traumatic brain injury in Australia.
To establish the determinants of death in hospital for patients with moderate to severe traumatic brain injury (TBI) in Australia. ⋯ Among people presenting to a major trauma hospital in Australia following moderate to severe TBI, there were multiple factors independently associated with death in hospital. The potentially modifiable determinants of in-hospital death included out-of-hours access to emergency care, mode of transfer from the scene of the injury, prior facility care and pre-definitive hospital endotracheal intubation.
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Emerg Med Australas · Feb 2025
Observational StudyEvaluation of older patients with minor blunt head trauma to identify those who do not have clinically important traumatic brain injury and can be safely managed without cranial computed tomography.
Our primary aim was to identify a low-risk subgroup of older adults (aged 65 and older) presenting to ED with minor head trauma which can be safely managed without a cranial CT (cCT). ⋯ Alert, haemodynamically stable, older ED adults with suspected head trauma had a low incidence of ciTBI in the present study. Abnormal physical examination findings were consistently present in patients with ciTBI. Shared decision-making prior to cCT may be the pragmatic way ahead in the management of this patient cohort, especially among those from RACFs.
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Traumatic brain injury (TBI) is a prevalent type of disabling and fatal injury in infants/toddlers, which is usually caused by falls or traffic accidents. Considering that it is difficult to collect realistic material properties and validation data of child heads due to ethical reasons, experiments on the piglet heads and the finite element (FE) models are generally used as a substitute for the investigations of child TBI. ⋯ The results show that the piglet head model has high bio-fidelity, which can be used to predict the head global response and the ICP, and further to assist the investigation of child TBI. The model provides another effective way to evaluate the modeling strategies and material constitute models suitable for child head FE model, and can better to understand the inducement and mechanism of child TBI under different external loading conditions.
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Review
Management of post-injury anticoagulation in the traumatic brain injury patient: A scoping review.
Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality among trauma patients. The care of these patients continues to be a complex endeavor with prevention of associated complications, often requiring as much attention as that of the treatment of the primary injury. Paramount among these are venous thromboembolic events (VTE) due to their high incidence, additive effect on the risk of morbidity and mortality, and the careful balance that must be utilized in their diagnosis and treatment to prevent progression of the brain injury itself. ⋯ The timing of prophylaxis remains important, as the risk of VTE increases with each day that prophylaxis is held. Consensus findings favor initiation within 24-72 h, in the absence of documented progression, life threatening bleeding, or need for major surgical intervention. Despite available data, there continues to be significant variability in practice patterns which we hope to address with this review.
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Journal of neurosurgery · Feb 2025
Novel application of latent class analysis to outcome assessment in traumatic brain injury with multiple injury subtypes or poly-TBI.
The aim of this study was to stratify poly-traumatic brain injury (poly-TBI) patterns into discrete classes and to determine the association of these classes with mortality and withdrawal of life-sustaining treatment (WLST). ⋯ Distinct poly-TBI classes were associated with increased in-hospital mortality and WLST. Further research with larger datasets will allow for more comprehensive poly-TBI class definitions and outcomes analysis.