Blostein Paul, Jones Susan J
Trauma Surgery Service, Bronson Methodist Hospital, Kalamazoo, Michigan 49007,USA.
J Trauma. 2003 Sep;55(3):450-3. doi: 10.1097/01.TA.0000038545.24879.4D.
Mild traumatic brain injury (MTBI), alone or in combination with other injuries, is frequently present in trauma patients requiring hospital admission. A survey was conducted to characterize the current practices of identification and management of patients with MTBI at Level I trauma centers in the United States.
Surveys were mailed to trauma program managers at 68 verified Level I trauma centers.
Thirty-five (51.4%) centers responded, representing 24 states. Multiple terms are used synonymously with MTBI, and less than half (45%) of centers formally evaluate all trauma patients with MTBI. Patients identified with MTBI discharged from the emergency department are referred for further evaluation at only 34% of centers. There is no consistent practice for determining which hospitalized patients with MTBI are formally evaluated, who performs the evaluations, or which evaluation tool(s) are used. Patients with MTBI and cognitive deficits are referred to a variety of specialists after discharge.
There is currently no standard practice for defining, evaluating, or managing MTBI at Level I trauma centers. A consistent definition of MTBI and its management could promote recognition of MTBI; facilitate data collection, analysis, and comparison; and provide guidelines for activity modification during recovery.
轻度创伤性脑损伤（MTBI）单独或与其他损伤合并出现，在需要住院治疗的创伤患者中很常见。开展了一项调查，以描述美国一级创伤中心对MTBI患者的识别与管理现状。
向68家经核实的一级创伤中心的创伤项目管理人员邮寄调查问卷。
35家（51.4%）中心做出回应，覆盖24个州。多个术语与MTBI同义使用，不到一半（45%）的中心对所有MTBI创伤患者进行正式评估。从急诊科出院的MTBI确诊患者仅在34%的中心被转诊接受进一步评估。对于确定哪些住院MTBI患者接受正式评估、由谁进行评估或使用哪种评估工具，没有一致的做法。MTBI及认知缺陷患者出院后被转诊至各类专科医生处。
目前一级创伤中心在MTBI的定义、评估或管理方面没有标准做法。MTBI的一致定义及其管理可促进对MTBI的识别；便于数据收集、分析和比较；并为康复期间的活动调整提供指导。
