Modin Albert, Wickbom Fredrik, Kamis Christian, Undén Johan
Department of Surgery Hallands Hospital Halmstad Sweden.
Department of Operation and Intensive Care Hallands Hospital Halmstad Sweden.
Health Sci Rep. 2023 Oct 30;6(11):e1651. doi: 10.1002/hsr2.1651. eCollection 2023 Nov.
Mild traumatic brain injury (mTBI) is a common cause for seeking care. Previous studies have shown considerable variations in TBI management. New guidelines may have influenced management routines.
This is a descriptive cross-sectional study, collecting data through structured questionnaires. All Swedish emergency hospitals that manage and treat adult patients with mTBI (Reaction Level Scale [RLS] 1-3, Glasgow Coma Scale [GCS] 13-15, age > 18 years) for the initial 24 h after injury were included in this study.
The response rate among hospitals fulfilling the study criteria's was 61/67 (91%). We observed a distinct predominance of nonspecialists being responsible for the initial management of these patients, with general surgeons and ED-physicians being the dominating specialties. A total of 45/61 (74%) of the hospitals use a guideline when managing TBI, with 12 hospitals (20%) stating that no guideline was used.
In general, established guidelines are used for the management of TBI in Sweden. However, some of these are outdated and several hospitals used local guidelines not based upon reliable evidence-based methodology. Most patients with TBI are managed by nonspecialist doctors, stressing the need of a reliable guideline.
轻度创伤性脑损伤（mTBI）是寻求治疗的常见原因。先前的研究表明，创伤性脑损伤的管理存在很大差异。新的指南可能影响了管理流程。
这是一项描述性横断面研究，通过结构化问卷收集数据。本研究纳入了所有在瑞典对成年mTBI患者（反应水平量表[RLS]1-3，格拉斯哥昏迷量表[GCS]13-15，年龄>18岁）受伤后最初24小时进行管理和治疗的急诊医院。
符合研究标准的医院的回复率为61/67（91%）。我们观察到，这些患者的初始管理主要由非专科医生负责，普通外科医生和急诊科医生是主要的专科。共有45/61（74%）的医院在管理TBI时使用指南，12家医院（20%）表示未使用指南。
总体而言，瑞典在TBI管理中使用既定指南。然而，其中一些指南已经过时，几家医院使用的是基于不可靠的循证方法的当地指南。大多数TBI患者由非专科医生管理，这凸显了可靠指南的必要性。
