Karvandi Elika, Barrett Liam, Newcombe Virginia, Hutchinson Peter, Helmy Adel
Division of Neurosurgery, University of Cambridge, Cambridge, UK.
PACE, Department of Medicine, University of Cambridge, Cambridge, UK.
Br J Neurosurg. 2024 May 6:1-7. doi: 10.1080/02688697.2024.2346564.
After a mild traumatic brain injury (mild TBI,) a significant number of patients may experience persistent symptoms and disabilities for months to years. Early identification and timely management of persistent symptoms may help to reduce the long-term impacts of mild TBIs. There is currently no formalised method for identifying patients with persistent symptoms after mild TBI once they are discharged from emergency department.
Assess the feasibility of a remote monitoring tool for early identification of persistent symptoms after mild TBI in the outpatient setting using digital tools.
Electronic surveys were sent to patients with mild TBI who presented to the emergency department at a Major Trauma Centre in England. The surveys were completed at three different timepoints (within days of injury (S1), 1 month (S2), and 3 months (S3) after injury). The indicators used to assess feasibility were engagement, number of eligible patients for follow-up evidence of need for the intervention, and consistency with the literature. Feedback was sought from participants.
Of the 200 people invited to participate, 134 (67.0%) completed S1, 115 (57.5%) completed S2, and 95 (47.5%) completed S3. The rates of persistent symptoms ranged from 17.9%-62.6% depending on the criteria used, and we found a significant proportion of the participants experienced morbidity 1 and 3 months after injury. The electronic follow-up tool was deemed an acceptable and user-friendly method for service delivery by participants.
Using digital tools to monitor and screen mild TBI patients for persistent symptoms is feasible. This could be a scalable, cost-effective, and convenient solution which could improve access to healthcare and reduce healthcare inequalities. This could enable early identification of patients with further medical needs and facilitate timely intervention to improve the clinical workflows, patient satisfaction, and health outcomes for people with persistent morbidities after mild TBIs.
轻度创伤性脑损伤（轻度TBI）后，相当一部分患者可能会经历数月至数年的持续症状和残疾。早期识别和及时处理持续症状可能有助于减轻轻度TBI的长期影响。目前，对于轻度TBI患者从急诊科出院后，尚无正式方法来识别有持续症状的患者。
评估一种远程监测工具在门诊环境中使用数字工具早期识别轻度TBI后持续症状的可行性。
向在英国一家主要创伤中心急诊科就诊的轻度TBI患者发送电子调查问卷。这些调查问卷在三个不同时间点（受伤后数天（S1）、1个月（S2）和3个月（S3））完成。用于评估可行性的指标包括参与度、符合随访条件的患者数量、干预需求的证据以及与文献的一致性。征求了参与者的反馈意见。
在邀请参与的200人中，134人（67.0%）完成了S1，115人（57.5%）完成了S2，95人（47.5%）完成了S3。根据所使用的标准，持续症状的发生率在17.9%-62.6%之间，我们发现相当一部分参与者在受伤后1个月和3个月出现发病情况。参与者认为电子随访工具是一种可接受且用户友好的服务提供方式。
使用数字工具监测和筛查轻度TBI患者的持续症状是可行的。这可能是一种可扩展、具有成本效益且方便的解决方案，可改善医疗服务的可及性并减少医疗不平等。这可以早期识别有进一步医疗需求的患者，并促进及时干预，以改善临床工作流程、患者满意度以及轻度TBI后有持续疾病患者的健康结局。
