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CC BY-NC-ND 4.0 · Indian Journal of Neurosurgery 2022; 11(02): 123-127
DOI: 10.1055/s-0040-1719236
Original Article

Emergency Department Management of Mild Traumatic Brain Injury in New Delhi–A Single Institute Cohort Management Data

Ajay Choudhary    *
1   Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Ashok Kumar    *
1   Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Rajesh Kumar Sharma 
1   Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Rahul Varshney
1   Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Satya Shiva Munjal 
1   Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Kaviraj Kaushik 
1   Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
,
Laxmi Narayan Gupta 
1   Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Abstract

Introduction The purpose of this study is to compare the current clinical management practices and decision guidelines of the Brain Trauma Foundation (BTF) for mild traumatic brain insult with line of treatment followed at our center to identify the clinically significant treatment outcome in pediatric to elderly patients.

Materials and Methods This is a questionnaire-based prospective observational study at the emergency department of neurosurgery in Dr. Ram Manohar Lohia (RML) Hospital, New Delhi. A registry questionnaire was administered to all the eligible subjects by the neurosurgery resident in emergency department (ED) to correlate clinical status, severity of traumatic brain injury (TBI) and associated comorbid conditions and its outcome after management.

Results Out of 154 mild TBI cases attending ED, 115 (74.7%) were males and 39 (25.3%) were females, with average age of 27 years. Of the patients with mild TBI, road traffic accidents (RTA) were the main cause (50.6%), followed by fall from height (42.9%), assault and sports-related injury (6.4%). Of the total, 96.1% underwent CT. Of these, 31.8% found abnormal CT results, 27.5% received wound treatment care, and 9.1% received emergency care. Nearly 30.5% were admitted and 1.3% patients were died in the hospital, 75.3% patients were discharged and 23.4% were referred to other department for associated co morbid conditions.

Conclusion The present study identified deficiencies in and variation around several important aspects of ED care. The development of BTF guidelines specific for mild TBI could reduce variation and improve emergency care for this injury.

Keywords

mild traumatic brain injury - emergency care - clinical management

* Both authors contributed equally to this work.




Publication History

Article published online:
11 March 2021

© 2021. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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