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עמוד בית
Sun, 21.07.24

ORIGINAL ARTICLES

IMAJ | volume 24

Journal 9, September 2022
pages: 574-578

Isolated Versus Non-isolated Traumatic Brain Injuries Identification and Decision Making: A Comparative Study

1Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel Departments of 2Medicine B and 3Surgery and Transplantation, and 4Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Israel 5Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel 6Hospital Management, Meir Medical Center, Kfar Saba, Israel 7Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Summary

Background:

Traumatic brain injury (TBI) is a significant cause of death in the battlefield. TBI can be challenging to diagnose in the combat setting and remains a substantial challenge for advanced life support (ALS) providers.

Objectives:

To compare prehospital and hospitalization characteristics between isolated and non-isolated TBI. To examine the effects of TBI with coexisting injuries on patient evaluation and outcomes based on the Israeli Defense Forces Trauma Registry and the Israeli National Trauma Registry of soldiers hospitalized for TBI between the years 2006–2017.

Methods:

A total of 885 casualties were eligible for our study, of whom 271 (30%) had isolated TBI. Only 35% of hospitalized patients with isolated TBI were defined as urgent by the ALS providers versus 67% in the non-isolated TBI group (P < 0.001).

Results:

Overall, 29% of the TBIs in the non-isolated group were missed by the ALS providers vs. 11% in the isolated group.

Conclusions:

Concomitant injuries may delay the diagnosis of TBI by ALS providers. These findings should be considered in the prehospital evaluation to potentially improve the care and outcome of head injury patients.

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