Prehospital on-scene anaesthetist treating severe traumatic brain injury patients is associated with lower mortality and better neurological outcome

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http://hdl.handle.net/10138/300203

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Pakkanen , T , Nurmi , J , Huhtala , H & Silfvast , T 2019 , ' Prehospital on-scene anaesthetist treating severe traumatic brain injury patients is associated with lower mortality and better neurological outcome ' , Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine , vol. 27 , 9 . https://doi.org/10.1186/s13049-019-0590-x

Title: Prehospital on-scene anaesthetist treating severe traumatic brain injury patients is associated with lower mortality and better neurological outcome
Author: Pakkanen, Toni; Nurmi, Jouni; Huhtala, Heini; Silfvast, Tom
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Diagnostics and Therapeutics
Date: 2019-01-28
Language: eng
Number of pages: 7
Belongs to series: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
ISSN: 1757-7241
URI: http://hdl.handle.net/10138/300203
Abstract: Background: Patients with isolated traumatic brain injury (TBI) are likely to benefit from effective prehospital care to prevent secondary brain injury. Only a few studies have focused on the impact of advanced interventions in TBI patients by prehospital physicians. The primary end-point of this study was to assess the possible effect of an on-scene anaesthetist on mortality of TBI patients. A secondary end-point was the neurological outcome of these patients. Methods: Patients with severe TBI (defined as a head injury resulting in a Glasgow Coma Score of Results: The mortality data for 651 patients and neurological outcome data for 634 patients were available for primary and secondary analysis. In the primary analysis higher age (OR 1.06 CI 1.05-1.07), lower on-scene GCS (OR 0.85 CI 0.79-0.92) and the unavailability of an on-scene anaesthetist (OR 1.89 CI 1.20-2.94) were associated with higher mortality together with hypotension (OR 3.92 CI 1.08-14.23). In the secondary analysis lower age (OR 0.95 CI 0.94-0.96), a higher on-scene GCS (OR 1.21 CI 1.20-1.30) and the presence of an on-scene anaesthetist (OR 1.75 CI 1.09-2.80) were demonstrated to be associated with good patient outcomes while hypotension (OR 0.19 CI 0.04-0.82) was associated with poor outcome. Conclusion: Prehospital on-scene anaesthetist treating severe TBI patients is associated with lower mortality and better neurological outcome.
Subject: Prehospital emergency care (MeSH)
Emergency medical services (MeSH)
Critical care (MeSH)
Traumatic brain injury (MeSH)
Airway management (MeSH)
Endotracheal intubation (MeSH)
Patient outcome assessment (MeSH)
Glasgow outcome scale (MeSH)
EMERGENCY MEDICAL-SERVICES
SYSTOLIC BLOOD-PRESSURE
COMA SCALE SCORE
HYPOTENSION
INTUBATION
MANAGEMENT
ADMISSION
EPIDEMIOLOGY
GUIDELINES
SURVIVAL
3126 Surgery, anesthesiology, intensive care, radiology
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