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A scoping review on the challenges, improvement programs, and relevant output metrics for neurotrauma services in major trauma centers

Abstract:
Background: For a neurotrauma unit to be defined as a structured neurotrauma service (NS) the following criteria must be satisfied: A dedicated neurointensive care unit, endovascular neuroradiology, in-hospital neurorehabilitation unit and helicopter platform within the context of a Level I trauma center. Designing an effective NS can be challenging, particularly when considering the different priorities and resources of countries across the globe. In addition the impact on clinical outcomes is not clearly established. Methods: A scoping review of the literature spanning from 2000 to 2020 meant to identify protocols, guidelines, and best practices for the management of traumatic brain injury (TBI) in NS was conducted on the US National Library of Medicine and National Institute of Health databases. Results: Limited evidence is available regarding quantitative and qualitative metrics to assess the impact of NSs and specialist follow-up clinics on patients' outcome. Of note, the available literature used to lack detailed reports for: (a) Geographical clusters, such as low-to-middle income countries (LMIC); (b) clinical subgroups, such as mild TBI; and (c) long-term management, such as rehabilitation services. Only in the last few years more attention has been paid to those research topics. Conclusion: NSs can positively impact the management of the broad spectrum of TBI in different clinical settings; however more research on patients' outcomes and quality of life metrics is needed to establish their efficacy. The collaboration of global clinicians and the development of international guidelines applicable also to LMIC are warranted
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.25259/sni_203_2022

Authors

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Role:
Author
ORCID:
0000-0002-0247-9639
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Institution:
University of Oxford
Role:
Author
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Role:
Author
ORCID:
0000-0001-6703-8095


Publisher:
Scientific Scholar
Journal:
Surgical Neurology International More from this journal
Volume:
13
Pages:
171-171
Article number:
171
Publication date:
2022-04-29
DOI:
EISSN:
2152-7806
ISSN:
2229-5097


Language:
English
Keywords:
Pubs id:
1256995
Local pid:
pubs:1256995
Source identifiers:
W4225151990
Deposit date:
2026-04-24
ARK identifier:
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