Author(s): Gillespie C.; McLeavy C.M.; McMahon C.

Source: British Journal of Neurosurgery; 2019; vol. 33 (no. 4); p. 458

Publication Date: 2019

Publication Type(s): Conference Abstract

Abstract:Objectives: No criteria currently exists to guide referrers to which patients with Traumatic Brain Injury (TBI) require referral to neurosurgery and what is ‘surgically significant’. The aim of this study is to develop a CTB scoring system and referral criteria to reduce unnecessary referrals to tertiary Neurosurgical centres in patients with mild TBI. Design(s): Retrospective analysis of 258 patients with mild TBI to create a CT scoring system and referral criteria. Subjects: Patients referred to the Neurosurgical centre with GCS 13-15 with a history of head injury during the months of June and December 2017 were eligible for the study. Method(s): Radiological and clinical features of patients were reviewed. The CT score and referral guidelines were tested for those accepted and not accepted. This was then analysed. Result(s): 258 patients were referred with TBI and GCS of 13-15 during the months analysed. Of these 85.7% (n = 221) were not accepted and 14.3% (n = 37) accepted. Of the 221 patients not accepted, if the referral guidelines had been followed, 119 would not have required discussion and subsequent referral. None of the patients accepted would have been missed under the referral guidelines. The CT scoring system and referral guidelines would therefore have reduced referrals by 54%. Conclusion(s): The implementation of a new CT scoring system and referral guidelines could reduce the number of mild TBI referrals to tertiary Neurosurgical centres by up to 54%. This could therefore reduce workload for referrers and Neurosurgical on-call teams.

Database: EMBASE