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dc.contributor.authorCuevas-Østrem, Mathias
dc.contributor.authorThorsen, Kjetil
dc.contributor.authorWisborg, Torben
dc.contributor.authorRøise, Olav
dc.contributor.authorHelseth, Eirik
dc.contributor.authorJeppesen, Elisabeth
dc.date.accessioned2023-09-06T11:25:04Z
dc.date.available2023-09-06T11:25:04Z
dc.date.issued2023-06-26
dc.description.abstractBackground Systems ensuring continuity of care through the treatment chain improve outcomes for traumatic brain injury (TBI) patients. Non-neurosurgical acute care trauma hospitals are central in providing care continuity in current trauma systems, however, their role in TBI management is understudied. This study aimed to investigate characteristics and care pathways and identify factors associated with interhospital transfer to neurotrauma centers<p> for patients with isolated moderate-to-severe TBI primarily admitted to acute care trauma hospitals. <p>Methods A population-based cohort study from the national Norwegian Trauma Registry (2015–2020) of adult patients (≥16 years) with isolated moderate-to-severe TBI (Abbreviated Injury Scale [AIS] Head≥3, AIS Body<3 and maximum 1 AIS Body=2). Patient characteristics and care pathways were compared across transfer status strata. A generalized additive model was developed using purposeful selection to identify factors associated with transfer and how they affected transfer probability. <p>Results The study included 1735 patients admitted to acute care trauma hospitals, of whom 692 (40%) were transferred to neurotrauma centers. Transferred patients were younger (median 60 vs. 72 years, P<0.001), more severely injured (median New Injury Severity Score [NISS]: 29 vs. 17, P<0.001), and had lower admission Glasgow Coma Scale (GCS) scores (≤13: 55% vs. 27, P<0.001). Increased transfer probability was significantly associated with reduced GCS scores, comorbidity in patients<77 years, and increasing NISSs until the effect was inverted at higher scores. Decreased transfer probability was significantly associated with increasing age and comorbidity, and distance between the acute care trauma hospital and the nearest neurotrauma center, except for extreme NISSs. <p>Conclusions Acute care trauma hospitals managed a substantial burden of isolated moderate-to-severe TBI patients primarily and definitively, highlighting the importance of high-quality neurotrauma care in non-neurosurgical hospitals. The transfer probability declined with increasing age and comorbidity, suggesting that older patients were carefully selected for transfer to specialized care.en_US
dc.identifier.citationCuevas-Østrem, Thorsen, Wisborg, Røise, Helseth, Jeppesen. Care pathways and factors associated with interhospital transfer to neurotrauma centers for patients with isolated moderate-to-severe traumatic brain injury: a population-based study from the Norwegian trauma registry. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine. 2023;31(1)en_US
dc.identifier.cristinIDFRIDAID 2169248
dc.identifier.doi10.1186/s13049-023-01097-7
dc.identifier.issn1757-7241
dc.identifier.urihttps://hdl.handle.net/10037/30738
dc.language.isoengen_US
dc.publisherBMCen_US
dc.relation.journalScandinavian Journal of Trauma, Resuscitation and Emergency Medicine
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2023 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleCare pathways and factors associated with interhospital transfer to neurotrauma centers for patients with isolated moderate-to-severe traumatic brain injury: a population-based study from the Norwegian trauma registryen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Except where otherwise noted, this item's license is described as Attribution 4.0 International (CC BY 4.0)