Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Edoardo Picetti; Fausto Catena; Fikri Abu-Zidan; Luca Ansaloni; Rocco A. Armonda; Miklosh Bala; Zsolt J. Balogh; Alessandro Bertuccio; Walt L. Biffl; Pierre Bouzat; Andras Buki; Davide Cerasti; Randall M. Chesnut; Giuseppe Citerio; Federico Coccolini; Raul Coimbra; Carlo Coniglio; Enrico Fainardi; Deepak Gupta; Jennifer M. Gurney; Gregory W.J. Hawrylux; Raimund Helbok; Peter J.A. Hutchinson; Corrado Iaccarino; Angelos Kolias; Ronald W. Maier; Matthew J. Martin; Geert Meyfroidt; David O. Okonkwo; Frank Rasulo; Sandro Rizoli; Andres Rubiano; Juan Sahuquillo; Valerie G. Sams; Franco Servadei; Deepak Sharma; Lori Shutter; Philip F. Stahel; Fabio S. Taccone; Andrew Udy; Tommaso Zoerle; Vanni Agnoletti; Francesca Bravi; Belinda De Simone; Yoram Kluger; Costanza Martino; Ernest E. Moore; Massimo Sartelli; Dieter Weber; Chiara Robba

doi:10.1186/s13017-022-00468-2

Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

Edoardo Picetti, Fausto Catena, Fikri Abu-Zidan, Luca Ansaloni, Rocco A. Armonda, Miklosh Bala, Zsolt J. Balogh, Alessandro Bertuccio, Walt L. Biffl, Pierre Bouzat, Andras Buki, Davide Cerasti, Randall M. Chesnut, Giuseppe Citerio, Federico Coccolini, Raul Coimbra, Carlo Coniglio, Enrico Fainardi, Deepak Gupta, Jennifer M. GurneyGregory W.J. Hawrylux, Raimund Helbok, Peter J.A. Hutchinson, Corrado Iaccarino, Angelos Kolias, Ronald W. Maier, Matthew J. Martin, Geert Meyfroidt, David O. Okonkwo, Frank Rasulo, Sandro Rizoli, Andres Rubiano, Juan Sahuquillo, Valerie G. Sams, Franco Servadei, Deepak Sharma, Lori Shutter, Philip F. Stahel, Fabio S. Taccone, Andrew Udy, Tommaso Zoerle, Vanni Agnoletti, Francesca Bravi, Belinda De Simone, Yoram Kluger, Costanza Martino, Ernest E. Moore, Massimo Sartelli, Dieter Weber, Chiara Robba

Surgery

Research output: Contribution to journal › Article › peer-review

11 Citations (Scopus)

Abstract

Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.

Original language	English
Article number	5
Journal	World Journal of Emergency Surgery
Volume	18
Issue number	1
DOIs	https://doi.org/10.1186/s13017-022-00468-2
Publication status	Published - Dec 2023

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Picetti, E., Catena, F., Abu-Zidan, F., Ansaloni, L., Armonda, R. A., Bala, M., Balogh, Z. J., Bertuccio, A., Biffl, W. L., Bouzat, P., Buki, A., Cerasti, D., Chesnut, R. M., Citerio, G., Coccolini, F., Coimbra, R., Coniglio, C., Fainardi, E., Gupta, D., ... Robba, C. (2023). Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES). World Journal of Emergency Surgery, 18(1), Article 5. https://doi.org/10.1186/s13017-022-00468-2

@article{3055979980584d2ab10d9f8bd793e1a3,

title = "Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)",

abstract = "Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician{\textquoteright}s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.",

keywords = "Hub, Management, Spoke, Transfer, Traumatic brain injury",

author = "Edoardo Picetti and Fausto Catena and Fikri Abu-Zidan and Luca Ansaloni and Armonda, {Rocco A.} and Miklosh Bala and Balogh, {Zsolt J.} and Alessandro Bertuccio and Biffl, {Walt L.} and Pierre Bouzat and Andras Buki and Davide Cerasti and Chesnut, {Randall M.} and Giuseppe Citerio and Federico Coccolini and Raul Coimbra and Carlo Coniglio and Enrico Fainardi and Deepak Gupta and Gurney, {Jennifer M.} and Hawrylux, {Gregory W.J.} and Raimund Helbok and Hutchinson, {Peter J.A.} and Corrado Iaccarino and Angelos Kolias and Maier, {Ronald W.} and Martin, {Matthew J.} and Geert Meyfroidt and Okonkwo, {David O.} and Frank Rasulo and Sandro Rizoli and Andres Rubiano and Juan Sahuquillo and Sams, {Valerie G.} and Franco Servadei and Deepak Sharma and Lori Shutter and Stahel, {Philip F.} and Taccone, {Fabio S.} and Andrew Udy and Tommaso Zoerle and Vanni Agnoletti and Francesca Bravi and {De Simone}, Belinda and Yoram Kluger and Costanza Martino and Moore, {Ernest E.} and Massimo Sartelli and Dieter Weber and Chiara Robba",

note = "Funding Information: We would like to thank WSES for the support. Publisher Copyright: {\textcopyright} 2023, The Author(s).",

year = "2023",

month = dec,

doi = "10.1186/s13017-022-00468-2",

language = "English",

volume = "18",

journal = "World Journal of Emergency Surgery",

issn = "1749-7922",

publisher = "BioMed Central",

number = "1",

}

Picetti, E, Catena, F, Abu-Zidan, F, Ansaloni, L, Armonda, RA, Bala, M, Balogh, ZJ, Bertuccio, A, Biffl, WL, Bouzat, P, Buki, A, Cerasti, D, Chesnut, RM, Citerio, G, Coccolini, F, Coimbra, R, Coniglio, C, Fainardi, E, Gupta, D, Gurney, JM, Hawrylux, GWJ, Helbok, R, Hutchinson, PJA, Iaccarino, C, Kolias, A, Maier, RW, Martin, MJ, Meyfroidt, G, Okonkwo, DO, Rasulo, F, Rizoli, S, Rubiano, A, Sahuquillo, J, Sams, VG, Servadei, F, Sharma, D, Shutter, L, Stahel, PF, Taccone, FS, Udy, A, Zoerle, T, Agnoletti, V, Bravi, F, De Simone, B, Kluger, Y, Martino, C, Moore, EE, Sartelli, M, Weber, D & Robba, C 2023, 'Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)', World Journal of Emergency Surgery, vol. 18, no. 1, 5. https://doi.org/10.1186/s13017-022-00468-2

Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES). / Picetti, Edoardo; Catena, Fausto; Abu-Zidan, Fikri et al.
In: World Journal of Emergency Surgery, Vol. 18, No. 1, 5, 12.2023.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities

T2 - a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

AU - Picetti, Edoardo

AU - Catena, Fausto

AU - Abu-Zidan, Fikri

AU - Ansaloni, Luca

AU - Armonda, Rocco A.

AU - Bala, Miklosh

AU - Balogh, Zsolt J.

AU - Bertuccio, Alessandro

AU - Biffl, Walt L.

AU - Bouzat, Pierre

AU - Buki, Andras

AU - Cerasti, Davide

AU - Chesnut, Randall M.

AU - Citerio, Giuseppe

AU - Coccolini, Federico

AU - Coimbra, Raul

AU - Coniglio, Carlo

AU - Fainardi, Enrico

AU - Gupta, Deepak

AU - Gurney, Jennifer M.

AU - Hawrylux, Gregory W.J.

AU - Helbok, Raimund

AU - Hutchinson, Peter J.A.

AU - Iaccarino, Corrado

AU - Kolias, Angelos

AU - Maier, Ronald W.

AU - Martin, Matthew J.

AU - Meyfroidt, Geert

AU - Okonkwo, David O.

AU - Rasulo, Frank

AU - Rizoli, Sandro

AU - Rubiano, Andres

AU - Sahuquillo, Juan

AU - Sams, Valerie G.

AU - Servadei, Franco

AU - Sharma, Deepak

AU - Shutter, Lori

AU - Stahel, Philip F.

AU - Taccone, Fabio S.

AU - Udy, Andrew

AU - Zoerle, Tommaso

AU - Agnoletti, Vanni

AU - Bravi, Francesca

AU - De Simone, Belinda

AU - Kluger, Yoram

AU - Martino, Costanza

AU - Moore, Ernest E.

AU - Sartelli, Massimo

AU - Weber, Dieter

AU - Robba, Chiara

PY - 2023/12

Y1 - 2023/12

N2 - Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.

AB - Background: Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods: A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results: A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions: This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.

KW - Hub

KW - Management

KW - Spoke

KW - Transfer

KW - Traumatic brain injury

UR - http://www.scopus.com/inward/record.url?scp=85145957640&partnerID=8YFLogxK

U2 - 10.1186/s13017-022-00468-2

DO - 10.1186/s13017-022-00468-2

M3 - Article

C2 - 36624517

AN - SCOPUS:85145957640

SN - 1749-7922

VL - 18

JO - World Journal of Emergency Surgery

JF - World Journal of Emergency Surgery

IS - 1

M1 - 5

ER -

Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES)

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