Scholarlink

Background <p>Civilian penetrating traumatic brain injury (cpTBI) is a rare entity associated with severe and often devastating consequences. Guidelines recommend CT angiography (CTA), prophylactic antibiotics (AB) and antiseizure medication (ASM), early surgical revision with dural closure whenever feasible, and intracranial pressure (ICP)-guided therapy. The study aimed to investigate guideline compliance, as well as outcome after cpTBI for patients admitted to Oslo University Hospital (OUH).</p> Methods <p>We identified and included cpTBI patients admitted to OUH between 2015 and 2023 through the Oslo TBI Registry – Neurosurgery. Guideline adherence was assessed and variables associated with 30-day mortality and Glasgow Outcome Scale (GOS) were examined using standard uni- and multivariable techniques.</p> Results <p>The incidence of cpTBI was 1.9/1.000.000 with a 30-day mortality rate of 42.3%. Among the survivors, 70% achieved a favourable outcome (GOS 4 and 5) at 6 months. CTA was obtained at an acceptable rate (81%) in concordance with guidelines, but the guideline compliance for AB (12%) and ASM (29%) was substantially lower-than-expected. Surgery started within 12&#xa0;h after injury in 58%, and ICP was monitored in 53.5% of patients with GCS &lt; 9.</p> Conclusions <p>Despite high mortality in cpTBI, most survivors achieved favourable outcome. We found a lower-than-expected guideline compliance for prophylactic AB and ASM, ICP monitoring, and surgical revision within 12&#xa0;h. Thus, we identified several key factors that can improve cpTBI treatment at our institution. For patients considered potential survivors, management should be aggressive and aligned with established TBI treatment principles, including early vascular imaging with CTA, prompt wound debridement with dural closure, and prophylactic administration of AB and ASM.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Civilian penetrating traumatic brain injury in South-East Norway

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月7日

查看全文
  • Mads Aarhus,
  • Dag Ferner Netteland,
  • Cathrine Tverdal,
  • Vidar Stenset,
  • Pål Rønning,
  • Eirik Helseth

摘要

Background

Civilian penetrating traumatic brain injury (cpTBI) is a rare entity associated with severe and often devastating consequences. Guidelines recommend CT angiography (CTA), prophylactic antibiotics (AB) and antiseizure medication (ASM), early surgical revision with dural closure whenever feasible, and intracranial pressure (ICP)-guided therapy. The study aimed to investigate guideline compliance, as well as outcome after cpTBI for patients admitted to Oslo University Hospital (OUH).

Methods

We identified and included cpTBI patients admitted to OUH between 2015 and 2023 through the Oslo TBI Registry – Neurosurgery. Guideline adherence was assessed and variables associated with 30-day mortality and Glasgow Outcome Scale (GOS) were examined using standard uni- and multivariable techniques.

Results

The incidence of cpTBI was 1.9/1.000.000 with a 30-day mortality rate of 42.3%. Among the survivors, 70% achieved a favourable outcome (GOS 4 and 5) at 6 months. CTA was obtained at an acceptable rate (81%) in concordance with guidelines, but the guideline compliance for AB (12%) and ASM (29%) was substantially lower-than-expected. Surgery started within 12 h after injury in 58%, and ICP was monitored in 53.5% of patients with GCS < 9.

Conclusions

Despite high mortality in cpTBI, most survivors achieved favourable outcome. We found a lower-than-expected guideline compliance for prophylactic AB and ASM, ICP monitoring, and surgical revision within 12 h. Thus, we identified several key factors that can improve cpTBI treatment at our institution. For patients considered potential survivors, management should be aggressive and aligned with established TBI treatment principles, including early vascular imaging with CTA, prompt wound debridement with dural closure, and prophylactic administration of AB and ASM.