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Research Letter | Pacific Coast Surgical Association

Guidelines for the Treatment of Severe Traumatic Brain Injury Are They Used?

Lydia C. Piper, MD1; Cheryl K. Zogg, MSPH, MHS2,3; Eric B. Schneider, PhD1; Jean A. Orman, ScD4; Todd E. Rasmussen, MD5; Lorne H. Blackbourne, MD6; Adil H. Haider, MD, MPH2,3
[+] Author Affiliations
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
2Center for Surgery and Public Health, Harvard School of Public Health, Harvard Medical School, Boston, Massachusetts
3Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts
4Department of Medicine, Uniformed Services University of Health Sciences, Washington, DC
5Department of Surgery, University of Maryland School of Medicine, Baltimore
6Department of Surgery, Brooke Army Medical Center, Joint Base San Antonio–Fort Sam Houston, Texas
JAMA Surg. 2015;150(10):1013-1015. doi:10.1001/jamasurg.2015.1838.
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This study determines the extent to which Brain Trauma Foundation guidelines are used for the management of patients with severe traumatic brain injury.

Persons with severe traumatic brain injury (STBI) are frequently admitted to the neurologic intensive care unit. Each year, an estimated 1.4 million people in the United States have a TBI, resulting in 235 000 hospitalizations, 50 000 deaths, and $56.3 million in direct/indirect costs. Evidence-based guidelines for the management of patients with STBI have been available from the Brain Trauma Foundation (BTF) since 1995.1 Current recommendations, particularly those related to intracranial pressure (ICP),1 remain controversial owing to the questions raised by single-center studies and international trials about the benefit24 and feasibility5 of implementation. Based on a national assessment of US trauma medical directors (TMDs), the objective of our study was to determine the extent to which BTF guidelines are used.

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