Compliance with Brain Trauma Foundation Guidelines in TBI Patients

Siddiqui Shahla, Quindipan Mariam, Jiexun Wang
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Abstract

Aims: The aim of this audit done prior to the release of the 4th guidelines was to audit the compliance with the brain trauma foundation guidelines in our Surgical Intensive Care Unit from Dec 2013 to Mar 2014. Methods: All adult traumatic brain injury patients admitted to the SICU between December 2013 and March 2014 were included. The third edition of the BTF guidelines was taken as a standard to assess compliance. A computerized ICU database established in 2011 allowed access to the patient records and all data was cross checked with the hospital patient record system. Results: A total of 28 patients were admitted to the SICU during the audit period. 15 variables were checked from the database and corroborated from the hospital records. The variables were collected at 24 hours after admission. All patients were with low Glasgow coma scale (GCS) and admitted to the ICU for neuro monitoring. Of the 15 variables recommended the compliance rate was 60.7%. The ICU mortality for this group of TBI patients during this period was 25%. Conclusions: Our audit shows a higher compliance rate and an acceptable mortality rate. Further studies will be required to see the mortality benefit between groups as well as development of local protocols to improve adherence to the guidelines suggested.
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TBI患者脑外伤基金会指南的依从性
目的:本次审核是在第4版指南发布之前进行的,目的是审核2013年12月至2014年3月我们外科重症监护室对脑外伤基础指南的遵守情况。方法:纳入2013年12月至2014年3月在SICU住院的所有成人外伤性脑损伤患者。BTF指南的第三版被用作评估遵守情况的标准。2011年建立的计算机化ICU数据库允许访问患者记录,并与医院患者记录系统交叉核对所有数据。结果:审计期间,SICU共收治28例患者。从数据库中检查了15个变量,并从医院记录中得到证实。入院后24小时收集变量。所有患者均为低格拉斯哥昏迷评分(GCS),并入住ICU进行神经监测。在推荐的15个变量中,符合率为60.7%。该组TBI患者在此期间的ICU死亡率为25%。结论:我们的审计显示较高的依从率和可接受的死亡率。需要进行进一步的研究,以了解不同群体之间的死亡率效益,并制定地方协议,以提高对所建议指导方针的遵守程度。
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