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New Research Shows Better Outcomes When TBI Guidelines Are Followed

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Dr. Roger Hartl

A new study co-authored by Dr. Roger Härtl shows that patients who suffer a severe traumatic brain injury do better when their caregivers follow established guidelines for managing the injury. The study, “Marked reduction in mortality in patients with severe traumatic brain injury,” was published October 8, 2013, in the Journal of Neurosurgery.

The guidelines, which were first published in 1986, were developed by the Brain Trauma Foundation in collaboration with the American Association of Neurological Surgeons and Congress of Neurological Surgeons. The guidelines included improved monitoring of pressure within the skull, management of blood flow in the brain, and administration of adequate nutritional support.

This new study looked at data collected between 2001 and 2009 at 22 trauma centers in New York State in a database established by the Brain Tumor Foundation. Analysis of the data showed that adherence to the guidelines decreased mortality from severe TBIs from 22 to 13 percent during that time.

"This work shows the importance of intensive monitoring and guideline-drive treatment of patients with severe TBI," says Dr. Härtl. "Mortality has decreased since the 1970s from more than fifty percent to now less than fifteen percent. This is due not to miracle drugs or new surgeries, but to the application of science and intensive care protocols. Traumatic brain injury has evolved from a devastating injury with minimal chances of meaningful survival to an injury that can be treated effectively with unprecedented clinical results."

The paper was co-authored by Dr. Linda Gerber, professor of public health and professor of epidemiology in medicine, Dr. Jamshid Ghajar, clinical professor of neurological surgery, Dr. Roger Härtl, director of spinal surgery and neurotrauma and professor of neurological surgery, and research biostatistician Ya-Lin Chiu from Weill Cornell, along with researchers from the Brain Trauma Foundation, Jamaica Hospital Medical Center in New York, and Oregon Health & Science University.

See an abstract of the paper.

See also: Increased Mortality in Patients with Severe Traumatic Brain Injury Treated Without Intracranial Pressure Monitoring