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oai:recercat.cat:11351/90482025-10-24T10:22:21Zcom_2072_378070com_2072_378040col_2072_378092

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 Abu‑Zidan, Fikri Armonda, Rocco A. Bala, Miklosh Sahuquillo Barris, Joan Catena, Fausto Ansaloni, Luca Institut Català de la Salut [Picetti E] Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy. [Catena F] Department of General and Emergency Surgery, Bufalini Hospital, Cesena, Italy. [Abu-Zidan F] The Research Ofce, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates. [Ansaloni L] Unit of General Surgery, San Matteo Hospital Pavia, University of Pavia, Pavia, Italy. [Armonda RA] Department of Neurosurgery, 71541MedStar Georgetown University Hospital, Washington, DC, USA. Department of Neurosurgery, 8405MedStar Washington Hospital Center, Washington, DC, USA. [Bala M] Acute Care Surgery and Trauma Unit, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem Kiriat Hadassah, Jerusalem, Israel. [Sahuquillo J] Servei de Neurocirurgia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain Vall d'Hebron Barcelona Hospital Campus Sistema nerviós - Cirurgia Dany cerebral Cervell - Ferides i lesions Presa de decisions DISEASES::Wounds and Injuries::Trauma, Nervous System::Craniocerebral Trauma::Brain Injuries::Brain Injuries, Traumatic Other subheadings::Other subheadings::Other subheadings::/surgery DISCIPLINES AND OCCUPATIONS::Health Occupations::Medicine::Specialties, Surgical::Neurosurgery PSYCHIATRY AND PSYCHOLOGY::Behavior and Behavior Mechanisms::Psychology, Social::Group Processes::Consensus ENFERMEDADES::heridas y lesiones::traumatismos del sistema nervioso::traumatismos craneocerebrales::lesiones encefálicas::lesiones encefálicas traumáticas Otros calificadores::Otros calificadores::Otros calificadores::/cirugía DISCIPLINAS Y OCUPACIONES::profesiones sanitarias::medicina::especialidades quirúrgicas::neurocirugía PSIQUIATRÍA Y PSICOLOGÍA::conducta y mecanismos de la conducta::psicología social::procesos de grupo::consenso Management; Transfer; Traumatic brain injury Gestión; Transferir; Lesión cerebral traumática Gestió; Transferència; Lesió cerebral traumàtica 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. 2023-02-23T13:47:23Z 2023-02-23T13:47:23Z 2023-01-09 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Picetti E, Catena F, Abu-Zidan F, Ansaloni L, Armonda RA, Bala M, et al. 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 J Emerg Surg. 2023 Jan 9;18:5. 1749-7922 https://hdl.handle.net/11351/9048 10.1186/s13017-022-00468-2 36624517 000913722100003 http://hdl.handle.net/11351/9048 eng World Journal of Emergency Surgery;18 https://doi.org/10.1186/s13017-022-00468-2 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf BMC Scientia