ArticlePloS one2016
Benchmarking Prehospital and Emergency Department Care for Argentine Children with Traumatic Brain Injury: For the South American Guideline Adherence Group.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Pediatric traumatic brain injury prehospital guidelines: a systematic review and appraisal.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2022Pooled it
- Clinical Epidemiology of Extracranial Injuries in Severe Pediatric Traumatic Brain Injury in South America.Injury · 2024Article
- The Status of Quality Improvement Programs for Pediatric Traumatic Brain Injury Care in Argentina.The Journal of surgical research · 2021Article
- Survey of resources available to implement severe pediatric traumatic brain injury management guidelines in low and middle-income countries.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2020Article
- Emergency department management of traumatic brain injuries: A resource tiered review.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2020Review
- Can we rely on out-of-hospital blood samples? A prospective interventional study on the pre-analytical stability of blood samples under prehospital emergency medicine conditions.Scandinavian journal of trauma, resuscitation and emergency medicine · 2017Article
- Article
- Clinico-radiologic Profile of Pediatric Traumatic Brain Injury in Western Rajasthan.Journal of neurosciences in rural practiceArticle
Corrections and comments
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Authors and funding
17 authors at 10 institutions in 2 countries.
Funding
Abstract
objectiveThere is little information on the type of early care provided to children with traumatic brain injury (TBI) in low middle income countries. We benchmarked early prehospital [PH] and emergency department [ED] pediatric TBI care in Argentina.
methodsWe conducted a secondary analysis of data from patients previously enrolled in a prospective seven center study of children with TBI. Eligible participants were patients 0-18 years, and had diagnosis of TBI (admission Glasgow Coma scale score [GCS] < 13 or with GCS 14-15 and abnormal head CT scan within 48 hours of admission, and head AIS > 0). Outcomes were transport type, transport time, PH and ED adherence to best practice, and discharge Pediatric Cerebral Performance Category Scale (PCPC) and Pediatric Overall Performance category Scale (POPC).
resultsOf the 366 children, mean age was 8.7 (5.0) years, 58% were male, 90% had isolated TBI and 45.4% were transported by private vehicle. 50 (34.7%) of the 144 children with severe TBI (39.3% of all TBI patients) were transported by private vehicle. Most (267; 73%) patients received initial TBI care at an index hospital prior to study center admission, including children with severe (81.9%) TBI. Transport times were shorter for those patients who were directly transported by ambulance to study center than for the whole cohort (1.4 vs.5.5 hours). Ambulance blood pressure data were recorded in 30.9%. ED guideline adherence rate was higher than PH guideline adherence rate (84.8% vs. 26.4%). For patients directly transferred from scene to study trauma centers, longer transport time was associated with worse discharge outcome (PCPC aOR 1.10 [1.04, 1.18] and (POPC aOR 1.10 [1.04, 1.18]). There was no relationship between PH or ED TBI guideline adherence rate and discharge POPC and PCPC.
conclusionThis study benchmarks early pediatric TBI care in Argentina and shows that many critically injured children with TBI do not receive timely or best practice PH care, that PH guideline adherence rate is low and that longer transport time was associated with poor discharge outcomes for patients with direct transfer status. There is an urgent need to improve the early care of children with TBI in Argentina, especially timely transportation to a hospital.
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