ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2021
The impact of delayed time to first CT head in traumatic brain injury.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Diagnostic Accuracy of S100B in Predicting Intracranial Abnormalities on CT Imaging Following Mild Traumatic Brain Injury: A Systematic Review and Meta-analysis.Neurocritical care · 2025Pooled it
- Accuracy of GFAP and UCH-L1 in predicting brain abnormalities on CT scans after mild traumatic brain injury: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Hypotension and Adverse Outcomes in Moderate to Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Timely access to computed tomography and magnetic resonance imaging in acute critical conditions: clinical and health system outcomes. A scoping review.Emergency radiology · 2026Article
- Impact of Initial Care at a Neurosurgery-Capable Facility on Mortality Among Patients with Moderate-to-Severe Traumatic Brain Injury in South Africa.Neurocritical care · 2026Article
- Biomarkers and clinical rules for the management of mild traumatic brain injury: a narrative review.International journal of emergency medicine · 2026Review
- Article
- Influence of Australasian Triage Scale on time to CT for major trauma patients: a Western Australian level 1 trauma centre experience.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Traumatic brain injuries in a district level emergency department in Cape Town: describing patients' journey from arrival to CT scan and neurosurgery.BMC emergency medicine · 2025Article
- Evaluation of a team-based approach for emergency department patients with time critical intracranial conditions.Emergency medicine Australasia : EMA · 2025Article
- Development of a Quality Indicator Set for the Optimal Acute Management of Moderate to Severe Traumatic Brain Injury in the Australian Context.Neurocritical care · 2025Article
- Time to traumatic intracranial hematoma evacuation: contemporary standard and room for improvement.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Distinct Serum Glial Fibrillary Acidic Protein and Neurofilament Light Time-Courses After Rapid Head Rotations.Journal of neurotrauma · 2024Article
- Impact of nonphysician, technology-guided alert level selection on rates of appropriate trauma triage in the United States: a before and after study.Journal of trauma and injury · 2023Article
- Effect of trauma center operation on emergency care and clinical outcomes in patients with traumatic brain injury.Journal of trauma and injury · 2023Article
- Impact of easing COVID-19 safety measures on trauma computed tomography imaging volumes.Emergency radiology · 2023Article
- The impact of delayed time to first CT head on functional outcomes after blunt head trauma with moderately depressed GCS.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- 50th anniversary of computed tomography: past and future applications in clinical neuroscience.Journal of medical imaging (Bellingham, Wash.) · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTrauma team activation (TTA) criteria trigger early mobilization of resources for the sickest trauma patients. Patients with moderately depressed GCS who do not trigger the highest level activation are at risk for adverse outcomes, potentially from delayed time to intervention. The study objective was to define the impact of time to first CT Head (CTH) on outcomes among blunt trauma patients with moderately depressed GCS.
methodsPatients from the Trauma Quality Improvement Program (TQIP) databank (2013-2016) with first ED GCS 9-12 were included. Transfers, penetrating mechanisms, death < 24 h, AIS = 6 in any body region, and patients with severe associated injuries were excluded. Study groups were defined by time to first CTH after ED arrival: immediate (≤ 1 h) vs. delayed (1-6 h). Primary outcomes were time to neurosurgical intervention and time to ED discharge.
resultsAfter exclusions, 4997 patients were identified. Of these, 79% (n = 3,954) underwent immediate CTH and 21% (n = 1,043) had delayed CTH. Median GCS was 11 [10-12] in both groups and there was no difference in median Head AIS (4 [3-4] vs. 4 [3-4], p = 0.586). Time to craniotomy and ICP monitor insertion were longer in the delayed group (4.2 h [3.0-7.6] vs. 3.1 h [2.1-8.7], p = 0.001; and 5.7 h [3.8-13.0] vs. 4.4 h [2.6-12.0], p = 0.008), as was time in the ED (4.3 h [2.7-6.5] vs. 2.1 h [1.2-3.7], p < 0.001). There was no difference in need for craniotomy (11% vs. 10%, p = 0.287), need for ICP monitor (12% vs. 12%, p = 0.899), or mortality (11% vs. 9%, p = 0.160). On multivariate analysis, age > 65 (OR 2.813, p < 0.001), SBP < 90 mmHg (OR 2.934, p < 0.001), ED intubation (OR 1.486, p = 0.001), and Head AIS scores of 4 (OR 1.884, p < 0.001) and 5 (OR 6.729, p < 0.001) were independently associated with death.
conclusionsImmediate CTH for blunt trauma patients with moderately depressed GCS decreases time to intervention and reduces ED time. A protocol to shorten time to CTH may be beneficial for both patients and hospitals.
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