Retrospective, Prospective Observational Study of the Impact of Severe Traumatic Brain Injury Management Protocol on Short Term Outcome

Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity worldwide, especially in low and middle income countries. The outcome of TBI does not only depend on the initial trauma, but is also affected by secondary neurological damage that follows the trauma. These secondary effects can be reduced by implementing an evidence based protocol of management for TBI. Aim: To evaluate the effect of TBI management protocol on short term outcome. Methods: retrospective evaluation of medical records of severe TBI patients admitted to ICU during three months prior to implementing the protocol for short term outcome (group 1), then prospective observation of short term outcome of patients with severe TBI admitted to ICU, and managed with the TBI protocol for three months. Results: there was statistically significant difference between the two groups regarding the GCS after 7 days (p=0.017), the length of ICU stay (p=0.009) and the duration of mechanical ventilation (p=0.013). Conclusion: There is some evidence that following an evidence based protocol of management for severe TBI improves short term outcome.