Minor Head Injury Clinical Trial
Official title:
Outcome of Patients With Mild Head Injury and Presence of an Acute Traumatic Abnormality on CT Scan of Head
NCT number | NCT04143347 |
Other study ID # | 2014P001407 |
Secondary ID | |
Status | Completed |
Phase | |
First received | |
Last updated | |
Start date | March 1, 2012 |
Est. completion date | May 1, 2014 |
Verified date | October 2019 |
Source | Massachusetts General Hospital |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Background: Patients with mild blunt traumatic brain injury (TBI) are frequently transferred
to Level 1 trauma centers (L1TC) if they have any positive finding of any acute intracranial
injury identified on a CT scan of the head. The hypothesis for the study is that patients
with such injuries and minor changes on the Head CT scan can be safely managed at community
hospitals (CH).
Methods: Patients with blunt, mild TBI (defined as a GCS 13-15 at presentation) presenting to
CH, L1TC, and transferred from CH to L1TC between March, 2012 and February, 2014 were
included. Minor changes on head CT were defined as: 1) epidural hematoma<2mm; 2) subarachnoid
hemorrhage<2mm; 3) subdural hematoma<4mm; 4) intraparenchymal hemorrhage<5mm; 5) minor
pneumocephalus; or 6) linear or minimally depressed skull fracture. TBI-specific
interventions were defined as intracranial pressure monitor placement, administration of
hyperosmolar therapy, or neurosurgical operation. Three groups of patients were compared: 1)
those receiving treatment at CH, 2) those transferred from CH to L1TC, and 3) those
presenting directly to L1TC.
The primary endpoint was the need for TBI-specific intervention and secondary outcome was
death of any patient.
Status | Completed |
Enrollment | 192 |
Est. completion date | May 1, 2014 |
Est. primary completion date | March 1, 2014 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: 1. Blunt Trauma to Head 2. Patients with Glasgow Coma Scale (GCS) 13-15 3. Head CT scan showing the following minor changes 1. an epidural hematoma less than 2 mm thick 2. a subarachnoid hemorrhage measuring less than 2 mm 3. a subdural hematoma less than 4 mm thick 4. an intraparenchymal hemorrhage measuring less than 5 mm 5. minor pneumocephalus defined as 2-3 small bubbles of intracranial air 6. linear or minimally depressed skull fracture 4. Patients who had more than one of the above findings were also included 5. Patients on aspirin were included 6. Patients who were intoxicated with alcohol were included if their GCS could still be assessed as being between 13-15 - Exclusion Criteria: 1. Patients with more severe CT scan findings than those noted above 2. Less than 18 years of age 3. Open skull fractures 4. Intubated patients 5. Hemodynamically unstable upon presentation 6. Prior history of bleeding diathesis 7. Patients with severe extracranial injuries - defined as Abbreviated Injury Scale (AIS) greater than or equal to 3 in any other body region - |
Country | Name | City | State |
---|---|---|---|
United States | Massachusetts General hospital | Boston | Massachusetts |
Lead Sponsor | Collaborator |
---|---|
Massachusetts General Hospital |
United States,
Sugerman DE, Xu L, Pearson WS, Faul M. Patients with severe traumatic brain injury transferred to a Level I or II trauma center: United States, 2007 to 2009. J Trauma Acute Care Surg. 2012 Dec;73(6):1491-9. doi: 10.1097/TA.0b013e3182782675. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Neurosurgical intervention | Patients requiring Hyperosmolar therapy - either mannitol or hypertonic saline. Neurosurgical operation Insertion of an Intracranial pressure monitor |
30 days after admission with minor Head Injury | |
Secondary | Death | patients who died during the index hospitalization | 30 days after admission with minor head injury |
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