Traumatic Brain Injury Clinical Trial
Official title:
Field Triage of Older Adults Who Experience Traumatic Brain Injury
Our overall goal in this proposed study is to describe the current prehospital trauma triage process for older adult (ageā„55) patients with suspected Traumatic Brain Injury (TBI), to identify the effect of certain medications (anticoagulants and platelet inhibitors) on TBI-related need for trauma center services, and to identify novel TBI screening strategies that are feasible for use in the prehospital setting.
Traumatic brain injury (TBI) is major source of disability and death for older adults. Of
particular concern is that older adults most frequently sustain TBIs after low-mechanism
injuries, such as falls from standing height, and frequently use anticoagulants and platelet
inhibitors, which place them at risk for worse clinical outcomes. With the growth of the
older adult population and the expanding use of anticoagulants and platelet inhibitors, TBI
among older adults will continue to be a major source of morbidity and mortality unless
methods are identified to improve outcomes in this unique population.
Building upon our long-standing and highly successful EMS research laboratory that has
specifically focused on the triage of injured patients and the prehospital care of older
patients and employing a combination of qualitative and quantitative methods, we will
collect data from a large, multi-county catchment area that includes multiple EMS agencies,
urban and rural environments, as well as trauma centers and non-trauma centers. In this
study, we will: 1) identify candidate neurologic scales to maximize detection of high-risk
older adult TBI patients; 2) characterize the current trauma triage process used by EMS
providers to identify older patients with suspected TBI and patients taking anticoagulants
and/or platelet inhibitors; 3) assess the public health burden of TBI among older adult EMS
patients taking anticoagulants and/or platelet inhibitors; 4) assess the predictive ability
of novel prehospital-based neurologic screening strategies to identify high-risk older adult
TBI patients in the prehospital setting who require TBI-related trauma center care. Findings
from this study have the potential to shift clinical practice in the prehospital setting by
informing future recommendations for the identification of TBI among older adults taking
anticoagulants or platelet inhibitors.
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Observational Model: Cohort, Time Perspective: Prospective
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