Management of mild traumatic brain injuries in emergency departments in Sweden: Evidence of a change in clinical practice
Samuel Carlsson, Jean-Luc af Geijerstam
Clinical Epidemiology Unit, Karolinska University Hospital, SE-171 76 Stockholm, Sweden. E-mail: firstname.lastname@example.org
Objective: A study published in 2000 on the acute clinical
management of mild traumatic brain injuries in Sweden
showed that these patients were routinely admitted to hospital
for observation. This study aims to compare current
clinical management of mild traumatic brain injury with
clinical practice a decade ago.
Design: Questionnaire to senior residents in all emergency
departments in Sweden and data from registers covering all
in-hospital care in Sweden.
Results: The response rate to the questionnaire was 100%.
In Sweden, 71 emergency departments treat patients with
mild traumatic brain injuries. An estimated mean of 58%
of patients with mild traumatic brain injuries receive computerized
tomography scanning, which represents a 3-fold
increase compared with 2000. In 2010, Swedish hospitals admitted
8821 patients for mild traumatic brain injuries (94
per 100,000 inhabitants). This figure is approximately half
that of 1996, when 16,877 patients were treated as inpatients
for mild traumatic brain injuries (191 per 100,000 inhabitants).
However, admission rates continue to vary widely
among departments. The mean hospital stay 2010 was 1.21
days, compared with 1.6 days in 1996.
Conclusion: This study provides evidence of a change in
clinical practice in the acute management of mild traumatic
brain injuries in Sweden. Acute management is increasingly
based on computed tomography, and in-hospital observation
is used less frequently as a strategy for these patients.
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