Save the patient a trip. Outcome difference between conservatively treated patients with traumatic brain injury in a nonspecialized intensive care unit vs a specialized neurosurgical intensive care unit in the Sultanate of Oman.
Traumatic brain injury (TBI) continues to be the main cause of death among trauma patients. Accurate diagnosis and timely surgical interventions are critical steps in reducing the mortality from this disease. For patients who have no surgically reversible head injury pathology, the decision to transfer to a dedicated neurosurgical unit is usually controversial.


OBJECTIVE
To compare the outcome of patients with severe TBI treated conservatively in a specialized neurosurgical intensive care unit (ICU) and those treated conservatively at a general ICU in the Sultanate of Oman.


METHODS
Retrospective cohort study.


METHODS
This is a retrospective study of patients with severe TBI admitted to Khoula Hospital ICU (specialized neurosurgical ICU) and Nizwa Hospital ICU (general ICU) in Oman in 2013. Surgically treated patients were excluded. Data extracted included demographics, injury details, interventions, and outcomes. The outcome variables included mortality, length of stay, length of ICU days, and ventilated days.


RESULTS
There were 100 patients with severe TBI treated conservatively at Khoula Hospital compared with 74 patients at Nizwa Hospital. Basic demographics were similar between the 2 groups. No significant difference was found in mortality, length of stay, ICU days, and ventilation days.


CONCLUSIONS
There is no difference in outcome between patients with TBI treated conservatively in a specialized neurosurgical ICU and those treated in a general nonspecialized ICU in Oman in 2013. Therefore, unless neurosurgical intervention is warranted or expected, patients with TBI may be managed in a general ICU, saving the risk and expense of a transfer to a specialized neurosurgical ICU.
Emergency Department, Khoula Hospital Muscat, Oman. Electronic address: ammar.k@moh.gov.om.
Ammar M
AM
Al-Kashmiri
Department of Plastic and Reconstructive Surgery, Khoula Hospital Muscat, Oman.
Sultan Z
SZ
Al-Shaqsi
Intensive Care Department, Khoula Hospital Muscat, Oman.
Adil S
AS
Al-Kharusi
Intensive Care Department, Nizwa Hospital, Nizwa, Oman.
Laila A
LA
Al-Tamimi
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009850:Oman; D017063:Outcome Assessment, Health Care; D010360:Patient Transfer; D012121:Respiration, Artificial; D012189:Retrospective Studies; D055815:Young Adult
Critical care; Head injury; Intensive care; Mortality; Sultanate of Oman; Traumatic brain injury