29 research outputs found

    The BIG (brain injury guidelines) project: Defining the management of traumatic brain injury by acute care surgeons

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    BACKGROUND: It is becoming a standard practice that any ''positive'' identification of a radiographic intracranial injury requires transfer of the patient to a trauma center for observation and repeat head computed tomography (RHCT). The purpose of this study was to define guidelinesVbased on each patient's history, physical examination, and initial head CT findingsVregarding which patients require a period of observation, RHCT, or neurosurgical consultation. METHODS: In our retrospective cohort analysis, we reviewed the records of 3,803 blunt traumatic brain injury patients during a 4-year period. We classified patients according to neurologic examination results, use of intoxicants, anticoagulation status, and initial head CT findings. We then developed brain injury guidelines (BIG) based on the individual patient's need for observation or hospitalization, RHCT, or neurosurgical consultation. RESULTS: A total of 1,232 patients had an abnormal head CT finding. In the BIG 1 category, no patients worsened clinically or radiographically or required any intervention. BIG 2 category had radiographic worsening in 2.6% of the patients. All patients who required neurosurgical intervention (13%) were in BIG 3. There was excellent agreement between assigned BIG and verified BIG. J statistic is equal to 0.98. CONCLUSION: We have proposed BIG based on patient's history, neurologic examination, and findings of initial head CT scan. These guidelines must be used as supplement to good clinical examination while managing patients with traumatic brain injury. Prospective validation of the BIG is warranted before its widespread implementation. (J Trauma Acute Care Surg. 2014;76: 965Y969

    Search for high-mass diphoton resonances in proton-proton collisions at 13 TeV and combination with 8 TeV search

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    Search for leptophobic Z ' bosons decaying into four-lepton final states in proton-proton collisions at root s=8 TeV

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    Search for black holes and other new phenomena in high-multiplicity final states in proton-proton collisions at root s=13 TeV

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    Searches for R-parity-violating supersymmetry in pp collisions at √s=8  TeV in final states with 0–4 leptons

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    Searches for R-parity-violating supersymmetry in pp collisions at √s=8  TeV in final states with 0–4 leptons

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    Search for t t ¯ tt \mathrm{t}\overline{\mathrm{t}} resonances in highly boosted lepton+jets and fully hadronic final states in proton-proton collisions at s = 13 s=13 \sqrt{s}=13 TeV

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