Traumatic brain injury: have NICE guidelines improved outcomes?

  • Marincowitz C & al.
  • BMJ Open
  • 4 Jun 2019

  • curated by Dawn O'Shea
  • UK Medical News
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The introduction of NICE guidelines on the management of traumatic brain injury (TBI) has coincided with improved admitted mortality in 16-64 age group but not in other age groups, according to research published in BMJ Open.

The study used hospital episode statistics (HES) to evaluate the impact of the 2003, 2007 and 2014 NICE head injury guidelines on deaths and hospital admissions caused by TBI. The data were drawn from all hospitals in England between 1998 and 2017.

The findings show that the monthly TBI mortality and admission rates in the 65+ age group increased from 0.5 to 1.5 and 10 to 30 per 100,000 population, respectively. The increasing mortality rate was unaffected by the introduction of any of the guidelines.

The introduction of the second NICE head injury guideline was associated with a significant reduction in the monthly TBI mortality rate in the 16-64 age group (−0.005; 95% CI, −0.002 to −0.007).

In the 0-15 age group, the TBI mortality rate fell from around 0.05 to 0.01 per 100,000 population and this trend was unaffected by any guideline.

The authors say the cause of the observed increased admission and mortality rates in patients aged above 65 years and potential treatments for TBI in this age group require further investigation.