‘Smarter’ Brain Injury Guidelines Developed by UA-Banner Trauma Team Prove Effective, Save Money

Brain injury guidelines developed by trauma surgeons at Banner – University Medical Center Tucson are providing positive outcomes while reducing hospital stays and significantly saving money, according to a study published in the September 2015 issue of Annals of Surgery.

Brain injury guidelines developed by trauma surgeons at Banner – University Medical Center Tucson are providing positive outcomes while reducing hospital stays and significantly saving money, according to a study published in the September 2015 issue of Annals of Surgery.

The journal article, “Changing Paradigms in the Management of 2,184 Patients with Traumatic Brain Injury,” describes how new Brain Injury Guidelines (“BIG”) protocols adopted by the hospital’s trauma center in 2012 to treat minimally brain-injured patients have reduced repeat CT scans by 38 percent and shaved more than a day and a half from the average hospital stay for these patients.

The five-year retrospective study and journal article suggest that  head-injured patients with miniscule brain bleeds – half the size of a pea -- may not need to been seen by a neurosurgeon, require repeated head scans or be admitted to an ICU, as is routine in many U.S. hospitals.

Dr. Bellal JosephIn fact, many of these mildly injured patients can be discharged safely from the hospital within 24 hours, said trauma surgeon Bellal Joseph, MD, associate professor in the University of Arizona Department of Surgery and lead author of the journal article.

“Our evidence-based practice showed that we can reduce unnecessary and prolonged hospital admissions in patients with mild head injuries, ” said Dr. Joseph, who presented the study findings at the 135th annual meeting of the American Surgical Association in April in San Diego, Calif. “The consensus around the country, from both neurosurgeons and trauma surgeons, is that defined, safe protocols like these are much needed.”

Dr. Peter RheeThe BIG protocols have saved more than  $4 million in hospital charges a year at Banner – UMC, said Peter Rhee, MD, medical director of the hospital’s Level 1 trauma center and chief of Trauma, Critical Care, Burns and Emergency Surgery in the UA Department of Surgery.

“This is big money and I am very proud of our team, who was able to show through careful research that our way of managing traumatic brain injury is safe yet smarter.  It saves the patient and the health-care system a lot of money.  Everyone is a winner with this type of smarter medicine,” Dr. Rhee said.

The BIG protocols were developed at Banner – University Medical Center Tucson in collaboration with the hospital’s neurosurgeons. The trauma center treats about 1,000 patents a year for Traumatic Brain Injury (TBI), mostly the result of falls and motor vehicle accidents. Patients with mild TBI make up about 70 percent of these TBI patients.

The journal article was co-authored by Ansab Haider, MD; Viraj Pandit, MD; Andrew Tang, MD; Narong Kulvatunyou, MD; Terence O’Keeffe, MD, and Peter Rhee, MD, of the UA Department of Surgery Division of Trauma.