Functional outcome of surgically treated patients with moderate traumatic brain injury (GCS 9-12) under the fast-track protocol

Narongpong  Lowprukmanee

Authors

Narongpong Lowprukmanee Sawanpracharak Hospital, Nakhonsawan, Thailand

Keywords:

Glasgow coma scale, Glasgow outcome scale, traumatic brain injury (TBI)

Abstract

Background: Traumatic brain injury (TBI) is a major cause of disability, morbidity, and mortality worldwide.

Objective: This study aimed to determine the effect of the fast-track protocol on the clinical outcome of patients with TBI.

Methods: This study evaluated the functional outcomes in surgical groups of the TBI fast-track protocol, with Glasgow coma scale (GCS) scores between 9 and 12. Data were retrospectively collected from 52 patients with TBI who were treated surgically under the fast-track protocol at Sawanpracharak Hospital, Thailand, between September 1, 2016, and February 28, 2024, and compared with 52 patients who underwent routine surgical treatment (non-fast-track). Risk factors, causes of accidents, clinical parameters, and the outcomes were analyzed, which included time from the emergency room (ER) to the operating room (OR), pneumonia, sepsis, pressure sores, tracheostomy, length of hospital stay (LOS), and the Glasgow outcome scale (GOS) score.

Results: Significant associations were observed between the fast-track and non-fast-track groups regarding time from ER to OR (P < 0.001), pneumonia (P < 0.001), sepsis (P = 0.027), pressure sores (P = 0.016), tracheostomy (P = 0.028), LOS (P < 0.001), and GOS score (P < 0.001).

Conclusion: The fast-track protocol exhibited improved clinical outcomes, including reduced complication rates, a shorter LOS, and better GOS outcomes. Therefore, timely surgical intervention within 60 minutes of ER admission is critical for optimizing patient outcomes.

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