Hostname: page-component-8448b6f56d-xtgtn Total loading time: 0 Render date: 2024-04-18T17:09:32.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Does Teleradiology Improve Inter-hospital Management of Head-Injury?

Published online by Cambridge University Press:  18 September 2015

Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective:

In many countries, neurosurgical care is concentrated in regional centres, which often necessitates the inter-hospital transfer of patients with head injury for optimal treatment. The aim of this study was to evaluate the role of teleradiology in the management of head-injured patients when referred from a district general hospital to a tertiary neurosurgical centre.

Methods:

Prospective data were collected over a fifteen month period from March '95 to May '96. Head-injured patients referred without the facility of teleradiology (Group 1), were compared to similar patients referred with teleradiologie images (Group 2), with particular regard to therapeutic intervention before transfer and adverse events during transfer.

Results:

There were 28 patients in Group 1 and 35 in Group 2, of which 31 were transferred. Both groups were comparable with respect to age, admission Glasgow Coma Scale score, and intracranial pathology. For patients transferred with teleradiology consultation (Group 2), therapeutic interventions were more (32.1% vs. 10.7%, p = 0.06), adverse events during transfer were significantly lower (6.4% vs. 32.1%, p = 0.01), and transfer time was reduced (72 vs. 80 minutes, p = 0.38). Four patients in Group 2 were treated by a mobile neurosurgical team at the referring hospital because of rapid clinical deterioration.

Conclusion:

Our findings indicate that teleradiology has an important role in improving inter-hospital management of head-injured patients.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 24 , Issue 3 , August 1997 , pp. 235 - 239
Copyright
Copyright © Canadian Neurological Sciences Federation 1997

References

REFERENCES

1.Coiera, E. Medical informatics. Br Med J 1995; 310: 1381–1387.Google Scholar
2.Wynn-Jones, J, Lewis, L, Groves-Phillips, S. Telemedicine: if it is the answer, then what are the questions? Br J Hosp Med 1996; 55: 4–5 (Editorial).Google ScholarPubMed
3.Goldberg, MA, Rosenthal, DI, Chew, FS, et al. New high-resolution teleradiology system: prospective study of diagnostic accuracy in 685 transmitted clinical cases. Radiology 1993; 186: 429–434.Google Scholar
4.Barry, PW, Ralston, C. Adverse events occurring during interhospital transfer of the critically ill. Arch Dis Child 1994; 71: 8–11.Google Scholar
5.Jennett, B, Bond, M. Assessment of outcome after severe brain damage. A practical scale. Lancet 1975; 1: 480–484.Google Scholar
6.Kanter, RK, Tompkins, JM. Adverse events during interhospital transport: physiological deterioration associated with pretransport severity of illness. Pediatrics 1989; 84: 43–48.Google Scholar
7.Gentleman, D, Jennett, B. Hazards of inter-hospital transfer of comatose head-injured patients. Lancet 1981; 2: 853–855.Google Scholar
8.Britto, J, Nadel, S, Maconochie, I, Levin, M, Habibi, P. Morbidity and severity of illness during transfer: impact of a specialized paediatric retrieval team. Br Med J 1995; 311: 836–839.Google Scholar
9.Hicks, IR, Hedley, RM, Razis, P.Audit of transfer of head-injured patients to a stand-alone neurosurgical unit. Injury 1994; 25: 545–549.CrossRefGoogle ScholarPubMed
10.Poon, WS, Rehman, SU, Poon, CYF, Li, AKC. Traumatic extradural haematoma of delayed onset is not a rarity. Neurosurgery 1992; 30: 681–686.Google Scholar
11.Servadei, F, Nanni, A, Nasi, MT, et al. Evolving brain lesions in the first 12 hours after head injury: analysis of 37 comatose patients. Neurosurgery 1995; 37: 899–906.CrossRefGoogle ScholarPubMed
12.Simpson, DA, Heyworth, JS, McLean, AJ. Extradural haemorrhage: strategies for management in remote places. Injury 1988; 19: 307.Google Scholar
13.Poon, WS, Li, AKC. Comparison of management outcome of primary and secondary referred patients with traumatic extradural haematoma in a neurosurgical unit. Injury 1991; 22: 323–325.Google Scholar
14.Tonks, A. New ambulance targets could save 3,000 lives a year. Br Med J 1995; 311: 281.Google Scholar
15.Sakas, DE, Bullock, MR, Teasdale, GM. One-year outcome following craniotomy for traumatic haematoma in patients with fixed dilated pupils. J Neurosurg 1995; 82: 961–965.CrossRefGoogle ScholarPubMed