• Francisco Martín-Rodríguez, Raúl López-Izquierdo, Alicia Mohedano-Moriano, Begoña Polonio-López, Clara Maestre Miquel, Antonio Viñuela, Carlos Durantez Fernández, Jesús Gómez Correas, Gonçalo Marques, and José Luis Martín-Conty.
• Advanced Clinical Simulation Center, School of Medicine, Universidad de Valladolid, 47005 Valladolid, Spain.
• Int J Environ Res Public Health. 2020 Feb 26; 17 (5).

AbstractTraumatic brain injuries are complex situations in which the emergency medical services must quickly determine the risk of deterioration using minimal diagnostic methods. The aim of this study is to analyze whether the use of early warning scores can help with decision-making in these dynamic situations by determining the patients who need the intensive care unit. A prospective, multicentric cohort study without intervention was carried out on traumatic brain injury patients aged over 18 given advanced life support and taken to the hospital. Our study included a total of 209 cases. The total number of intensive-care unit admissions was 50 cases (23.9%). Of the scores analyzed, the National Early Warning Score2 was the best result presented with an area under the curve of 0.888 (0.81-0.94; p < 0.001) and an odds ratio of 25.4 (95% confidence interval (CI):11.2-57.5). The use of early warning scores (and specifically National Early Warning Score2) can help the emergency medical services to differentiate traumatic brain injury patients with a high risk of deterioration. The emergency medical services should use the early warning scores routinely in all cases for the early detection of high-risk situations.

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