• Maxim Bez, Dana Bez, Avishai M Tsur, Roy Nadler, Avi Benov, and Jacob Chen.
• Medical Corps, Surgeon General's Headquarters, Israel Defense Forces, Ramat Gan, Israel.
• Isr Med Assoc J. 2022 Sep 1; 24 (9): 574-578.

BackgroundTraumatic brain injury (TBI) is a significant cause of death in the battlefield. TBI can be challenging to diagnose in the combat setting and remains a substantial challenge for advanced life support (ALS) providers.ObjectivesTo compare prehospital and hospitalization characteristics between isolated and non-isolated TBI. To examine the effects of TBI with coexisting injuries on patient evaluation and outcomes based on the Israeli Defense Forces Trauma Registry and the Israeli National Trauma Registry of soldiers hospitalized for TBI between the years 2006-2017.MethodsA total of 885 casualties were eligible for our study, of whom 271 (30%) had isolated TBI. Only 35% of hospitalized patients with isolated TBI were defined as urgent by the ALS providers versus 67% in the non-isolated TBI group (P < 0.001).ResultsOverall, 29% of the TBIs in the non-isolated group were missed by the ALS providers vs. 11% in the isolated group.ConclusionsConcomitant injuries may delay the diagnosis of TBI by ALS providers. These findings should be considered in the prehospital evaluation to potentially improve the care and outcome of head injury patients.

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