• Eiichi Suehiro, Tatsuya Tanaka, Yuhei Michiwaki, Tomihiro Wakamiya, Kazuaki Shimoji, Keisuke Onoda, Fumitake Yamane, Masatou Kawashima, and Akira Matsuno.
• Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Chiba, Japan. Electronic address: suehiro-nsu@umin.ac.jp.
• World Neurosurg. 2023 Jan 1; 169: e279e284e279-e284.

BackgroundStandardization of seamless treatment from prehospital injury care to initial injury and specialized care through collaboration among departments have been promoted in Japan since 2000. This survey was conducted to examine the current status of the system for treatment of traumatic brain injury (TBI) in Japan.MethodsIn February 2022, questionnaires on the treatment system and TBI care were sent to 869 facilities that participated in a training program held by the Japan Neurosurgical Society. Responses were received from 480 facilities (55.2%). These responses were compared with those in a similar survey performed in 2008.ResultsAmong the responding facilities, 39.4% had neurosurgeons in emergency departments. Initial care for TBI was the responsibility of the neurosurgery department in 42.3% of the facilities, the emergency department in 26.0%, and jointly between these departments in 29.6%; and neurocritical care was managed by the neurosurgery department in 81.9%, the emergency department in 5.2%, and jointly in 12.1%. For patients with acute-phase TBI, intracranial pressure monitoring was performed in 72.1%. Active normothermia was performed in 86.0%, and decompressive craniectomy in 99.4%, as required. There was compliance with guidelines for treatment and management of TBI in 93.3%.ConclusionsComparison with the 2008 results suggested role-sharing between 2 departments in TBI treatment is increasing. TBI treatment compliance with the guidelines was high. In-hospital mortality of Japanese patients with TBI has decreased since 2000. This may be due to the progress with standardization of TBI treatment and collaboration among departments in compliance with guidelines.Copyright © 2022 Elsevier Inc. All rights reserved.

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