• C Brorsson, M Rodling-Wahlström, M Olivecrona, L-O D Koskinen, and S Naredi.
• Department of Anaesthesia and Intensive Care, Institution of Surgery and Perioperative Sciences, Umeå University, Sweden. camilla.brorsson@anestesi.umu.se
• Acta Anaesthesiol Scand. 2011 Sep 1;55(8):944-51.

BackgroundSeveral factors associated with an unfavourable outcome after severe traumatic brain injury (TBI) have been described: prolonged pre-hospital time, secondary referral to a level 1 trauma centre, the occurrence of secondary insults such as hypoxia, hypotension or low end-tidal carbon dioxide (ETCO(2)). To determine whether adverse events were linked to outcome, patients with severe TBI were studied before arrival at a level 1 trauma centre.MethodsProspective, observational study design. Patients with severe TBI (n = 48), admitted to Umeå University Hospital between January 2002 to December 2005 were included. All medical records from the site of the accident to arrival at the level 1 trauma centre were collected and evaluated.ResultsA pre-hospital time of >60 min, secondary referral to a level 1 trauma centre, documented hypoxia (oxygen saturation <95%), hypotension (systolic blood pressure <90 mmHg), hyperventilation (ETCO(2) <4.5 kPa) or tachycardia (heart rate >100 beats/min) at any time before arrival at a level 1 trauma centre were not significantly related to an unfavourable outcome (Glasgow Outcome Scale 1-3).ConclusionEarly adverse events before arrival at a level 1 trauma centre were without significance for outcome after severe TBI in the trauma system studied.© 2011 The Authors. Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.

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