Trauma Monthly

Trauma Monthly

Adaptation of Traumatic Brain Injury Guidelines in Iran

Authors
Shayan Abdollah Zadegan
Seyed Mohammad Ghodsi
Jalil Arabkheradmand
Abbas Amirjamshidi
Abdolreza Sheikhrezaei
Masoud Khadivi
Morteza Faghih Jouibari
Seyed Mahmood Tabatabaeifar
Guive Sharifi
Jalal Abbaszadeh Ahranjani
Farhad Motlagh Pirooz
Seyed Fakhredin Tavakoli
Parviz Mohit
Yadollah Alimohammadi
Vafa Rahimi-Movaghar
10.5812/traumamon.28012
Abstract
Context: The National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country. Evidence Acquisition: The guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed. Results: The following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge. Conclusions: The evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.
Keywords
Brain Injuries
Trauma
Practice Guideline
Referral and Consultation
comorbidity
Age Factors
Trauma Monthly
Volume 21, Issue 2
May and June 2016