Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Nov 28:1-8.
doi: 10.3171/2025.7.JNS25409. Online ahead of print.

Telemedicine-based triage protocol for complicated mild traumatic brain injury: a strategy to reduce unnecessary interhospital transfers

Forough Yazdanian  1   2 , Alejandro Enriquez-Marulanda  1   2 , Jonathan S Anderson  3   2 , Bryan A Stenson  3   2 , Kyle W Trecartin  3   2 , Terrance Lee  3   2 , Jason C Imperato  3   2 , Roger B Davis  4 , Carlo L Rosen  3   2 , Ron L Alterman  1   2 , Martina Stippler  1   2
Affiliations

Telemedicine-based triage protocol for complicated mild traumatic brain injury: a strategy to reduce unnecessary interhospital transfers

Forough Yazdanian et al. J Neurosurg. .

Abstract

Objective: Complicated mild traumatic brain injury (cmTBI) is a common emergency consultation in trauma care at community and tertiary hospitals. While neurosurgical evaluation is typically required, actual neurosurgical intervention is rare. The aim of this study was to evaluate the adoption, safety, and effectiveness of a telemedicine-based neurosurgery consultation program (tele-TBI) in reducing unnecessary interhospital transfers of patients with cmTBI.

Methods: A multidisciplinary team implemented the tele-TBI program at 4 community hospitals. Patients with cmTBI who were eligible to receive telehealth consultations over the first 2 years of the program were retrospectively analyzed. The program's impact on reducing interhospital transfers, disposition outcomes, and safety were assessed.

Results: Of 179 eligible patients (94 female, mean age 75 years) reviewed, 117 underwent tele-TBI consultation and 62 did not. Among the patients with tele-TBI consultations, 15 (13%) were transferred to tertiary centers, with 2 (1.7%) admitted to the ICU, 10 (8.5%) admitted to the floor, and 3 (2.6%) managed in the emergency department. Most patients (87%) who underwent tele-TBI consultation were effectively managed at community hospitals; 90 (77%) were observed in the emergency department then discharged and 12 (10%) were admitted. In contrast, all 62 patients without tele-TBI consultation were transferred to tertiary hospitals, of whom 10 (16%) were admitted and 52 (84%) were observed in the emergency department and then discharged. Multivariate analysis revealed that subdural hematoma (OR 2.90, 95% CI 1.53-5.51) and age < 80 years (OR 0.25, 95% CI 0.11-0.56) significantly influenced the likelihood of transfer.

Conclusions: The tele-TBI program reduced unnecessary interhospital transfers. Notably, most patients with tele-TBI consultation were successfully managed in their community hospital. Moreover, nearly 4 of 5 patients without tele-TBI consultation were transferred, only to be discharged directly from the tertiary referral center's emergency department.

Keywords: interhospital transfer; mild traumatic brain injury; neurosurgical consultation; telemedicine.

PubMed Disclaimer

LinkOut - more resources