مرکز منطقه ای اطلاع رساني علوم و فناوري - adaptation of traumatic brain injury guidelines in iran

Author/Authors :

abdollah zadegan, shayan sina trauma and surgery research center, tehran university of medical sciences, tehran, ir iran - sina trauma and surgery research center, tehran university of medical sciences, tehran, ir iran, IR Iran , ghodsi, seyed mohammad department of neurosurgery, shariati hospital, tehran university of medical sciences, tehran, ir iran - department of neurosurgery, shariati hospital, tehran university of medical sciences, tehran, ir iran, IR Iran , arabkheradmand, jalil ahya neuroscience research center, tehran, ir iran - ahya neuroscience research center, tehran, ir iran, IR Iran , amirjamshidi, abbas department of neurosurgery, sina hospital, tehran university of medical sciences, tehran, ir iran - department of neurosurgery, sina hospital, tehran university of medical sciences, tehran, ir iran, IR Iran , sheikhrezaei, abdolreza department of neurosurgery, imam hospital, tehran university of medical sciences, tehran, ir iran - department of neurosurgery, imam hospital, tehran university of medical sciences, tehran, ir iran, IR Iran , khadivi, masoud department of neurosurgery, shariati hospital, tehran university of medical sciences, tehran, ir iran - department of neurosurgery, shariati hospital, tehran university of medical sciences, tehran, ir iran, IR Iran , faghih jouibari, morteza department of neurosurgery, shariati hospital, tehran university of medical sciences, tehran, ir iran - department of neurosurgery, shariati hospital, tehran university of medical sciences, tehran, ir iran, IR Iran , tabatabaeifar, seyed mahmood functional neurosurgery research center, shohadaye tajrish hospital, shahid beheshti university of medical sciences, tehran, ir iran - functional neurosurgery research center, shohadaye tajrish hospital, shahid beheshti university of medical sciences, tehran, ir iran, IR Iran , sharifi, guive department of neurosurgery, loghman hospital, shahid beheshti university of medical sciences, tehran, ir iran - department of neurosurgery, loghman hospital, shahid beheshti university of medical sciences, tehran, ir iran, IR Iran , abbaszadeh ahranjani, jalal department of neurosurgery, urmia university of medical sciences, urmia, ir iran - department of neurosurgery, urmia university of medical sciences, urmia, ir iran, IR Iran , motlagh pirooz, farhad department of neurosurgery, islamic azad university, medical branch, mashhad, ir iran - department of neurosurgery, islamic azad university, medical branch, mashhad, ir iran, IR Iran , tavakoli, seyed fakhredin department of neurosurgery, islamic azad university, medical branch, mashhad, ir iran - department of neurosurgery, islamic azad university, medical branch, mashhad, ir iran, IR Iran , mohit, parviz tehran university of medical sciences tums - tehran university of medical sciences, tehran, ir iran, تهران, ايران , alimohammadi, yadollah tehran university of medical sciences tums - tehran university of medical sciences, tehran, ir iran, تهران, ايران , rahimi-movaghar, vafa sina trauma and surgery research center, tehran university of medical sciences, tehran, ir iran - sina trauma and surgery research center, tehran university of medical sciences, tehran, ir iran, IR Iran

Abstract :

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. 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. 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. 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.