The Impact of JSNT Guidelines on the Care and Outcomes of Patients with Severe Traumatic Brain Injury(<SPECIAL ISSUE>Current Trends of the Treatment of Neurotrauma)

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  • Tokutomi Takashi
    Department of Neurosurgery, Kurume University School of Medicine:The Japan Society of Neurotraumatology Guidelines for Management of Severe Head Injury Committee:The Japan Society of Neurotraumatology:The Japan Council of Traffic Science:The Japan Neurotrauma Data Bank Committee:The Japan Society of Neurotraumatology:The Japan Council of Traffic Science
  • Ogawa Takeki
    Department of Emergency Medicine, Jikei University School of Medicine:The Japan Society of Neurotraumatology Guidelines for Management of Severe Head Injury Committee:The Japan Society of Neurotraumatology:The Japan Council of Traffic Science:The Japan Neurotrauma Data Bank Committee:The Japan Society of Neurotraumatology:The Japan Council of Traffic Science
  • Shigemori Minoru
    Department of Neurosurgery, Kurume University School of Medicine:The Japan Society of Neurotraumatology Guidelines for Management of Severe Head Injury Committee:The Japan Society of Neurotraumatology:The Japan Council of Traffic Science:The Japan Neurotrauma Data Bank Committee:The Japan Society of Neurotraumatology:The Japan Council of Traffic Science

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  • 重症頭部外傷治療・管理のガイドラインに関する調査 : 現ガイドラインに準拠した治療は頭部外傷患者の予後に影響を与えたか?(<特集>神経外傷治療の最新動向)

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In 2000 the Japan Society of Neurotraumatology (JSNT) Guidelines for the Management of Severe Head Injury were published and disseminated. In 2005 a questionnaire intended to investigate compliance with the Guidelines was mailed to all neurosurgical training hospitals in Japan. Of 1,319 hospitals, 518 returned completed questionnaires (a 39.2% response rate). Of these, 93 hospitals (18%) were almost fully compliant. To examine the impact of the Guidelines on patient outcomes, data from the Japan Neurotrauma Data Bank were compared before (January 1998〜December 1999) and after (July 2004〜June 2005) the implementation of the Guidelines. The mean age, Glasgow Coma Scale score, and Injury Severity Score were similar in both groups. The mortality rate decreased from 52% to 43% (p=0.0311), and preventable trauma deaths derived from Revised Trauma Score and Injury Severity Score (TRISS) methodology decreased from 37% to 28% (p=0.0791). Although active implementation of the JSNT Guidelines is infrequent, following the recommendation in the guidelines may reduce mortality.

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