Traumatic Brain Injury, Concussion, Chronic Traumatic Encephalopathy: Level of Care Pathways & Treatment Strategies

Research Objectives: To develop level of care pathways for patients with traumatic brain injuries, chronic traumatic encephalopathy and concussions. Utilizing the scores of serial Glasgow Coma Scales and Rancho Los Amigos Scores with imaging studies and biomarkers in order to place brain injury patients into the appropriate clinical category and provide appropriate care.

Design: Literature reviews combined with clinical experience were used to create a level of care pathways.
The Glasgow Coma Scale, Colorado Concussion Guideline and Rancho Los Amigos Scores were paired with imaging studies to clinically categorize the patient's traumatic brain injury clinical stage.

Setting: The level of care pathway was created based on clinical experience from memory care units, assisted living, independent living, and private practice settings.

Participants: Utilizing incidence and prevalence data of traumatic brain injuries, chronic traumatic encephalopathy and concussion patients, this pathway will be applicable to all patients with these traumas.

Interventions: The proposed pathway correlates serial Glasgow Coma Scale and Rancho Los Amigo Scores, imaging data and biomarker to assess the progressive stages of traumatic brain injures. Testing patients with these tools during the clinical stages can be used to establish a baseline cognitive/functional abilities and when used repeatedly, show progression/recovery.

Main Outcome Measures: The main outcome could be discharge home, memory unit, outpatient rehabilitation and preventing readmissions.

Results: The goal of this proposed pathway is to provide a streamlined process for managing patients with traumatic brain injuries, chronic traumatic encephalopathy and concussions. Using this pathway will ease communication between the healthcare team, patient and their family. It will also provide a guideline for level of care dependent on clinical/ functional progression.

Conclusions: By developing efficient clinical assessment tools and pathways, it will be more efficient to categorize patients into traumatic brain injury, chronic traumatic encephalopathy and concussions, therefore, leading to better management, decrease complications, costs, caregiver burden and improve outcomes.

Author(s) Disclosures: No Conflicts of Interest to disclose for any of the authors