{"id":"https://openalex.org/W7140832016","doi":"https://doi.org/10.1227/neu.0000000000003964_1102","title":"1102 Initial Triage Location in Moderate Traumatic Brain Injury: A Comparison of Direct Level 1 Trauma Center Admission Versus Transfer From Regional Centers","display_name":"1102 Initial Triage Location in Moderate Traumatic Brain Injury: A Comparison of Direct Level 1 Trauma Center Admission Versus Transfer From Regional Centers","publication_year":2026,"publication_date":"2026-03-26","ids":{"openalex":"https://openalex.org/W7140832016","doi":"https://doi.org/10.1227/neu.0000000000003964_1102"},"language":"en","primary_location":{"id":"doi:10.1227/neu.0000000000003964_1102","doi":"https://doi.org/10.1227/neu.0000000000003964_1102","is_oa":false,"landing_page_url":"https://doi.org/10.1227/neu.0000000000003964_1102","pdf_url":null,"source":{"id":"https://openalex.org/S111727011","display_name":"Neurosurgery","issn_l":"0148-396X","issn":["0148-396X","1081-1281","1524-4040"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurosurgery","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5047677179","display_name":"Julian Michael Burwell","orcid":"https://orcid.org/0009-0006-1059-5134","observed_orcids":["https://orcid.org/0009-0006-1059-5134"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Julian M. Burwell","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5062349048","display_name":"Rhudjerry E. Arnet","orcid":"https://orcid.org/0009-0001-1856-6980","observed_orcids":["https://orcid.org/0009-0001-1856-6980"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Rhudjerry Arnet","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130667885","display_name":"Nia Long","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Nia Long","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130642093","display_name":"Sofia Muniz de la Nuez","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Sofia Muniz de la Nuez","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5094224371","display_name":"Ahmad Higazy","orcid":"https://orcid.org/0009-0002-1939-5105","observed_orcids":["https://orcid.org/0009-0002-1939-5105"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ahmad Higazy","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]},{"author_position":"last","author":{"id":"https://openalex.org/A5042660769","display_name":"Clemens Maria Schirmer","orcid":"https://orcid.org/0000-0003-1743-8781","observed_orcids":["https://orcid.org/0000-0003-1743-8781"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Clemens M. Schirmer","raw_affiliation_strings":[],"raw_orcid":null,"affiliations":[]}],"institutions":[],"countries_distinct_count":0,"institutions_distinct_count":0,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":6.0889,"has_fulltext":false,"cited_by_count":2,"citation_normalized_percentile":{"value":0.93816093,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":95,"max":96},"biblio":{"volume":"72","issue":"Supplement_1","first_page":"206","last_page":"207"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10706","display_name":"Traumatic Brain Injury and Neurovascular Disturbances","score":0.5195000171661377,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10706","display_name":"Traumatic Brain Injury and Neurovascular Disturbances","score":0.5195000171661377,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11467","display_name":"Trauma and Emergency Care Studies","score":0.3257000148296356,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10416","display_name":"Traumatic Brain Injury Research","score":0.13770000636577606,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/moderate-traumatic-brain-injury","display_name":"moderate traumatic brain injury","score":0.9419999718666077},{"id":"https://openalex.org/keywords/patient-transfer","display_name":"patient transfer","score":0.6010000109672546},{"id":"https://openalex.org/keywords/regional-trauma-centers","display_name":"regional trauma centers","score":0.9139999747276306},{"id":"https://openalex.org/keywords/in-hospital-mortality","display_name":"in-hospital mortality","score":0.8949999809265137},{"id":"https://openalex.org/keywords/discharge-disposition","display_name":"discharge disposition","score":0.7409999966621399},{"id":"https://openalex.org/keywords/extended-glasgow-outcome-scale","display_name":"Glasgow Outcome Scale-Extended","score":0.8980000019073486},{"id":"https://openalex.org/keywords/functional-outcome","display_name":"functional outcome","score":0.6179999709129333},{"id":"https://openalex.org/keywords/polytrauma","display_name":"polytrauma","score":0.8669999837875366},{"id":"https://openalex.org/keywords/intracranial-hemorrhage","display_name":"intracranial hemorrhage","score":0.8519999980926514},{"id":"https://openalex.org/keywords/brain-trauma-foundation-guidelines","display_name":"Brain Trauma Foundation guidelines","score":0.6679999828338623},{"id":"https://openalex.org/keywords/inpatient-rehabilitation","display_name":"inpatient rehabilitation","score":0.5630000233650208},{"id":"https://openalex.org/keywords/skilled-nursing-facilities","display_name":"skilled nursing facilities","score":0.7049999833106995}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9693999886512756},{"id":"https://openalex.org/C2777120189","wikidata":"https://www.wikidata.org/wiki/Q780067","display_name":"Triage","level":2,"score":0.8112000226974487},{"id":"https://openalex.org/C2780110798","wikidata":"https://www.wikidata.org/wiki/Q2980337","display_name":"Trauma center","level":3,"score":0.7225000262260437},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.625},{"id":"https://openalex.org/C2779463800","wikidata":"https://www.wikidata.org/wiki/Q5062222","display_name":"Center (category theory)","level":2,"score":0.482699990272522},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.43220001459121704},{"id":"https://openalex.org/C2776175482","wikidata":"https://www.wikidata.org/wiki/Q1195816","display_name":"Transfer (computing)","level":2,"score":0.38850000500679016},{"id":"https://openalex.org/C2781017439","wikidata":"https://www.wikidata.org/wiki/Q1995526","display_name":"Traumatic brain injury","level":2,"score":0.35510000586509705},{"id":"https://openalex.org/C85004164","wikidata":"https://www.wikidata.org/wiki/Q1089964","display_name":"Injury Severity Score","level":4,"score":0.28040000796318054},{"id":"https://openalex.org/C3017944768","wikidata":"https://www.wikidata.org/wiki/Q1450463","display_name":"Poison control","level":2,"score":0.27399998903274536},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2734000086784363},{"id":"https://openalex.org/C2780724011","wikidata":"https://www.wikidata.org/wiki/Q1295316","display_name":"Emergency department","level":2,"score":0.2671000063419342},{"id":"https://openalex.org/C3019520628","wikidata":"https://www.wikidata.org/wiki/Q2920572","display_name":"Head trauma","level":2,"score":0.2574999928474426}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.1227/neu.0000000000003964_1102","doi":"https://doi.org/10.1227/neu.0000000000003964_1102","is_oa":false,"landing_page_url":"https://doi.org/10.1227/neu.0000000000003964_1102","pdf_url":null,"source":{"id":"https://openalex.org/S111727011","display_name":"Neurosurgery","issn_l":"0148-396X","issn":["0148-396X","1081-1281","1524-4040"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-scientific","cwts-core","dongbi-b","doyens","jufo-2","ki-jl-2","medline","norway-2","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315671","host_organization_name":"Lippincott Williams & Wilkins","host_organization_lineage":["https://openalex.org/P4310315671","https://openalex.org/P4310318547"],"host_organization_lineage_names":["Lippincott Williams & Wilkins","Wolters Kluwer"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Neurosurgery","raw_type":"journal-article"}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3","score":1.0}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7204438068","https://openalex.org/W7163916868","https://openalex.org/W3027487147","https://openalex.org/W1999190300","https://openalex.org/W4390838571","https://openalex.org/W6889676203","https://openalex.org/W7126159711","https://openalex.org/W4401949050","https://openalex.org/W7139013657","https://openalex.org/W2024008985"],"abstract_inverted_index":{"INTRODUCTION:":[0],"The":[1],"Brain":[2],"Trauma":[3,79,87],"Foundation's":[4],"2023":[5],"guidelines":[6],"highlight":[7],"the":[8,275,285],"need":[9],"to":[10,47,76,199],"determine":[11],"optimal":[12],"post-traumatic":[13],"destination":[14],"for":[15,113,135,139,229],"patients":[16,231,254,269],"with":[17,50,63,232],"moderate":[18],"traumatic":[19],"brain":[20],"injury":[21,123],"(mTBI)":[22],"defined":[23],"as":[24,125],"a":[25],"field":[26],"Glasgow":[27,101],"Coma":[28],"Scale":[29,103],"(GCS)":[30],"Score":[31],"of":[32,58,119,129,160,259,288],"9-12.":[33],"We":[34],"investigated":[35],"outcomes":[36,94,257],"between":[37,147],"direct":[38,85],"Level":[39,77],"1":[40,78],"trauma":[41,299],"center":[42],"admission":[43],"versus":[44],"initial":[45,116,260],"triage":[46,72,261],"regional":[48,71,277,298],"centers":[49,278],"subsequent":[51,74],"transfer.":[52],"METHODS:":[53],"A":[54],"retrospective":[55],"cohort":[56],"study":[57],"179":[59],"consecutive":[60],"adult":[61],"(\u226518)":[62],"mTBI":[64,252,268],"from":[65],"2019-2023.":[66],"Patients":[67],"were":[68,111,184,227],"dichotomized":[69],"into":[70],"and":[73,100,121,170],"transfer":[75],"Centers":[80],"(n":[81,90],"=":[82,91,157,168,179,196,209,220,237,243,247],"53)":[83],"verses":[84],"Level-1":[86],"Center":[88],"admissions":[89],"126).":[92],"Primary":[93],"included":[95],"in-hospital":[96],"mortality,":[97],"discharge":[98,198],"disposition,":[99],"Outcome":[102],"Extended":[104],"(GOSE)":[105],"scores":[106,223],"at":[107,224,274],"six":[108,225],"months.":[109],"Groups":[110],"compared":[112],"similarity":[114],"using":[115],"GCS,":[117],"rates":[118,128,159],"polytrauma,":[120],"intracranial":[122],"severity":[124],"measured":[126],"by":[127],"mulit-compartment":[130],"hemorrhage":[131,172],"(Rotterdam":[132],"4+).":[133],"Epi":[134],"R":[136],"was":[137,145],"used":[138],"statistical":[140],"analysis.":[141],"RESULTS:":[142],"Initial":[143],"presentation":[144],"similar":[146,256],"groups":[148],"including":[149],"GCS":[150],"(transfer:":[151,162,173,190,203,214,235],"11.17":[152],"vs.":[153,164,175,192,205,216,240],"direct:":[154,165,176,193,206,217,241],"11.12,":[155],"p":[156,167,178,195,208,219,246],"0.61),":[158],"polytrauma":[161],"14/53":[163],"32/126,":[166],"1.0),":[169],"multicompartment":[171],"19/53":[174],"46/126,":[177],"1.0).":[180],"No":[181],"significant":[182],"differences":[183],"found":[185],"in":[186],"in-":[187],"hospital":[188],"mortality":[189],"10/53":[191],"22/126,":[194],"0.84),":[197],"home/skilled":[200],"nursing":[201],"facility":[202],"29/53":[204],"72/126,":[207],"0.89),":[210],"or":[211],"in-patient":[212],"rehabilitation":[213],"13/53":[215],"20/126,":[218],"0.25).":[221],"GOSE":[222],"months":[226],"comparable":[228],"surviving":[230],"active":[233],"follow-up":[234],"n":[236,242],"32,":[238],"4.72":[239],"80,":[244],"5.51,":[245],"0.27).":[248],"CONCLUSIONS:":[249],"In":[250],"this":[251],"cohort,":[253],"demonstrated":[255],"regardless":[258],"location.":[262],"These":[263,290],"findings":[264,291],"may":[265,292],"suggest":[266],"that":[267],"can":[270],"be":[271],"safely":[272],"evaluated":[273],"closest":[276],"before":[279],"potential":[280],"transfer,":[281],"particularly":[282],"when":[283],"considering":[284],"emergent":[286],"nature":[287],"TBI.":[289],"help":[293],"optimize":[294],"resource":[295],"utilization":[296],"within":[297],"networks.":[300]},"counts_by_year":[{"year":2026,"cited_by_count":2}],"updated_date":"2026-11-04T10:54:05.112534","created_date":"2026-03-27T00:00:00"}