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Abstract Details

The Use of Standardized Interpretation & Reporting for Multimodality Neuromonitoring
Neuro Trauma and Critical Care
P11 - Poster Session 11 (11:45 AM-12:45 PM)
1-004

MMM is the integration and interpretation of information about the brain to detect and prevent secondary injury. Increasingly, measurements from intensive care unit (ICU) devices are combined as high-resolution time series not unlike EEG. Therefore, the interpretation of this data is time-intensive and a novel standardized method for daily reporting of clinically-relevant findings was developed.

Quantify consistent elements within standardized interpretation and reporting of multimodality neuromonitoring (MMM) data.

A retrospective case control study was performed. We began standardized MMM 4/2015 and standardized reporting was rolled out on 8/2017. Cases were consecutive patients with severe traumatic brain injury (sTBI) who underwent formal interpretation/reporting compared with historical controls. Each reporting element within the reporting template was quantified to determine its consistency. Clinical outcome was Glasgow Outcome Score (GOS) based on chart review on follow up 3-6 months after admission.

There were 40 patients with reporting and 46 historical controls without reporting (age 42+/-17, 67 [84%] male). There were no differences between groups in injury severity. We tabulated 135 individual reports. Sections consistently (>99%) reported included intracranial pressure, autoregulation, brain tissue oxygen, and electrocorticography. Data was reported in less than one-third for those measures not available for review or typically already reported; shifts in trends overtime were often not expressly documented. Similar outcome was seen between groups (median [IQR] GOS 3 [1-4] with reporting vs 2 [1-3] without; N.S.), although shift analysis stratified by age, sex, and injury severity parameters showed significant improvement in outcome category (Mann-Whitney estimate 0.38; p=0.02).

Standardized interpretation and reporting of MMM data is a novel paradigm designed to provide critical insight and guide care. We inferred elements important to report and identified a shift toward improvement in clinical outcome as a result. 
Authors/Disclosures
Rudy Luna, MD
PRESENTER
Dr. Luna has nothing to disclose.
Barbara Basil, MD (Vanderbilt University Medical Center Department of Neurology) Dr. Basil has nothing to disclose.
Davis L. Ewbank, DO Dr. Ewbank has nothing to disclose.
Moshe A. Mizrahi, MD, FAAN (The Brookdale Hospital Medical Center) Dr. Mizrahi has nothing to disclose.
No disclosure on file
Brandon P. Foreman, MD (University of Cincinnati) Dr. Foreman has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB Pharma Inc. Dr. Foreman has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell, Inc. Dr. Foreman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sage Therapeutics. Dr. Foreman has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Marinus Pharmaceuticals. Dr. Foreman has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for UCB Pharma Inc.. The institution of Dr. Foreman has received research support from DOD/AMRMC. The institution of Dr. Foreman has received research support from Biogen, Inc.. The institution of Dr. Foreman has received research support from DOD/AFRL. The institution of Dr. Foreman has received research support from NSF SCH:INT. The institution of Dr. Foreman has received research support from NIH/NIBIB. The institution of Dr. Foreman has received research support from DOD/JWMRP. The institution of Dr. Foreman has received research support from Marinus Pharmaceuticals. Dr. Foreman has received personal compensation in the range of $500-$4,999 for serving as a Honoraria with Natus Medical Incorporated. Dr. Foreman has received personal compensation in the range of $500-$4,999 for serving as a Honoraria with Ceribell, Inc.. Dr. Foreman has received personal compensation in the range of $0-$499 for serving as a Peer-to-peer program honoraria with Marinus Pharmaceuticals.