Study Questions Relevance of TBI Treatment Guidelines

Last updated on March 27th, 2026 at 12:58 pm

Research conducted by the Los Angeles County Trauma Consortium suggests that adherence to prior guidelines for treating traumatic brain injuries (TBI) do not necessarily result in better patient outcomes. The guidelines, published more than twenty years ago, have been the industry standard for medical personnel considering a craniotomy or intracranial pressure monitoring for critically injured patients.

Comprised of health researchers from the University of Southern California and UCLA as well as trauma centers and the county’s EMS agency, the consortium concluded that medical providers need to focus on providing “evidence-based care” when treating brain trauma and that much work is needed to improve the quality of hospital care in this arena.

One positive result of the findings, which were published in the journal JAMA Surgery, is that they’ve encouraged consortium members to reassess how they treat brain injury, which could lead to more positive outcomes for patients.

Researchers analyze brain trauma treatment outcomes

The health care researchers evaluated more than 700 adults diagnosed with a traumatic brain injury, and found that hospital compliance rates with the brain trauma guidelines were relatively low across the board. Only 46 percent of patients who needed intracranial pressure monitoring per the guidelines actually had the monitor placed, and just 45.6 percent of those whose trauma called for a craniotomy – where part of the skull is removed — actually had the operation.

Researchers say the mortality rate (patients who died from their TBI) varied from hospital to hospital, ranging from 20 to 50 percent.

“Despite improvements in care, mortality from [traumatic brain injury] remains both common and variable from hospital to hospital,” concluded the study’s authors. “Our results demonstrate no association between hospitals’ compliance with two [Brain Trauma Foundation] guidelines and risk-adjusted mortality, suggesting that neither measure should be used as an independent marker of hospital quality.”

Causes & consequences of TBI

Depending on the severity of the damage, a traumatic brain injury can result in life-altering complications for the victim, ranging from memory loss, slurred speech and poor coordination, to convulsions, seizures and coma.

This sort of injury is most often caused by a sharp blow to the head that damages brain cells and creates swelling and/or bleeding around the brain. TBIs may be caused sport injuries, car accidents, explosions, falls from great heights and acts of physical violence. Those who suffer a severe TBI may be left with permanent cognitive dysfunction, coordination difficulties as well as nerve damage that can cause vision problems and partial paralysis.

Other long-term effects may include behavioral and executive functioning problems, and unfortunately treatments are not always successful and can place tremendous financial burdens on the patients and their loved ones.

Personal injury lawyers in Maine

Hardy, Wolf & Downing know from experience that symptoms of brain trauma are not always evident right away. If you were involved in a car accident, slip and fall or were physically assaulted by another person, it’s imperative to seek medical attention immediately so that doctors can diagnose and treat appropriately.

Residents of Lewiston, Portland, Bangor and throughout the state have relied on our services and legal advocacy for more than four decades, helping victims and their families pursue just compensation when negligence is to blame. To schedule a free consultation with a Maine traumatic brain injury lawyer at our firm, please call 800.465.8733.

The information contained herein is meant for general information only and should not be relied upon as legal advice. There are exceptions and exclusions that may not be reflected here. Any legal matter or potential claim should be discussed with a lawyer licensed to practice in the State of Maine. Contact us to learn more.
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Hardy Wolf and Downing
Since 1976, Hardy, Wolf & Downing has served as a tireless advocate for injured Mainers, growing from a local Lewiston practice into one of the state’s most respected personal injury law firms. With offices in Lewiston and Portland, the firm specializes in auto accidents, premises liability, and complex personal injury litigation. Distinguished by a "courtroom-ready" philosophy, the HWD legal team is prepared to take every case as far as necessary to secure justice, a commitment that has resulted in over $500 million recovered for their clients to date.