Does teleradiology improve interhospital management of head-injury?

Abstract

Objective: In many countries, neurosurgical care is concentrated in regional centres, which often necessitates the inter-hospital transfer of patients with head injury for optimal treatment. The aim of this study was to evaluate the role of teleradiology in the management of head-injured patients when referred from a district general hospital to a tertiary neurosurgical centre. Methods: Prospective data were collected over a fifteen month period from March '95 to May '96. Head-injured patients referred without the facility of teleradiology (Group 1), were compared to similar patients referred with teleradiologic images (Group 2), with particular regard to therapeutic intervention before transfer and adverse events during transfer. Results: There were 28 patients in Group 1 and 35 in Group 2, of which 31 were transferred. Both groups were comparable with respect to age, admission Glasgow Coma Scale score, and intracranial pathology. For patients transferred with teleradiology consultation (Group 2), therapeutic interventions were mere (32.1% vs 10.7%, p = 0.06), adverse events during transfer were significantly lower (6.4% vs. 32.1%. p = 0.01), and transfer time was reduced (72 vs. 80 minutes, p = 0.38). Four patients in Group 2 were treated by a mobile neurosurgical team at the referring hospital because of rapid clinical deterioration. Conclusion: Our findings indicate that teleradiology has an important role in improving inter-hospital management of head-injured patients.