American College of Surgeons Releases Revised Best Practices Guidelines in Management of TBI

CHICAGO (October 28, 2024)—The American College of Surgeons (ACS) has announced the release of its revised Best Practices Guidelines in the Management of Traumatic Brain Injury, offering health care providers comprehensive strategies to improve the care and outcomes of patients with traumatic brain injury (TBI).

TBI is a major public health concern, with more than 4.8 million emergency department visits, 214,000 hospitalizations, and 69,000 deaths annually in the United States alone. The updated guidelines address the latest evidence-based practices to manage the acute and long-term challenges of TBI, which can lead to temporary or permanent disability and impose a significant burden on health care systems.

These revised guidelines reflect the evolving understanding of TBI as both an acute injury and a chronic condition, requiring ongoing management. A multidisciplinary expert panel collaborated on the update, incorporating new research and insights to ensure health care providers have the most up-to-date information available.

“Traumatic brain injury is one of the most complex and devastating conditions we treat,” said Avery B. Nathens, MD, PhD, FACS, FRCSC, Medical Director of Trauma Quality Programs at ACS. “The updated guidelines reflect the progress we've made in the field and aim to provide trauma centers with a roadmap for delivering high-quality care from the moment of injury through rehabilitation. With the latest research on biomarkers, imaging, and neuromonitoring, these guidelines will help improve outcomes for patients affected by TBI.”

Key points from the guidelines:

Advanced Neuromonitoring: New recommendations for the use of advanced tools to improve monitoring of intracranial pressure and cerebral oxygenation.

Biomarkers in TBI Diagnosis: The inclusion of emerging blood-based biomarkers to help identify the severity of brain injury and guide imaging decisions.

Tiered Intracranial Pressure (ICP) Management: A tiered approach to ICP management is recommended to prevent secondary brain injury, with specific interventions based on the severity of the condition.

Comprehensive Rehabilitation: Early multidisciplinary rehabilitation is encouraged, including physical, cognitive, and psychological therapies, to improve long-term recovery and quality of life for TBI patients.

Seizure Prophylaxis Medication: New evidence supports the use of prophylactic antiseizure medication for high-risk TBI patients to prevent early post-traumatic seizures.

The ACS’ revised Best Practices Guidelines in the Management of Traumatic Brain Injury are grounded in the latest research and expert consensus. These guidelines provide trauma centers and health care professionals with an essential resource for improving care quality, reducing mortality, and enhancing the recovery and long-term health outcomes of patients with TBI.

The original Best Practices Guidelines in the Management of Traumatic Brain Injury were launched in 2015. The revised guidelines are available on the ACS website, offering a detailed framework for implementing these new best practices.

The American College of Surgeons (ACS) is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The ACS is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The ACS has approximately 90,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the ACS.