{
  "abstract": "Background While Emergency Medical Services (EMS) guidelines improve outcomes in severe traumatic brain injury (TBI), the effect of optimal blood pressure and oxygenation on sports-related and recreation-related TBI (SRR-TBI) is unclear. This study assessed whether EMS management of systolic blood pressure (SBP) and oxygen saturation (SpO ₂) influences outcomes in SRR-TBI.Methods This retrospective cohort study analysed data from patients diagnosed with TBI sustaining injuries during sports, education or leisure activities and were transported by EMS from 1 January 2016 to 31 December 2022, at Pan-Asian Trauma Outcomes Study facilities. Patients were classified as receiving optimal care (SBP>110 mm Hg and SpO₂>94%), intermediate care (either SBP<110 mm Hg or SpO₂<94%) or suboptimal care (both <thresholds). Outcomes were favourable neurological recovery (Modified Rankin Scale 0–3) and survival to discharge. Adjusted ORs with 95% CIs were calculated using multivariable logistic regression, adjusting for activity, age, sex, Charlson Comorbidity Index, mechanism and intent of injury, alcohol intake, time of injury and the Excess Mortality Ratio-adjusted Injury Severity Score.Results Among 4629 patients, 74% were male and 18.4% were <18 years old. Injuries occurred during education (3%), sports (14.5%) and leisure (82.5%). Care was optimal in 77.7%, intermediate in 19.6% and suboptimal in 2.7%. Favourable outcomes were 96.3%, 88.7% and 76%, with mortality of 0.9%, 4.7% and 8.8%, respectively (p<0.0001). Compared with suboptimal care, adjusted odds of favourable recovery and survival were 2.76 and 3.30 for optimal care, and 1.27 and 1.01 for intermediate care.Conclusion Maintaining optimal SBP and SpO 2 during EMS care is associated with better neurological outcomes and survival in patients with SRR-TBI.",
  "authors": [
    {
      "affiliations": [
        "Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"
      ],
      "name": "Jirayu Chantanakomes"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"
      ],
      "name": "Wasin Pansiritanachot"
    },
    {
      "affiliations": [
        "Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"
      ],
      "name": "Sattha Riyapan"
    },
    {
      "affiliations": [
        "Emergency Department, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea (the Republic of)"
      ],
      "name": "Sang Do Shin"
    },
    {
      "affiliations": [
        "Emergency Medicine, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Seoul, Seoul, Korea (the Republic of)"
      ],
      "name": "Kyoung Jun Song"
    },
    {
      "affiliations": [
        "Emergency Medicine, National Taiwan University College of Medicine, Taipei City, Taipei City, Taiwan"
      ],
      "name": "Wen-Chu Chiang"
    },
    {
      "affiliations": [
        "Emergency and Trauma Department, Universiti Teknologi MARA, Shah Alam, Selangor, Malaysia"
      ],
      "name": "Sabariah Faizah Jamaluddin"
    },
    {
      "affiliations": [
        "Department of Emergency and Critical Care Medicine, Kansai Medical University, Hirakata, Osaka Prefecture, Japan"
      ],
      "name": "Kentaro Kajino"
    }
  ],
  "title": "Association of prehospital optimal blood pressure and peripheral oxygen saturation with hospital outcomes in sports-related and recreation-related traumatic brain injury (SRR-TBI) in Asia",
  "uid": "a9ee6f76-2f33-52e2-b236-97b0393c1569"
}