923 Exploring the Impact of Interhospital Transfers on Patients Who Are Managed Conservatively Following Traumatic Spinal Injury: A Scoping Review

Abstract

Abstract Introduction Traumatic spinal injury (TSI) is a devastating event that could lead to serious permanent disability to patients. Therefore, a multidisciplinary team is needed to manage such cases. In the UK, patients with a TSI score a minimum of 16 on the Injury Severity Score (ISS) and are transported to a Major Trauma Centre (MTC). In cases where patients initially present to a none MTC, patients are stabilised and transferred to MTC prominently. Specialised Spinal Cord Units (SCIU) are centres specialised in the definitive management of TSI patients and it is advised that patients get referred to SCIU in a timely manner as studies demonstrate improved patient outcomes. Early transfers are recommended due to the positive impact of early surgical decompression of the injury, which relieves the pressure on the neural tissue. Nevertheless, is this impact still positive if patients are managed conservatively? Aim To explore the impact of intermediate interhospital transfers on TSI patients when no surgical intervention is taking place. Method A scoping review is utilised to explore the research question. CINAHL, MEDLINE, Pubmed, Cochrane library and ASSIA were the search engines utilised. Results The search resulted in 4,595 papers. 15 met the inclusion and exclusion criteria and included in the review. Conclusions There are no studies that directly explored the impact of transfer on conservatively managed patients, and most of the studies were of low-quality evidence. Age, length of stay, mechanism of injury and cost were all explored as factors related to patients transfer status.