In this issue of JNN, the article by Michelson and colleagues (1) is an excellent example of researchers exploring solutions for triaging challenges of patients with traumatic brain injury (TBI) who present to the emergency department (ED) under the influence of drug and/or alcohol (DA). The study shows the potential use of integrating electroencephalogram (EEG)-based biomarkers into the triage process.
Both DA-related ED visits and TBI-related ED visits are on the rise, with 35% and 80% of alcohol-intoxicated patients reported with TBI in the adult population. Studies show that patients with alcohol-related head injuries are twice likely to have abnormal computed tomography (CT) than sober head-injured patients. Presence of DA adds difficulty to both patient assessment and management.
Although a CT scan is the accepted "standard" for TBI workup in the ED, around 91% of these patients are found to be negative. The EEC-based Structural Injury Classifier (SIC) and EEG-only Brain Function Index (BFI) are outputs that indicate the likelihood of a structural or functional injury. In a multisite, prospective, US Food and Drug Administration validation trial, BrainScope One showed to have high accuracy in predicting the likelihood of TBI visible on CT (CT+), with a high negative predictive value, and the BFI showed to scale significantly with functional impairment.
The purpose of this study was to retrospectively investigate the influence of intoxication on the accuracy of an EEG-based SIC and BFI.
Seven hundred one(N = 701) subjects of...