A national audit of head injury discharge advice

None of the 99 leaflets reviewed (0/99) complied with all aspects of NICE guidance. The mean score of the leaflets was 0.42 out of 1, falling short of the set target of 0.95. There was no significant difference in mean scores between adult and paediatric leaflets. Safety information based on surgically-relevant deterioration achieved the compliance target of 95%. Advice on concussion management (including symptoms to expect, return to normal activities, and the details about further support and information in case of persistent symptoms) was generally poor. Additionally, 50.5% (50/99) of leaflets advised against returning to activities 'until feeling completely back to normal', which contradicts current guidance. The quality of head injury discharge leaflets currently does not meet satisfactory standards. A centrally curated, regularly updated discharge leaflet, with provision for local modifications, is recommended to standardise practice based on current specialist practice. This is a cost-effective intervention which has considerable potential to improve outcomes after head injury.

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Publication Details

Journal
British Journal of Neurosurgery
Published
2025-10-16
DOI
https://doi.org/10.1080/02688697.2025.2565284
Primary Topic
Trauma and Emergency Care Studies
Type
article
Field-Weighted Citation Impact
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article

A national audit of head injury discharge advice

Nicholas Gikas, David Davies, Arnav Singh, Antonio Belli et al.
British Journal of Neurosurgery
Trauma and Emergency Care Studies
article

A national audit of head injury discharge advice

Nicholas Gikas, David Davies, Arnav Singh, Antonio Belli, Philip J. O’Halloran, Andrew R. Stevens, Dinesh Yasothkumar
article en

Abstract

None of the 99 leaflets reviewed (0/99) complied with all aspects of NICE guidance. The mean score of the leaflets was 0.42 out of 1, falling short of the set target of 0.95. There was no significant difference in mean scores between adult and paediatric leaflets. Safety information based on surgically-relevant deterioration achieved the compliance target of 95%. Advice on concussion management (including symptoms to expect, return to normal activities, and the details about further support and information in case of persistent symptoms) was generally poor. Additionally, 50.5% (50/99) of leaflets advised against returning to activities 'until feeling completely back to normal', which contradicts current guidance. The quality of head injury discharge leaflets currently does not meet satisfactory standards. A centrally curated, regularly updated discharge leaflet, with provision for local modifications, is recommended to standardise practice based on current specialist practice. This is a cost-effective intervention which has considerable potential to improve outcomes after head injury.

British Journal of Neurosurgery
Royal College of Surgeons in Ireland (IE), Queen Elizabeth Hospital Birmingham (GB), Mater Misericordiae Hospital (AU), Institut thématique Immunologie, inflammation, infectiologie et microbiologie (FR), Office of Readiness and Response (US), University of Birmingham (GB)
Openalex Percentile: Top 57%
Trauma and Emergency Care Studies
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A national audit of head injury discharge advice — Nicholas Gikas, David Davies, et al. · British Journal of Neurosurgery (2025) | TGRS Research Map | TGRS