Abstract:
Introduction. Traumatic brain injury remains a leading global health concern with significant social and economic impact.
The main causes include traffic accidents, falls, and violence, especially affecting young adults. In the Republic of Moldova,
TBI incidence is rising, particularly during the prehospital phase. TBI involves both primary and secondary brain injuries, the latter often resulting from hypoxia, hypotension, or hyperglycemia. These secondary insults critically influence
outcomes and are associated with high mortality. Effective prehospital management – focused on stabilizing oxygenation
and hemodynamics – is essential in reducing neurological deterioration. Emergency teams play a key role in preventing
secondary injury and improving survival.
Material and methods. This study, conducted from 2020 to 2024, analyzed 486 patients with acute traumatic brain injury
(TBI) assessed in both prehospital and emergency department settings. It aimed to evaluate injury severity and prognosis
using clinical tools and structured observation forms, developed specifically for this research.
Results. Significant correlations were found between increased age, low systolic blood pressure, prehospital hypoxia, and
both TBI severity and mortality (p < 0.0001). While hyperglycemia was not significantly associated with injury severity, it
showed a moderate negative correlation with mortality (p < 0.01). Findings emphasize the importance of early monitoring
and stabilization of vital signs in the prehospital phase to improve TBI outcomes.
Conclusions. This study emphasizes the importance of systematic prehospital monitoring and management of physiological parameters to mitigate secondary brain injury and improve patient prognosis. Early intervention targeting hypoxia and
hypotension remains vital in the acute management of TBI.
