International Journal of Health Sciences & Research (www.ijhsr.org) 80 Vol.5; Issue: 5; May 2015 International Journal of Health Sciences and Research www.ijhsr.org ISSN: 2249-9571 Original Research Article Retrospective, Prospective Observational Study of the Impact of Severe Traumatic Brain Injury Management Protocol on Short Term Outcome Abdulrahman Alharthy, Waleed Al-etreby, Ahmed Fouad Madi, Wasim Alzayer, Ahmed Albalshi, Omar Elsayed Ramadan, Mohammed Ali Alodat Department of Intensive Care Medicine, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia. Corresponding Author: Waleed Al-etreby Received: 13/03/2015 Revised: 08/04/2015 Accepted: 09/04/2015 ABSTRACT Traumatic brain injury (TBI) is one of the leading causes of mortality and morbidity worldwide, especially in low and middle income countries. The outcome of TBI does not only depend on the initial trauma, but is also affected by secondary neurological damage that follows the trauma. These secondary effects can be reduced by implementing an evidence based protocol of management for TBI. Aim: To evaluate the effect of TBI management protocol on short term outcome. Methods: retrospective evaluation of medical records of severe TBI patients admitted to ICU during three months prior to implementing the protocol for short term outcome (group 1), then prospective observation of short term outcome of patients with severe TBI admitted to ICU, and managed with the TBI protocol for three months. Results: there was statistically significant difference between the two groups regarding the GCS after 7 days (p=0.017), the length of ICU stay (p=0.009) and the duration of mechanical ventilation (p=0.013). Conclusion: There is some evidence that following an evidence based protocol of management for severe TBI improves short term outcome. Key words: traumatic brain injury, critical care, outcome. INTRODUCTION Traumatic brain injury (TBI) is considered to be one of the leading causes of mortality and morbidity worldwide, as about 1.5 million people die annually and several millions receive emergency treatment. [1] Moreover, victims of TBI suffer loss of productive years and potential outcome making it a major public health problem, in addition to the financial burden imposed on healthcare systems, [2,3] the majority of which (90%) affects low and middle income countries. [4] Since motor vehicle accidents (MVA) is one of the most important causes of TBI, [5] it is easy to imagine the magnitude of the problem in Saudi Arabia, where the road fatalities per 100,000 inhabitants per year is 24.8, and the road fatalities per 100,000 motor vehicles is 103. [6] It is of at most importance to understand that most of the neurological damage from TBI does not occur at the time of impact, but develops over the hours and days following the incidence of the trauma, and