{
  "abstract": "Background\n\nMild Traumatic Brain Injury (mTBI) neurosurgical referrals are increasing. This study aimed to externally validate a radiological scoring system to define a 'neurosurgically significant' mild TBI and evaluate its impact on referral outcome if implemented.Method\n\nRetrospective, external validation of the UK Liverpool Head Injury Tomography Score (LIV-HITS). Consecutive neurosurgery referrals to a tertiary neurosurgery centre for mild TBI were included (1st January 2022-30th June 2022). Mechanism of injury, LIV-HITS and management decision were identified, and diagnostic accuracy determined.Results\n\nA total of 1547 referrals were included. 147 (9.5%) were accepted for transfer, and 1400 (90.5%) were designated as local management. For neurosurgical transfer, the sensitivity of LIV-HITS was 99.3% and the specificity was 43.9%, with a positive predictive value of 15.7%, and negative predictive value of 99.8%. Discriminatory power of the model was fair (AUC 0.71, 95% CI 0.66-0.76). In 6 months, the score identified 615 referrals (39.8%) that could have been successfully triaged to local management if the scoring system was used.Conclusions\n\nThe LIV-HITS has a sensitivity of over 99% for excluding a neurosurgically significant mild TBI in an externally validated cohort. However, the discriminatory power of the score is poor for stratifying which patients eventually get transferred to a neurosurgical centre. The score in clinical practice could be used as a 'rule out' tool for mild TBI referrals, whilst identifying potentially significant mild TBI that would warrant emergency neurosurgical consideration.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK. cg823@cam.ac.uk.",
    "Department of Clinical Neurosciences, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK. cg823@cam.ac.uk.",
    "Department of Clinical Neurosciences, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.",
    "Department of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK.",
    "Orion MedTech Ltd. CIC, Cambridge, UK.",
    "Perioperative, Acute, Critical, and Emergency Care (PACE) Section, Department of Medicine, University of Cambridge, Cambridge, UK.",
    "NIHR HealthTech Research Centre in Brain Injury, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.",
    "Department of Neurosurgery, Salford Royal NHS Foundation Trust, Manchester, UK."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Conor S Gillespie"
    },
    {
      "affs": [
        2
      ],
      "name": "Yuhan Guo"
    },
    {
      "affs": [
        3
      ],
      "name": "Matthew Kingham"
    },
    {
      "affs": [
        2
      ],
      "name": "Shangqing W Yang"
    },
    {
      "affs": [
        2
      ],
      "name": "Zhikai Li"
    },
    {
      "affs": [
        3,
        2
      ],
      "name": "Munashe Veremu"
    },
    {
      "affs": [
        3,
        2
      ],
      "name": "William H Cook"
    },
    {
      "affs": [
        3,
        2
      ],
      "name": "Youssef Chedid"
    },
    {
      "affs": [
        4
      ],
      "name": "Emily Simmons"
    },
    {
      "affs": [
        2
      ],
      "name": "Naomi Deakin"
    },
    {
      "affs": [
        3,
        2
      ],
      "name": "David Clark"
    },
    {
      "affs": [
        5,
        6
      ],
      "name": "Virginia F J Newcombe"
    },
    {
      "affs": [
        3,
        2,
        6
      ],
      "name": "Peter J Hutchinson"
    },
    {
      "affs": [
        7
      ],
      "name": "Catherine J McMahon"
    },
    {
      "affs": [
        3,
        2,
        4,
        6
      ],
      "name": "Alexis J Joannides"
    },
    {
      "name": "East of England Emergency Neurosurgery Collaborative"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/5p6bb2n2naf5f.bib",
  "cited_by": 0,
  "doi": "10.1007/s00701-026-06991-4",
  "fulltext_url": "https://europepmc.org/articles/PMC13724666",
  "id": "5p6bb2n2naf5f",
  "issns": [
    "0001-6268",
    "0942-0940"
  ],
  "landing_url": "https://europepmc.org/article/MED/42967959",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2713|Traumatic Brain Injury Research"
    ]
  ],
  "openalex": "W7172413765",
  "pdf_url": "https://europepmc.org/articles/PMC13724666?pdf=render",
  "pmcid": "PMC13724666",
  "pmid": "42967959",
  "published": "2026-08-04",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/5p6bb2n2naf5f.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T15:20:54Z",
      "native_id": "MED:42967959",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42967959"
    },
    {
      "first_seen": "2026-11-04T12:23:12Z",
      "native_id": "PMC13724666",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00701-026-06991-4"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2713|Traumatic Brain Injury Research",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "External validation of the Liverpool Head Injury Tomography Score for mild traumatic brain injury.",
  "title_text": "External validation of the Liverpool Head Injury Tomography Score for mild traumatic brain injury.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:21:23Z",
  "url": "https://research.draconitic.com/paper/5p6bb2n2naf5f",
  "venue": "Acta neurochirurgica",
  "versions": []
}