Jones, BDicker, BHowie, GTodd, V2024-02-202024-02-202024-01-23EMA - Emergency Medicine Australasia, ISSN: 1742-6731 (Print); 1742-6723 (Online), Wiley. doi: 10.1111/1742-6723.143751742-67311742-6723http://hdl.handle.net/10292/17238Patients with severe traumatic brain injuries require urgent medical attention at a hospital. We evaluated whether transporting adult patients with a severe traumatic brain injury (TBI) to a Neuroscience Centre is associated with reduced mortality. We reviewed studies published between 2010 and 2023 on severe TBI in adults (>18 years) using Medline, CINAHL, Google Scholar and Cochrane databases. We focused on mortality rates and the impact of transferring patients to a Neuroscience Centre, delays to neurosurgery and EMS triage accuracy. This review analysed seven studies consisting of 53 365 patients. When patients were directly transported to a Neuroscience Centre, no improvement in survivability was demonstrated. Subsequently, transferring patients from a local hospital to a Neuroscience Centre was significantly associated with reduced mortality in one study (adjusted odds ratio: 0.79, 95% confidence interval: 0.64–0.96), and 24-h (relative risk [RR]: 0.31, 0.11–0.83) and 30-day (RR: 0.66, 0.46–0.96) mortality in another. Patients directly transported to a Neuroscience Centre were more unwell than those taken to a local hospital. Subsequent transfers increased time to CT scanning and neurosurgery in several studies, although these were not statistically significant. Additionally, EMS could accurately triage. None of the included studies demonstrated statistically significant findings indicating that direct transportation to a Neuroscience Centre increased survivability for patients with severe traumatic brain injuries. Subsequent transfers from a non-Neuroscience Centre to a Neuroscience Centre reduced mortality rates at 24 h and 30 days. Further research is required to understand the differences between direct transport and subsequent transfers to Neuroscience Centres.© 2024 The Authors. Emergency Medicine Australasia published by John Wiley & Sons Australia, Ltd on behalf of Australasian College for Emergency Medicine. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.http://creativecommons.org/licenses/by/4.0/EMSMortalityNeuroscience CentreTBITransfer32 Biomedical and Clinical Sciences3202 Clinical SciencesPhysical Injury - Accidents and Adverse EffectsTraumatic Head and Spine InjuryBrain DisordersNeurosciencesTraumatic Brain Injury (TBI)Clinical ResearchNeurologicalInjuries and accidents3 Good Health and Well Being1103 Clinical Sciences1117 Public Health and Health ServicesEmergency & Critical Care Medicine3202 Clinical sciencesJournal ArticleOpenAccess10.1111/1742-6723.14375