Patients with isolated traumatic brain injury (TBI) are likely to benefit from effective prehospital care to prevent secondary brain injury.

Only a few studies have focused on the impact of advanced interventions in TBI patients by prehospital physicians.

Prehospital on-scene anesthetist treating severe TBI patients is associated with lower mortality and better neurological outcome.

The mortality data for 651 patients and neurological outcome data for 634 patients were available for primary and secondary analysis.

In the primary analysis higher age, lower on-scene GCS and the unavailability of an on-scene anesthetist were associated with higher mortality together with hypotension.

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