{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T22:17:03Z","timestamp":1788041823657,"version":"build-2784847793"},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T00:00:00Z","timestamp":1780358400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Traumatic brain injury (TBI) remains a major cause of death and disability worldwide. Traditional classification based on the Glasgow Coma Scale (GCS) provides a shared clinical language but insufficiently captures the biological heterogeneity, imaging variability, and contextual modifiers that influence outcomes. In January 2024, the National Institute of Neurological Disorders and Stroke (NINDS) convened a multidisciplinary working group to propose the Clinical\u2013Biomarkers\u2013Imaging\u2013Modifiers (CBI\u2010M) framework. This review aims to summarize the rationale, structure, and potential clinical relevance of the CBI\u2010M framework for trauma and acute care surgeons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A narrative literature review was conducted using PubMed and Scopus databases with the terms \u201ctraumatic brain injury,\u201d \u201cclassification,\u201d \u201cbiomarkers,\u201d \u201cneuroimaging,\u201d and \u201cpersonalized medicine.\u201d Articles published between 2000 and 2024 were prioritized, with emphasis on consensus statements, multicenter cohort studies (e.g.,\u00a0TRACK\u2010TBI, CENTER\u2010TBI), and materials from the NINDS TBI Classification and Nomenclature Workshop. Reference lists were manually screened to identify additional relevant publications. The review synthesizes conceptual foundations, domain structure, and practical implementation considerations of the CBI\u2010M model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The CBI\u2010M framework introduces a multidimensional and dynamic approach to TBI characterization by integrating four domains: Clinical assessment (detailed GCS components, pupillary reactivity, post\u2010traumatic amnesia, and structured symptom documentation); Biomarkers, including GFAP, UCH\u2010L1, S100\u00a0B, NfL, and pTau, which provide objective measures of neuronal and astroglial injury with defined temporal kinetics; Imaging, emphasizing standardized CT terminology within the first 24\u00a0h and harmonized radiologic lexicons; and Modifiers, incorporating psychosocial, environmental, and comorbidity factors that influence outcomes. This integrated model may support more comprehensive characterization of TBI, facilitate interdisciplinary communication, and enable structured documentation across trauma systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CBI\u2010M framework represents a conceptual shift from severity\u2010based classification toward a multidomain approach to TBI characterization. For trauma surgeons, it offers a structured framework that may support more comprehensive documentation and facilitate integration with registry\u2010based quality improvement and translational research. At present, its role is best understood as an evolving model with potential for future clinical applicability, pending prospective validation and assessment of feasibility across diverse trauma systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70440","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T11:31:09Z","timestamp":1780399869000},"page":"2042-2049","source":"Crossref","is-referenced-by-count":1,"title":["Updating Traumatic Brain Injury Classification for Surgeons: Integrating the CBI\u2010M Framework Into Trauma and Acute Care Practice"],"prefix":"10.1002","volume":"50","author":[{"given":"Ruben","family":"Peralta","sequence":"first","affiliation":[{"name":"Trauma Surgery Hamad Medical Corporation  Doha Qatar"},{"name":"Department of Surgery Universidad Nacional Pedro Henr\u00edquez Urena School of Medicine  Santo Domingo Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Santiago","family":"Cardona\u2010Collazos","sequence":"additional","affiliation":[{"name":"MEDITECH Foundation  Cali Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Msheik","sequence":"additional","affiliation":[{"name":"Neurosurgery Neuroscience Institute Hamad Medical Corporation  Doha Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy D.","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"MEDITECH Foundation  Cali Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9s Salazar","family":"Restrepo","sequence":"additional","affiliation":[{"name":"MEDITECH Foundation  Cali Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura M.","family":"Loaiza\u2010Cardona","sequence":"additional","affiliation":[{"name":"MEDITECH Foundation  Cali Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres M.","family":"Rubiano","sequence":"additional","affiliation":[{"name":"MEDITECH Foundation  Cali Colombia"},{"name":"Neuroscience Institute Neurotrauma Group El Bosque University  Bogot\u00e1 Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,2]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.10.JNS17352"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2011.2034"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.afjem.2020.05.006"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(14)70120\u20106"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01376517\u2010200704000\u201000002"},{"issue":"1","key":"e_1_2_13_7_1","first-page":"161","article-title":"Predictive Value of Glasgow Coma Scale After Brain Trauma: Change in Trend over the past Ten Years","volume":"75","author":"Balestreri M.","year":"2004","journal-title":"Journal of Neurology Neurosurgery and Psychiatry"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2006.111187"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2006.0029"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2008.0586"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(22)00309\u2010X"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978\u20100\u2010444\u201052892\u20106.00002\u20107"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10010148"},{"key":"e_1_2_13_14_1","unstructured":"NINDS TBI Classification and Nomenclature Workshop Videocast Recording https:\/\/videocast.nih.gov\/watch=54118."},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474\u20104422(19)30232\u20107"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701\u2010021\u201004928\u20107"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.molonc.2012.02.009"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines10092167"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/11772719221105145"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.2174\/1570159X19666210125153308"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2010.1617"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_776_2023"},{"key":"e_1_2_13_23_1","unstructured":"National Institute of Neurological Disorders and Stroke.NINDS TBI Classification and Nomenclature Workshop. 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