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Increase in Emergency Room Visits for Traumatic Brain Injury

Jun 2, 2014

The Centers for Disease Control and Prevention (CDC) describes traumatic brain injury (TBI) as a serious public health concern, which has spurred calls for increasing awareness and measures to prevent head injuries.

Researchers conducted an epidemiological study of TBI emergency room visits from 2006 to 2010, using the National Emergency Department Sample (NEDS) database, a source that includes 25 to 50 million visits to ERs at more than 950 hospitals. Their findings were published last month as a Research Letter in JAMA. The researchers included in their analysis visits with a diagnosis of TBI according to the International Classification of Disease, Ninth Revision, Clinical Modification. They evaluated patient demographics, severity of injury, associated injuries, mechanism of injury, and the hospital’s characteristics.

The researchers applied weighting procedures to account for unequal sampling probabilities. Their analysis showed that visits for TBI increased by 29.1 percent during the study period, according to the JAMA Research Letter. The majority of the increase was in visits coded as concussion or unspecified head injury. Children under 3 and adults over 60 had the greatest rates of increase. Forty percent of the TBI visits also involved another injury, for instance wounds to the head, neck, or trunk.

The researchers say the increases may be due to such factors as increased TBI exposure (through sports and other activities), increased awareness of TBI, increased TBI diagnosis, or a combination of these. The increases among the very young and the old may reflect the fact that these age groups do not benefit as much other age groups from public health initiatives like helmet laws and safer sports’ practices. Most of the TBI visits were not made to specialized pediatric or trauma centers, and in the Research Letter the researchers noted the increased burden of TBI care at non-specialized ERs.

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