According to a research letter published in the Journal of the American Medical Association (JAMA), the rate of emergency department visits for traumatic brain injuries (TBI) has increased. Researchers found that this rise was 8-fold more than the rate of increase of total emergency department visits between 2006 and 2010. The study was conducted in light of the fact that TBIs have gained more attention in the last decade; the authors aimed to describe national trends in emergency department visits for TBI.
The researchers used the Nationwide Emergency Department Sample (NEDS) database to gather information about emergency department visits. There were a total of 138, 223, 016 emergency department visits between 2006 and 2010 recorded in the database; 1.7 percent of these visits had a diagnosis of TBI. Researchers found that during the study period, there was a 29.1 percent increase in TBI visits, from 637 visits per 100,000 person-years in 2006 to 882 visits per 100,000 person-years in 2010. This compares to a 3.6 percent increase in total ED visits during the same time period.
The greatest increase in TBI visits were seen in children and adults older than 60 years of age. Most of the increased rates of TBI visits were categorized as a concussion or unspecified head injury.
The authors speculate that the rise in TBI visits may be due to a number of factors, such as increased TBI exposure, awareness, diagnoses or a combination of these influences. The fact that the very young and very old showed the largest increase may be a sign that public health interventions, such as helmet laws and safer sports’ practices, are not as effective in these populations. The study also revealed that there is a high and increasing burden for TBI care at nonspecialized centers. Most of the TBI visits were not at trauma centers and less than 2 percent of child TBI visits were at pediatric-specific emergency departments, even though nearly one-third of visits are by children.
The study had several limitations. Researchers did not have access to data for federal hospitals or on patients who died prior to reaching the emergency room. There is also a possibility that injuries were miscoded in the database, especially considering that a large number of visits were categorized as unspecified head injury. Regardless, the authors found that there is an increasing trend of TBI diagnoses in emergency department visits.
