Epidemiology of Isolated Versus Nonisolated Mild Traumatic Brain Injury Treated in Emergency Departments in the United States, 2006-2012: Sociodemographic Characteristics.
Carol Cancelliere, Victor G Coronado, Christopher A Taylor and 1 others
PMID 28489698WHAT IT FOUND
Emergency department visits for mild traumatic brain injury increased over time, and most involved other injuries or conditions too.
Young children were more likely to have head injury alone; older adults were less likely.
Key findings
01The rate of mild traumatic brain injury emergency department visits rose from 569.4 per 100,000 population in 2006 to 807.9 per 100,000 population in 2012, and the average annual percent change was 7.0%.
02Most mild traumatic brain injury emergency department visits were non-isolated, with 1,474,413 visits, or 69.6% of visits, involving other injuries or health conditions.
03Children aged 0 to 4 years had odds 6.766 times those of adults aged 45 to 64 for an isolated mild traumatic brain injury emergency department visit, while adults aged 65 and older had odds 0.552 times those of adults aged 45 to 64.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study counted emergency department visits, not individual people, because the database lacked identifiers, so one person could be counted more than once. The diagnosis codes used to identify mild traumatic brain injury have been reported with sensitivity 45.9% and specificity 97.8%, so some visits were misclassified. Code 959.01, unspecified head injury, was present in 68% of visits and was the only code in 67% of visits, and it is associated with many false positives. Isolated and non-isolated mild traumatic brain injury were classified from administrative codes, so coders could have missed or added other injury codes. The database did not include federal hospitals or people who died before reaching the emergency department. Because many mild traumatic brain injuries are not diagnosed in emergency departments, the visits captured may not represent all mild traumatic brain injury cases.
The easy way to misread this
Do not read the increasing emergency department rates as proof that mild traumatic brain injury is becoming more common or more severe. The authors say coding issues, awareness, diagnosis, and practice patterns may contribute.