TBI surveillance using the common data elements for traumatic brain injury: a population study

• Published in: International journal of emergency medicine Vol. 6; no. 1; p. 5
• Main Authors: Stead, Latha Ganti, Bodhit, Aakash N, Patel, Pratik Shashikant, Daneshvar, Yasamin, Peters, Keith R, Mazzuoccolo, Anna, Kuchibhotla, Sudeep, Pulvino, Christa, Hatchitt, Kelsey, Lottenberg, Lawrence, Elie-Turenne, Marie-Carmelle, Hoelle, Robyn M, Vedula, Abhijna, Gabrielli, Andrea, Miller, Bayard D, Slish, John H, Falgiani, Michael, Falgiani, Tricia, Tyndall, J Adrian
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 27-02-2013; Springer Nature B.V; BioMed Central Ltd; Springer
• Subjects: Angiology; Cardiology; Emergency Medicine; Internal Medicine; Medicine; Medicine & Public Health; Original Research; Pediatrics; Motor Vehicle Collision; Recreational Vehicle; Traumatic Brain Injury; Common Data Element; Head Injury
• ISSN: 1865-1380; 1865-1380
• DOI: 10.1186/1865-1380-6-5

Background
To characterize the patterns of presentation of adults with head injury to the Emergency Department.
Methods
This is a cohort study that sought to collect injury and outcome variables with the goal of characterizing the very early natural history of traumatic brain injury in adults. This IRB-approved project was conducted in collaboration with our Institution’s Center for Translational Science Institute. Data were entered in REDCap, a secure database. Statistical analyses were performed using JMP 10.0 pro for Windows.
Results
The cohort consisted of 2,394 adults, with 40% being women and 79% Caucasian. The most common mechanism was fall (47%) followed by motor vehicle collision (MVC) (36%). Patients sustaining an MVC were significantly younger than those whose head injury was secondary to a fall (
P
< 0.0001). Ninety-one percent had CT imaging; hemorrhage was significantly more likely with worse severity as measured by the Glasgow Coma Score (chi-square,
P
< 0.0001). Forty-four percent were admitted to the hospital, with half requiring ICU admission. In-hospital death was observed in 5.4%, while neurosurgical intervention was required in 8%. For all outcomes, worse TBI severity per GCS was significantly associated with worse outcomes (logistic regression,
P
< 0.0001, adjusted for age).
Conclusion
These cohort data highlight the burden of TBI in the Emergency Department and provide important demographic trends for further research.