Mild traumatic brain injury from motor vehicle accidents: Factors associated with return to work

ObjectiveTo determine (1) the frequency of reported cervical spine pain in patients diagnosed with mild traumatic brain injury (mTBI) in the Children's Hospital of Wisconsin emergency department (ED), and (2) the predictors of number of follow up visits for concussion related symptoms between those with and without neck pain.BackgroundThere has been little research on the frequency of concomitant injury, specifically neck pain associated with TBI in the pediatric population. Given the potential influence of neck pain on recovery from mTBI, we sought to report on the frequency of reported neck pain in the sample of pediatric ED patients reporting mTBI symptoms.Design/MethodsThe sample was obtained through a retrospective analysis in the setting of Children's Hospital of Wisconsin Emergency Department with a subject selection of patients diagnosed with a concussion/mTBI between the dates of 11/1/2015–06/30/2018.ResultsWe analyzed 652 charts. The frequency of reported neck pain in the pediatric population being evaluated for mTBI in the ED was 13.8%. Of these patients, 32.2% had subsequent follow up visits related to their concussion/neck pain compared to 31.1% in patients without neck pain in the ED. In regards to the TBI cause, 47.8% were due to accidental falls, 40.3% were due to other accidents not related to motor vehicles, and 10.0% were due to motor vehicle accidents.ConclusionsIn comparison to the adult mTBI population, the pediatric mTBI population had a significantly less reported frequency of neck pain in the ED. This is not surprising as the majority of adults presenting for concussions and neck pain are post-motor vehicle accidents, whereas the majority of children are presenting after accidental falls. There did not seem to be an association between concussions with concomitant neck pain and prolonged recovery or increased morbidity as determined by follow up visits.

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Traumatic Brain Injury Related Hospitalization and Mortality in California

BioMed Research International ◽

10.1155/2013/143092 ◽

2013 ◽

Vol 2013 ◽

pp. 1-9 ◽

Cited By ~ 12

Author(s):

Clint Lagbas ◽

Shahrzad Bazargan-Hejazi ◽

Magda Shaheen ◽

Dulcie Kermah ◽

Deyu Pan

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Age Groups ◽

Motor Vehicle Accidents ◽

Elderly Male ◽

Cross Sectional ◽

Discharge Data ◽

Vehicle Accidents

Objective. The aim of this study is to describe the traumatic brain injury (TBI) population and causes and identify factors associated with TBI hospitalizations and mortality in California.Methods. This is a cross-sectional study of 61,188 patients with TBI from the California Hospital Discharge Data 2001 to 2009. We used descriptive, bivariate, and multivariate analyses in SAS version 9.3.Results. TBI-related hospitalizations decreased by 14% and mortality increased by 19% from 2001 to 2009. The highest percentages of TBI hospitalizations were due to other causes (38.4%), falls (31.2%), being of age≥75years old (37.2%), being a males (58.9%), and being of Medicare patients (44%). TBIs due to falls were found in those age≤4years old (53.5%),≥75years old (44.0%), and females (37.2%). TBIs due to assaults were more frequent in Blacks (29.0%). TBIs due to motor vehicle accidents were more frequent in 15–19 and 20–24 age groups (48.7% and 48.6%, resp.) and among Hispanics (27.8%). Higher odds of mortality were found among motor vehicle accident category (adjusted odds ratio (AOR): 1.27, 95% CI: 1.14–1.41); males (AOR: 1.36, 95% CI: 1.27–1.46); and the≥75-year-old group (AOR: 6.4, 95% CI: 4.9–8.4).Conclusions. Our findings suggest a decrease in TBI-related hospitalizations but an increase in TBI-related mortality during the study period. The majority of TBI-related hospitalizations was due to other causes and falls and was more frequent in the older, male, and Medicare populations. The higher likelihood of TBI-related mortalities was found among elderly male≥75years old who had motor vehicle accidents. Our data can inform practitioners, prevention planners, educators, service sectors, and policy makers who aim to reduce the burden of TBI in the community. Implications for interventions are discussed.

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Analysis of patients with spinal cord trauma associated with traumatic brain injury

Coluna/Columna ◽

10.1590/s1808-18512014130400459 ◽

2014 ◽

Vol 13 (4) ◽

pp. 302-305 ◽

Cited By ~ 2

Author(s):

João Simão de Melo Neto ◽

Waldir Antônio Tognola ◽

Antonio Ronaldo Spotti ◽

Dionei Freitas de Morais

Keyword(s):

Risk Factors ◽

Traumatic Brain Injury ◽

Spinal Cord ◽

Brain Injury ◽

Injury Risk ◽

Motor Vehicle ◽

Motor Vehicle Accidents ◽

Vehicle Accidents ◽

Risk Of Death ◽

Cord Injury

Objective: Characterize victims of spinal cord injury (SCI) associated with traumatic brain injury (TBI) and risk factors. Methods: Study conducted with 52 victims of SCI associated with TBI. The variables studied were: sex; age; marital status; occupation; educational level; religion; etiology and the lesion area; neurological condition by the ASIA scale; associated injuries and potential risk factors. Results: The male (85%), aged between 21-30 years (25%), civil status stable union (56%), low level of education (69%) and the Roman Catholic religion (77%) presented the greater number of victims. Motor vehicle accidents (58%) were the main etiology. The cervical segment had higher injury risk (RR=3.48, p<0.0001). The neurological status ASIA-E (52%), the syndromic neck pain (35%) and the rate of mild TBI (65%) were the most frequent. Complications occurred in 13 patients with increased frequency of pneumonia (62%). The length of hospital stay was significantly higher (20±28 days) and 17% of patients died. Men (RR=2.14, p=0.028) and individuals exposed to motor vehicle accidents (RR=1.91, p=0.022) showed a higher risk of these lesions concurrently. Moreover, these patients had 2.48 (p<0.01) higher risk of death than victims of SCI alone. Conclusion: The SCI associated with TBI was more frequent in men, young adults, and individuals exposed to motor vehicle accidents. The cervical spine is more likely to be affected. Furthermore, the length of hospitalization is significantly higher and the subjects analyzed have higher risk of death.

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Traumatic brain injury and posttraumatic stress disorder: a preliminary investigation of neuropsychological test results in PTSD secondary to motor vehicle accidents

Brain Injury ◽

10.1080/026990598122566 ◽

1998 ◽

Vol 12 (4) ◽

pp. 265-274 ◽

Cited By ~ 42

Author(s):

E. J. HICKLING ◽

R. GILLEN ◽

E. B. BLANCHARD ◽

T. BUCKLEY ◽

A. TAYLOR

Keyword(s):

Traumatic Brain Injury ◽

Posttraumatic Stress Disorder ◽

Brain Injury ◽

Stress Disorder ◽

Motor Vehicle ◽

Neuropsychological Test ◽

Preliminary Investigation ◽

Motor Vehicle Accidents ◽

Test Results ◽

Vehicle Accidents

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P078: Derivation and validation of a non return to work predictive model three months after a mild traumatic brain injury

CJEM ◽

10.1017/cem.2017.280 ◽

2017 ◽

Vol 19 (S1) ◽

pp. S104

Author(s):

N. Le Sage ◽

J. Chauny ◽

M. Émond ◽

L. Moore ◽

P.M. Archambault ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Return To Work ◽

Predictive Model ◽

Mild Traumatic Brain Injury ◽

Predictive Value ◽

Prospective Cohort ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Area Under The Curve

Introduction: Mild traumatic brain injury (mTBI) is a common problem and until now, ED physicians don’t have any tool to predict when the patient will return to work. The purpose of this study is to develop and validate a clinical decision rule to identify the ED patients who are at risk of non-return to work or to school three months after a mTBI. Methods: Patients were recruiting in five Level I and II Trauma Centers ED in the province of Québec. All patients were referred for a systematic telephone follow-up after three months. Information about their return to work/school, partial or complete, was collected. Log binomial regression was used to develop a predictive model and the validation of this model was performed on a different prospective cohort. Results: 13,7% of the patients did not return to work/school at three months. The final model was derived from a prospective cohort of 398 patients and included three risk factors: motor vehicle accident (2 points), loss of consciousness (1 point) and headache during the emergency department assessment (1 point). With a one-point threshold, this model has a sensitivity of 97% and a negative predictive value (NPV) of 98%. However, the specificity is only 23% and the positive predictive value (PPV) is 17%. The area under the curve is 0.786. Validation of the model was performed with a new prospective cohort of 517 patients, and demonstrated a sensitivity of 86% and a NPV of 91%. Conclusion: Although this model is not very specific, its high sensitivity and NPV indicate to the clinician that mTBI patients who don’t have any of the three criteria are at low risk of prolonged work stoppage after their trauma.

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