scholarly journals How to estimate mild Traumatic Brain Injury Incidence? The interest of Emergency Departments data

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
V Bourdin ◽  
L Manitchoko ◽  
P Azouvi ◽  
R Hellmann ◽  
L Josseran
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Incidence Rate ◽  
Emergency Departments ◽  
Mild Tbi ◽  
Health Measures ◽  
High Incidence ◽  
High Incidence Rate ◽  
Screening Procedures

Abstract Background Traumatic brain injury (TBI) is a major public health issue, with a significant socio-economic burden. In France, very little is known about TBI epidemiology, and the TBI population is mainly described via studies carried out on the most severe patients. A large number of studies showed that a significant proportion of patients suffer from long-term disability after mild TBI (mTBI). This Post-Concussive Syndrome (PCS) remains poorly known by health professionals. Identifying early prognostic factors for the development of PCS is therefore essential, since it can ensure widespread clinical and economic benefits. This work aims at providing an updated description of the incidence of mild TBI (mTBI) based on data from Emergency Departments (ED) in the Ile-de-France (IDF) region (Paris area). Methods We estimated the mTBI incidence, using mainly data from the OSCOUR (Organisation de la Surveillance Coordonnée des Urgences) database from 01/01/2011 to 31/12/2015. The OSCOUR Network data collection methodology is based on the registration of all patients visiting the emergency services (ED) of participating hospitals. An extrapolation of the proportion of TBI patients visiting an OSCOUR ED to all ED of the IDF allowed us to compute a mTBI Annual Incidence Rate (AIR) in IDF. Results Between 2011 and 2015, 95,910 mTBI patients visited the OSCOUR ED in IDF, and the AIR was estimated at 292.4/100,000 inhabitants (when reported to the French population scale: a total of 196,000 mTBI are supposed to happen each year). Conclusions The surprisingly high incidence rate of mTBI observed in this study requires an evaluation of public health measures to prevent these injuries and reduce their consequences. New screening procedures should be implemented to point out the patients at risk for complications and PCS. Alongside the care aspect, prevention should be developed to reduce the incidence of TBIs, and prevention policies should be assessed by reiterating our evaluation. Key messages Between 2011 and 2015, 95,910 mTBI patients visited the OSCOUR Emergency Departments in Ile de France, and the annual incident rate was estimated at 292.4/100,000 inhabitants. The mTBI high incidence rate requires an evaluation of public health measures to prevent these injuries and reduce their consequences, but also the implementation of new screening procedures.

scholarly journals Traumatic brain injury: classification, models, and markers

2018 ◽  
Vol 96 (4) ◽  
pp. 391-406 ◽  
Author(s):  
Dema Najem ◽  
Kerry Rennie ◽  
Maria Ribecco-Lutkiewicz ◽  
Dao Ly ◽  
Julie Haukenfrers ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Care Expenditures ◽  
Detection Methods ◽  
Classification Models ◽  
High Incidence ◽  
High Incidence Rate ◽  
Imaging Detection ◽  
Potential Use

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide. Due to its high incidence rate and often long-term sequelae, TBI contributes significantly to increasing costs of health care expenditures annually. Unfortunately, advances in the field have been stifled by patient and injury heterogeneity that pose a major challenge in TBI prevention, diagnosis, and treatment. In this review, we briefly discuss the causes of TBI, followed by its prevalence, classification, and pathophysiology. The current imaging detection methods and animal models used to study brain injury are examined. We discuss the potential use of molecular markers in detecting and monitoring the progression of TBI, with particular emphasis on microRNAs as a novel class of molecular modulators of injury and its repair in the neural tissue.

scholarly journals Reply to Comment on Tsai, Y.-C., et al. Association of Stress-Induced Hyperglycemia and Diabetic Hyperglycemia with Mortality in Patients with Traumatic Brain Injury: Analysis of a Propensity Score-Matched Population. Int. J. Environ. Res. Public Health 2020, 17, 4266

2021 ◽  
Vol 18 (5) ◽  
pp. 2531
Author(s):  
Yu-Chin Tsai ◽  
Shao-Chun Wu ◽  
Ting-Min Hsieh ◽  
Hang-Tsung Liu ◽  
Chun-Ying Huang ◽  
...  
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Propensity Score ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Injury Analysis

Thank you for Eduardo Mekitarian Filho’s appreciation of our work on the study of stress-induced hyperglycemia (SIH) and diabetic hyperglycemia (DH) in patients with traumatic brain injuries [...]

scholarly journals Interrupted time series design to evaluate ICD-9-CM to ICD-10-CM coding changes on trends in Colorado emergency department visits related to traumatic brain injury

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Lauren Alexis De Crescenzo ◽  
Barbara Alison Gabella ◽  
Jewell Johnson
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Interrupted Time Series ◽  
Emergency Department Visits ◽  
Control And Prevention ◽  
Icd 10 ◽  
Ed Visits ◽  
The Impact

Abstract Background The transition in 2015 to the Tenth Revision of the International Classification of Disease, Clinical Modification (ICD-10-CM) in the US led the Centers for Disease Control and Prevention (CDC) to propose a surveillance definition of traumatic brain injury (TBI) utilizing ICD-10-CM codes. The CDC’s proposed surveillance definition excludes “unspecified injury of the head,” previously included in the ICD-9-CM TBI surveillance definition. The study purpose was to evaluate the impact of the TBI surveillance definition change on monthly rates of TBI-related emergency department (ED) visits in Colorado from 2012 to 2017. Results The monthly rate of TBI-related ED visits was 55.6 visits per 100,000 persons in January 2012. This rate in the transition month to ICD-10-CM (October 2015) decreased by 41 visits per 100,000 persons (p-value < 0.0001), compared to September 2015, and remained low through December 2017, due to the exclusion of “unspecified injury of head” (ICD-10-CM code S09.90) in the proposed TBI definition. The average increase in the rate was 0.33 visits per month (p < 0.01) prior to October 2015, and 0.04 visits after. When S09.90 was included in the model, the monthly TBI rate in Colorado remained smooth from ICD-9-CM to ICD-10-CM and the transition was no longer significant (p = 0.97). Conclusion The reduction in the monthly TBI-related ED visit rate resulted from the CDC TBI surveillance definition excluding unspecified head injury, not necessarily the coding transition itself. Public health practitioners should be aware that the definition change could lead to a drastic reduction in the magnitude and trend of TBI-related ED visits, which could affect decisions regarding the allocation of TBI resources. This study highlights a challenge in creating a standardized set of TBI ICD-10-CM codes for public health surveillance that provides comparable yet clinically relevant estimates that span the ICD transition.

scholarly journals Development of prognostic models for Health-Related Quality of Life following traumatic brain injury

2021 ◽  
Author(s):  
Isabel R. A. Retel Helmrich ◽  
David van Klaveren ◽  
Simone A. Dijkland ◽  
Hester F. Lingsma ◽  
Suzanne Polinder ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Model Performance ◽  
Prognostic Models ◽  
Health Related Quality ◽  
Mild Tbi ◽  
Related Quality ◽  
Health Related

Abstract Background Traumatic brain injury (TBI) is a leading cause of impairments affecting Health-Related Quality of Life (HRQoL). We aimed to identify predictors of and develop prognostic models for HRQoL following TBI. Methods We used data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Core study, including patients with a clinical diagnosis of TBI and an indication for computed tomography presenting within 24 h of injury. The primary outcome measures were the SF-36v2 physical (PCS) and mental (MCS) health component summary scores and the Quality of Life after Traumatic Brain Injury (QOLIBRI) total score 6 months post injury. We considered 16 patient and injury characteristics in linear regression analyses. Model performance was expressed as proportion of variance explained (R2) and corrected for optimism with bootstrap procedures. Results 2666 Adult patients completed the HRQoL questionnaires. Most were mild TBI patients (74%). The strongest predictors for PCS were Glasgow Coma Scale, major extracranial injury, and pre-injury health status, while MCS and QOLIBRI were mainly related to pre-injury mental health problems, level of education, and type of employment. R2 of the full models was 19% for PCS, 9% for MCS, and 13% for the QOLIBRI. In a subset of patients following predominantly mild TBI (N = 436), including 2 week HRQoL assessment improved model performance substantially (R2 PCS 15% to 37%, MCS 12% to 36%, and QOLIBRI 10% to 48%). Conclusion Medical and injury-related characteristics are of greatest importance for the prediction of PCS, whereas patient-related characteristics are more important for the prediction of MCS and the QOLIBRI following TBI.

scholarly journals Interrupted time Series Design to Evaluate ICD-9-CM to ICD-10-CM Coding Changes on Trends in Colorado Emergency Department visits Related to Traumatic Brain Injury

2020 ◽  
Author(s):  
Lauren Alexis De Crescenzo ◽  
Barbara Alison Gabella ◽  
Jewell Johnson
Keyword(s):  
Public Health ◽  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Interrupted Time Series ◽  
Emergency Department Visits ◽  
P Value ◽  
Icd 10 ◽  
The Usa ◽  
Definition Of

Abstract Background. The transition in 2015 to the Tenth Revision of the International Classification of Disease, Clinical Modification (ICD-10-CM) in the USA led public health professionals to propose a surveillance definition of traumatic brain injury (TBI) that uses ICD-10-CM codes. The proposed definition excludes “unspecified injury of the head,” previously included in the ICD-9-CM TBI definition. The purpose of this study was to evaluate this change in surveillance methods on monthly rates of TBI-related emergency department visits in Colorado from 2012 to 2017.Results. The monthly rate of TBI-related emergency department visits in the transition month to ICD-10-CM (October 2015) decreased 41 visits per 100,000 population (p-value <0.0001), compared to September 2015, and remained low through December 2017, due to the exclusion of “unspecified injury of head” (ICD-10-CM code S09.90) in the proposed TBI definition. Conclusion. This study highlights a challenge in creating a standardized set of TBI ICD-10-CM codes for public health surveillance that provides comparable yet clinically relevant estimates over time. The findings inform estimation of TBI magnitude based on ICD coded data and decisions about allocating TBI resources based on an estimated TBI magnitude.

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