scholarly journals Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action

2021 ◽  
Author(s):  
Emma A. Richie ◽  
Joseph G. Nugent ◽  
Ahmed M. Raslan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Outcomes ◽  
Ethnic Minority ◽  
Healthcare System ◽  
Traumatic Injury ◽  
University Hospital ◽  
Structural Racism ◽  
Probability Of Survival ◽  
Racial And Ethnic Minority

AbstractThe health disparities which drive inequities in health outcomes have long plagued our already worn healthcare system and are often dismissed as being a result of social determinants of health. Herein, we explore the nature of these inequities by comparing outcomes for racial and ethnic minority patients suffering from traumatic brain injury (TBI). We retrospectively reviewed all patients enrolled in the Trauma One Database at the Oregon Health & Science University Hospital from 2006 to October 2017 with an abbreviated injury scale (AIS) scale for the head or neck greater than 2. Racial and ethnic minority patients were defined as non-White or Hispanic. A total of 6,352 patients were included in our analysis with 1,504 in the racial and ethnic minority cohort vs. 4,848 in the non-minority cohort. A propensity score (PS) model was generated to account for differences in baseline characteristics between these cohorts to generate 1,500 matched pairs. The adjusted hazard ratio for in-hospital mortality for minority patients was 2.21 (95% Confidence Interval (CI) 1.43-3.41, p<0.001) using injury type, probability of survival, and operative status as covariates. Treating patients under our care is our greatest privilege and responsibility as physicians. As such, we have a societal duty to recognize and accept that the effects of structural racism have taken hold of our patients’ health long before they arrive in our trauma bays, ICU beds, and operating tables. These disparities permeate our society and contribute to inequitable health outcomes, and we must take action to identify the factors which perpetuate this disproportionate suffering. Simply treating the minority of patients who require surgical intervention or clinical consultation is not enough. Our roles demand that we recognize these larger social factors acting upstream on our patients before they enter our fractioned healthcare system which often fosters the very mistrust that hides them from our otherwise watchful eyes in the first place. What shape, if any, these health inequities take among other nations will enable us to better understand the root of these problems in our society and allow us to work together toward equitable healthcare for all victims of traumatic injury.

scholarly journals Racial and Ethnic Inequities in Mortality During Hospitalization for Traumatic Brain Injury: A Call to Action

2021 ◽  
Vol 8 ◽  
Author(s):  
Emma A. Richie ◽  
Joseph G. Nugent ◽  
Ahmed M. Raslan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Ethnic Minority ◽  
Healthcare System ◽  
Race And Ethnicity ◽  
Social Systems ◽  
Ethnic Disparities ◽  
University Hospital ◽  
Probability Of Survival ◽  
Racial And Ethnic Minority

The health disparities which drive inequities in health outcomes have long plagued our already worn healthcare system and are often dismissed as being a result of social determinants of health. Herein, we explore the nature of these inequities by comparing outcomes for racial and ethnic minorities patients suffering from traumatic brain injury (TBI). We retrospectively reviewed all patients enrolled in the Trauma One Database at the Oregon Health &amp; Science University Hospital from 2006 to October 2017 with an abbreviated injury scale (AIS) for the head or neck &gt;2. Racial and ethnic minority patients were defined as non-White or Hispanic. A total of 6,352 patients were included in our analysis with 1,504 in the racial and ethnic minority cohort vs. 4,848 in the non-minority cohort. A propensity score (PS) model was generated to account for differences in baseline characteristics between these cohorts to generate 1,500 matched pairs. The adjusted hazard ratio for in-hospital mortality for minority patients was 2.21 [95% Confidence Interval (CI) 1.43–3.41, p &lt; 0.001] using injury type, probability of survival, and operative status as covariates. Overall, this study is the first to specifically look at racial and ethnic disparities in the field of neurosurgical trauma. This research has demonstrated significant inequities in the mortality of TBI patients based on race and ethnicity and indicates a substantive need to reshape the current healthcare system and advocate for safer and more supportive pre-hospital social systems to prevent these life-threatening sequelae.

Differences in employment outcomes 10 years after traumatic brain injury among racial and ethnic minority groups

2010 ◽  
Vol 33 (1) ◽  
pp. 65-75 ◽  
Author(s):  
Kelli W. Gary ◽  
Jessica M. Ketchum ◽  
Juan Carlos Arango-Lasprilla ◽  
Jeffrey S. Kreutzer ◽  
Thomas Novack ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Ethnic Minority ◽  
Minority Groups ◽  
Employment Outcomes ◽  
Ethnic Minority Groups ◽  
Racial And Ethnic Minority

Impact of routine S100B protein assay on CT scan use in children with mild traumatic brain injury

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fleur Lorton ◽  
Jeanne Simon-Pimmel ◽  
Damien Masson ◽  
Elise Launay ◽  
Christèle Gras-Le Guen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
University Hospital ◽  
S100b Protein ◽  
Research Network ◽  
Ct Scans ◽  
Intermediate Risk ◽  
Protein Assay ◽  
The Impact

AbstractObjectivesTo evaluate the impact of implementing a modified Pediatric Emergency Care Applied Research Network (PECARN) rule including the S100B protein assay for managing mild traumatic brain injury (mTBI) in children.MethodsA before-and-after study was conducted in a paediatric emergency department of a French University Hospital from 2013 to 2015. We retrospectively included all consecutive children aged 4 months to 15 years who presented mTBI and were at intermediate risk for clinically important traumatic brain injury (ciTBI). We compared the proportions of CT scans performed and of in-hospital observations before (2013–2014) and after (2014–2015) implementation of a modified PECARN rule including the S100B protein assay.ResultsWe included 1,062 children with mTBI (median age 4.5 years, sex ratio [F/M] 0.73) who were at intermediate risk for ciTBI: 494 (46.5%) during 2013–2014 and 568 (53.5%) during 2014–2015. During 2014–2015, S100B protein was measured in 451 (79.4%) children within 6 h after mTBI. The proportion of CT scans and in-hospital observations significantly decreased between the two periods, from 14.4 to 9.5% (p=0.02) and 73.9–40.5% (p<0.01), respectively. The number of CT scans performed to identify a single ciTBI was reduced by two-thirds, from 18 to 6 CT scans, between 2013–2014 and 2014–2015. All children with ciTBI were identified by the rules.ConclusionsThe implementation of a modified PECARN rule including the S100B protein assay significantly decreased the proportion of CT scans and in-hospital observations for children with mTBI who were at intermediate risk for ciTBI.

scholarly journals Management of Traumatic Brain Injury: A review Update

2017 ◽  
Vol 6 (2) ◽  
pp. 87-89
Author(s):  
ATM Ashadullah ◽  
Monirul Islam ◽  
Fazley Elahi Milad ◽  
Abdullah Alamgir ◽  
Md Shafiul Alam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Traumatic Injury ◽  
Loss Of Consciousness ◽  
Extradural Haematoma ◽  
Inner Surface ◽  
Injury Patient ◽  
Extradural Haematomas

Traumatic Brain Injury leads to serious consequences. Approximately half of all deaths is related to traumatic injury and the main cause of head trauma. Extradural haematomas (EDH) develops in all major head injuries. A head injury patient who is only temporary loss of consciousness and is left asleep may sometimes be found dead in the bed next morning due to extradural haematoma. Extradural haematoma which lies in between the inner surface of skull and stripes of dural membrane, are nearly always caused by, and located near a skull fracture. The collection takes several forms in terms of size, location, speed of development and effects they exert on patient. Immediate management is necessary to decrease the bad consequences. In this review the management of traumatic brain injury is highlighted.J Shaheed Suhrawardy Med Coll, 2014; 6(2):87-89

Article 18: Women's Health Outcomes After Traumatic Brain Injury

2009 ◽  
Vol 90 (10) ◽  
pp. e8
Author(s):  
Angela Colantonio ◽  
Wanna Mar ◽  
Karen Yoshida ◽  
Michael Escobar ◽  
Nora Cullen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Outcomes ◽  
Women’S Health ◽  
Women's Health

Outcomes of emergency neurosurgical intervention in neuro-critical care patients with traumatic brain injury at Cork University Hospital

2018 ◽  
Vol 32 (6) ◽  
pp. 585-589 ◽  
Author(s):  
Michael Amoo ◽  
Philip J. O’Halloran ◽  
Anne-Marie Leo ◽  
Aoife O’Loughlin ◽  
Padraig Mahon ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Critical Care ◽  
Brain Injury ◽  
University Hospital ◽  
Critical Care Patients ◽  
Neurosurgical Intervention

Health Outcomes Associated With Military Deployment: Mild Traumatic Brain Injury, Blast, Trauma, and Combat Associations in the Florida National Guard

2012 ◽  
Vol 93 (11) ◽  
pp. 1887-1895 ◽  
Author(s):  
Rodney D. Vanderploeg ◽  
Heather G. Belanger ◽  
Ronnie D. Horner ◽  
Andrea M. Spehar ◽  
Gail Powell-Cope ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Health Outcomes ◽  
Mild Traumatic Brain Injury ◽  
National Guard ◽  
Military Deployment ◽  
Blast Trauma

Participation After Traumatic Brain Injury: Disparities by Household Income Groups

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510248p1-7512510248p1
Author(s):  
Alyssa M. Taubert ◽  
Kimberly Erler ◽  
Joseph G. Giacino ◽  
Michael Bergin ◽  
Amber Thomas ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Socioeconomic Status ◽  
Brain Injury ◽  
Health Outcomes ◽  
Household Income ◽  
Income Groups ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Participation is the overarching goal of neurorehabilitation and OT interventions. Despite this emphasis on participation, evidence suggests that people with traumatic brain injury (TBI) have poor participation. It is clear that socioeconomic status has a relationship with other health outcomes, but little is known about its relationship with participation after TBI. The objective of this research was to examine disparities in participation after TBI between household income groups. Primary Author and Speaker: Alyssa M. Taubert Additional Authors and Speakers: Kimberly Erler Contributing Authors: Joseph G. Giacino, Michael Bergin, Amber Thomas, andYelena Bodien

Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit

2021 ◽  
pp. 105477382110504
Author(s):  
Jeong Eun Yoon ◽  
Ok-Hee Cho
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Medical Records ◽  
Injury Severity ◽  
University Hospital ◽  
Factors Associated ◽  
Braden Scale

Pressure injuries (PIs) are one of the most important and frequent complications in patients admitted to the intensive care unit (ICU) or those with traumatic brain injury (TBI). The purpose of this study was to determine the incidence and risk factors of PIs in patients with TBI admitted to the ICU. In this retrospective study, the medical records of 237 patients with TBI admitted to the trauma ICU of a university hospital were examined. Demographic, trauma-related, and treatment-related characteristics of all the patients were evaluated from their records. The incidence of PIs was 13.9%, while the main risk factors were a higher injury severity score, use of mechanical ventilation, vasopressor infusion, lower Braden Scale score, fever, and period of enteral feeding. This study advances the nursing practice in the ICU by predicting the development of PIs and their characteristics in patients with TBI.

Incidence of head injury and traumatic brain injury among people with Alzheimer’s disease

2019 ◽  
Vol 73 (5) ◽  
pp. 451-454 ◽  
Author(s):  
Sarianna Ilmaniemi ◽  
Heidi Taipale ◽  
Antti Tanskanen ◽  
Jari Tiihonen ◽  
Sirpa Hartikainen ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Head Injuries ◽  
Community Dwelling ◽  
University Hospital ◽  
Health Concern ◽  
Increased Risk

BackgroundInjuries caused by falling are a major health concern among older population. For older people, falls are the leading cause of head injuries; especially, persons with cognitive disorders have an increased risk of falling.ObjectiveTo compare the incidence of head injury and traumatic brain injury (TBI) among persons with Alzheimer’s disease (AD) with persons without AD.MethodsThis register-based study was conducted on a nationwide cohort, which includes all community-dwelling persons diagnosed with AD in Finland in 2005–2011. Persons with previous head injuries were excluded, leaving 67 172 persons with AD. For each person with AD, a matching person without AD and previous head injury were identified with respect to age, sex and university hospital district. The Cox proportional hazard model and competing risk analyses were used to estimate HR for head injury and TBI.ResultsPersons with AD had 1.34-fold (95% CI 1.29 to 1.40) risk of head injuries and 1.49-fold (95% CI 1.40 to 1.59) risk of TBIs after accounting for competing risks of death and full adjustment by socioeconomic status, drug use and comorbidities.ConclusionPersons with AD are more likely to have a head injury or TBI incident than persons without AD.

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