Clinical and epidemiological profile of patients with traumatic brain injury treated in an emergency department

2011 ◽  
Vol 5 (5) ◽  
pp. 1145
Author(s):  
Elisabeth Do Nascimento Silveira ◽  
Candice Abdon Miranda ◽  
Raquell Alves De Araújo ◽  
Bertha Cruz Enders
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Risk Groups ◽  
Nursing Interventions ◽  
Microsoft Excel ◽  
Epidemiological Profile ◽  
Mechanism Of Trauma ◽  
And Control ◽  
Epidemiological Characteristics

ABSTRACT  Objective: to describe the clinical and epidemiological profile of patients with traumatic brain injury (TBI), as well as to report the nursing interventions in the care of these patients. Method: this is a retrospective descriptive study with a quantitative approach, the population was composed of all patients admitted to the hospital’s emergency department, and the sample was 676 patients diagnosed with cranioencephalic trauma. After the approval by the Committee of Ethics and Research of Hospital da Restauração (Protocol 0025.0.102.000-09), the data were collected from medical records through a questionnaire filled in by the researcher. The data were analyzed and plotted through the software Microsoft Excel using descriptive statistics. Results: there was a predominance of TBI in males (68.9%). The most affected age group was the older than 35 years (45.8%). Regarding the mechanism of trauma, most cases were due to falls (42.3%). There was a higher incidence of mild TBI (81.6%). Most patients had no lesions or abnormalities (63.6%). Conclusions: the clinical and epidemiological characteristics of patients with TBI provided important information on the risk groups for TBI, offering data for the development of preventive and control interventions. Descriptors: traumatic brain injury; emergency care; accidents; epidemiology; nursing care. RESUMOObjetivo: descrever o perfil clínico-epidemiológico de pacientes vítimas de lesão cerebral traumática (LCT), bem como relatar as intervenções de enfermagem no cuidado a esses pacientes. Método: estudo descritivo retrospectivo com abordagem quantitativa, a população foi composta por todos os pacientes admitidos na emergência do hospital e a amostra foi de 676 pacientes com diagnóstico de traumatismo cranioencefálico. Após aprovação pelo Comitê de Ética e Pesquisa do Hospital da Restauração (Protocolo n. 0025.0.102.000-09), os dados foram coletados nos prontuários através de um questionário preenchido pelo pesquisador.  Os dados foram analisados e tabulados através do programa Excel da Microsoft usando a estatística descritiva. Resultados: houve um predomínio de LCT no sexo masculino (68,9%). A faixa etária mais acometida foi os maiores de 35 anos (45,8%). Quanto ao mecanismo de trauma, a maioria dos casos ocorreu devido às quedas (42,3%). Houve uma maior incidência de LCT leve (81,6%). A maioria dos pacientes não apresentou lesões ou anormalidades (63,6%). Conclusões: as características clínico-epidemiológicas dos pacientes com LCT forneceram informações importantes sobre os grupos de risco para LCT, oferecendo subsídios para o desenvolvimento de intervenções preventivas e de controle. Descritores: lesão encefálica traumática; atendimento de emergência; acidentes; epidemiologia; cuidados de enfermagem.RESUMENObjetivo: describir las características clínicas y epidemiológicas de los pacientes con lesión cerebral traumática (LCT), así como informar las intervenciones de enfermería en el cuidado de estos pacientes. Método: estudio descriptivo retrospectivo con abordaje cuantitativa, la población estuvo constituida por todos los pacientes ingresados en la emergencia del hospital y la muestra fue de 676 pacientes con diagnóstico de traumatismo craneoencefálico. Después de la aprobación por el Comité de Ética y de Investigación del Hospital da Restauração (Protocolo 0025.0.102.000-09), los datos fueron recolectados de las historias clínicas a través de un cuestionario cumplimentado por el investigador. Los datos fueron analizados y tabulados por medio del programa Microsoft Excel usando la estadística descriptiva. Resultados: se encontró un predominio de LCT en el sexo masculino (68,9%). El grupo de edad más afectado fue el de más de 35 años (45,8%). En cuanto al mecanismo de trauma, en la mayoría de los casos se debió a caídas (42,3%). Hubo una mayor incidencia de LCT leve (81,6%). La mayoría de los pacientes no presentaba lesiones o anomalías (63,6%). Conclusiones: las características clínicas y epidemiológicas de los pacientes con LCT proporcionan información importante sobre los grupos de riesgo para LCT, ofreciendo subsidios para el desarrollo de intervenciones de prevención y control. Descriptores: lesión encefálica traumática; atención de emergencia; accidentes; epidemiología; atención de enfermería.

scholarly journals Emergency Department Referral Profile of Traumatic Brain Injury Records at a Tertiary Care Hospital of Pakistan

2021 ◽  
Author(s):  
Maria Khan ◽  
Uzair Yaqoob ◽  
Zair Hassan ◽  
Muhammad Muizz Uddin
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Road Traffic ◽  
Tertiary Care ◽  
Initial Assessment ◽  
Care Hospital ◽  
Mild Tbi ◽  
Epidemiological Characteristics ◽  
The Impact

Abstract Background: Traumatic Brain Injury (TBI) is the leading cause of morbidity and mortality all over the world and the impact is much worse in Pakistan. The objective here is to describe the epidemiological characteristics of patients with TBI in our country and to determine the immediate outcomes of patients with TBI after the presentation.Method: This was a cross-sectional study conducted at the Lady Reading Hospital, Peshawar, Pakistan. Data were extracted from the medical records from January 1st to December 31st, 2019. Patient age, sex, type of trauma, and immediate outcome of the referral to the Emergency Department were recorded. The severity of TBI was categorized based on Glasgow Coma Scale (GCS) in mild (GCS 13-15), moderate (GCS 9-12), and severe (GCS <8) classes. The Emergency Department referral profile was classified as admissions, disposed, detained and disposed, referred.Results: Out of 5047 patients, 3689 (73.1%) males and 1358 (26.9%) females. The most commonly affected age group was 0-10 years (25.6%) and 21-30 years (20.1%). Road Traffic accident was the predominant cause of injury (38.8%, n=1960) followed by fall (32.7%, n=1649). Most (93.6%, n=4710) of the TBIs were mild. After the full initial assessment and workup, and completing all first-aid management, the immediate outcome was divided into four, most frequent (67.2%, n=3393) of which was “disposed (discharged)”, and 9.3% (n=470) were admitted for further management.Conclusion: Our study represents a relatively commonplace picture of epidemiological data on the burden of TBI in Pakistan. As a large proportion of patients had a mild TBI, and there is a high risk of mild TBI being under-diagnosed, we warrant further investigation of mild TBI in population-based studies.

Divergence in the epidemiological estimates of traumatic brain injury in the United States: comparison of two national databases

2020 ◽  
pp. 1-10
Author(s):  
Brittany M. Stopa ◽  
Maya Harary ◽  
Ray Jhun ◽  
Arun Job ◽  
Saef Izzy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Data Bank ◽  
The United States ◽  
National Sample ◽  
Population Based ◽  
Weighted Estimates ◽  
True Incidence ◽  
Ed Visits

OBJECTIVETraumatic brain injury (TBI) is a leading cause of morbidity and mortality in the US, but the true incidence of TBI is unknown.METHODSThe National Trauma Data Bank National Sample Program (NTDB NSP) was queried for 2007 and 2013, and population-based weighted estimates of TBI-related emergency department (ED) visits, hospitalizations, and deaths were calculated. These data were compared to the 2017 Centers for Disease Control and Prevention (CDC) report on TBI, which used the Healthcare Cost and Utilization Project’s National (“Nationwide” before 2012) Inpatient Sample and National Emergency Department Sample.RESULTSIn the NTDB NSP the incidence of TBI-related ED visits was 59/100,000 in 2007 and 62/100,000 in 2013. However, in the CDC report there were 534/100,000 in 2007 and 787/100,000 in 2013. The CDC estimate for ED visits was 805% higher in 2007 and 1169% higher in 2013. In the NTDB NSP, the incidence of TBI-related deaths was 5/100,000 in 2007 and 4/100,000 in 2013. In the CDC report, the incidence was 18/100,000 in both years. The CDC estimate for deaths was 260% higher in 2007 and 325% higher in 2013.CONCLUSIONSThe databases disagreed widely in their weighted estimates of TBI incidence: CDC estimates were consistently higher than NTDB NSP estimates, by an average of 448%. Although such a discrepancy may be intuitive, this is the first study to quantify the magnitude of disagreement between these databases. Given that research, funding, and policy decisions are made based on these estimates, there is a need for a more accurate estimate of the true national incidence of TBI.

scholarly journals Multisite medical record review of emergency department visits for traumatic brain injury

2021 ◽  
Vol 27 (S1) ◽  
pp. i42-i48
Author(s):  
Barbara A Gabella ◽  
Jeanne E Hathaway ◽  
Beth Hume ◽  
Jewell Johnson ◽  
Julia F Costich ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Skull Fracture ◽  
Signs And Symptoms ◽  
International Classification Of Diseases ◽  
Emergency Department Visits ◽  
Intracranial Injury ◽  
Imaging Results ◽  
Icd 10

BackgroundIn 2016, the CDC in the USA proposed codes from the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) for identifying traumatic brain injury (TBI). This study estimated positive predictive value (PPV) of TBI for some of these codes.MethodsFour study sites used emergency department or trauma records from 2015 to 2018 to identify two random samples within each site selected by ICD-10-CM TBI codes for (1) intracranial injury (S06) or (2) skull fracture only (S02.0, S02.1-, S02.8-, S02.91) with no other TBI codes. Using common protocols, reviewers abstracted TBI signs and symptoms and head imaging results that were then used to assign certainty of TBI (none, low, medium, high) to each sampled record. PPVs were estimated as a percentage of records with medium-certainty or high-certainty for TBI and reported with 95% confidence interval (CI).ResultsPPVs for intracranial injury codes ranged from 82% to 92% across the four samples. PPVs for skull fracture codes were 57% and 61% in the two university/trauma hospitals in each of two states with clinical reviewers, and 82% and 85% in the two states with professional coders reviewing statewide or nearly statewide samples. Margins of error for the 95% CI for all PPVs were under 5%.DiscussionICD-10-CM codes for traumatic intracranial injury demonstrated high PPVs for capturing true TBI in different healthcare settings. The algorithm for TBI certainty may need refinement, because it yielded moderate-to-high PPVs for records with skull fracture codes that lacked intracranial injury codes.

Bypassing the nearest emergency department for a more distant neurosurgical centre in traumatic brain injury patients

2020 ◽  
pp. 1-7
Author(s):  
Callum J. Prosser ◽  
David Edwards ◽  
Omar Boumara ◽  
Gordon Fuller ◽  
Damian Holliman ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury

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.

Use of brain electrical activity to quantify traumatic brain injury in the emergency department

Brain Injury ◽  
2010 ◽  
Vol 24 (11) ◽  
pp. 1324-1329 ◽  
Author(s):  
Rosanne S. Naunheim ◽  
Matthew Treaster ◽  
Joy English ◽  
Teya Casner ◽  
Robert Chabot
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Electrical Activity ◽  
Brain Electrical Activity

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.

scholarly journals Immediate Outcomes of Traumatic Brain Injury at a Tertiary Care Hospital Of Pakistan- A Retrospective Study

2020 ◽  
Author(s):  
Maria Khan ◽  
Uzair Yaqoob ◽  
Zair Hassan ◽  
Muhammad Muizz Uddin
Keyword(s):  
Traumatic Brain Injury ◽  
Retrospective Study ◽  
Brain Injury ◽  
Tertiary Care ◽  
Epidemiological Data ◽  
Initial Assessment ◽  
Care Hospital ◽  
Hospital Data ◽  
Epidemiological Characteristics ◽  
The Impact

Abstract Background: Traumatic Brain Injury (TBI) which is the leading cause of morbidity and mortality all over the world and the impact is much worse in Pakistan. The objective of the study is to describe the epidemiological characteristics of patients with TBI in our country and to determine the immediate outcomes of patients with TBI after the presentation.Method: This retrospective study was conducted at the Lady Reading Hospital. Data were extracted from the medical record room from January 1st to December 31st, 2019. The severity of TBI was based on Glasgow Coma Scale (GCS) and was divided into mild (GCS 13-15), moderate (GCS 9-12), and severe TBI (GCS <8) based on the GCS. SPSS v.23 was used for data analysis. Results: Out of 5047 patients, 3689 (73.1%) males and 1358 (26.9%) females. The most commonly affected age group was 0-10 years (25.6%) and 21-30 years (20.1%). was the predominant cause of injury (38.8%, n=1960) followed by fall (32.7%, n=1649). Most (93.6%, n=4710) of the TBIs were mild. After the full initial assessment and workup, and completing all first-aid management, the immediate outcome was divided into four, most frequent (67.2%, n=3393) of which was “disposed (discharged)”, and 9.3% (n=470) were admitted for further management.Conclusion: Our study represents a relatively conclusive picture of epidemiological data on the burden of TBI in Pakistan. Although a large proportion of patients had a mild TBI, they may likely be under-diagnosed. This warrants for further investigation of MTBI in population-based studies across the globe.

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