Study Shows Rise in Emergency Department Visits for Traumatic Brain Injury

PITTSBURGH – There was a nearly 30 percent increase in the rate of visits to United States’ emergency departments (ED) for traumatic brain injury (TBI) from 2006 to 2010, according to a study led by a Children’s Hospital of Pittsburgh of UPMC physician. The rise might be attributable to a number of factors, including increased awareness and diagnoses.

Results of the study, led by Jennifer R. Marin, M.D., M.Sc., an emergency medicine physician at Children’s Hospital, are published in the recent issue of the Journal of the American Medical Association.

The team used data from the Nationwide Emergency Department Sample (NEDS) database to determine national trends in ED visits for TBI from 2006 through 2010. NEDS is a nationally representative database and includes 25 to 50 million visits from more than 950 hospitals each year.

Additionally, the authors used U.S. census data in order to determine incidence rates and the burden of traumatic brain injury on the U.S. population.

“The reason for this increase may be because more people are sustaining head injuries, patients are more aware of TBI and more likely to seek emergency care, health care professionals are more vigilant about making these diagnoses, or a combination of these,” said Marin, also assistant professor of pediatrics and emergency medicine at University of Pittsburgh School of Medicine.

“The findings underscore the need for more evaluation into why and how to reverse these trends so that we can minimize the incidence of traumatic brain injury and the consequences associated with these injuries.”

The team found that in 2010 there were an estimated 2.5 million ED visits for TBI, representing a 29 percent increase in the rate of visits for TBI during the study period. By comparison, total ED visits increased by 3.6 percent. The majority of the increase in the incidence of TBI occurred in visits coded as concussion or unspecified head injury. Children younger than 3 years and adults older than 60 years had the largest increase in TBI rates. The majority of visits were for minor injuries and most patients were discharged from the ED.

“Traumatic brain injury is an important cause of morbidity and mortality each year,” Marin said. “There has been widespread attention to traumatic brain injury, specifically in terms of prevention, in the last decade by policy makers and health professionals. Large-scale studies that assess national statistics and trends are one of the few ways we have to understand the scope of the problem.”

The authors suggest that the increase in TBI among the very young and very old may indicate these age groups do not benefit as much from public health interventions, such as concussion and helmet laws and safer sports’ practices.

For more information on Marin and Children’s Hospital of Pittsburgh of UPMC, visit www.chp.edu.

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