Assessment of Follow-up Care After Emergency Department Presentation for Mild Traumatic Brain Injury and Concussion

Abstract

Key Points Question Do patients with mild traumatic brain injury (mTBI) receive adequate levels of follow-up care? Findings In a cohort study using data on 831 patients with mTBI presenting to the emergency department at 1 of 11 level I trauma centers across the United States, 42% of patients reported receiving educational material at discharge and 44% reported seeing a physician or other medical practitioner within 3 months after injury. Among patients with 3 or more moderate to severe postconcussive symptoms, only 52% reported having seen a practitioner within 3 months following the injury. Meaning A large proportion of patients with mTBI do not receive follow-up care after injury even when they experience ongoing postconcussive symptoms.

The Long-Term Impact of Mild Traumatic Brain Injuries on Multiple Functional Outcomes and Epigenetics: A Pilot Study with College Students

“…Of nearly 2.8 million TBI cases in the US [2], mild TBI accounts for over 75-80% cases [3,4]. mTBI is conventionally diagnosed based on the following three criteria: (a) loss of consciousness shorter than 30 min; (b) post-traumatic amnesia shorter than 24 hours; and (c) when the injury is scored 13 to 15 on the Glasgow Coma Scale (GCS) (moderate TBI by 9-12 and severe TBI by [3][4][5][6][7][8] [1,5]. Although the injury is classified as 'mild', mTBI can cause multifaceted and persistent functional impairments.…”

“…Although the injury is classified as 'mild', mTBI can cause multifaceted and persistent functional impairments. Such persistent and chronic, often untreated, impairments can severely disturb the quality of life of affected individuals [6]. While most post-mTBI functional deficits may recover in 3 to 6 months [7], up to 40% of affected individuals [8][9][10] suffer from 3 All subjects submitted their informed consent for inclusion before they participated in the study.…”

“…The NSI has 22 items to cover a comprehensive range of the symptom domains (physical, cognitive, affective, and sensory) [41,42] and has good-to-excellent reliabilities across domains (r, ranged: 0.77-0.93). Both RPQ and NSI have been widely used with various clinical samples with mTBI or concussion, including active military service members and veterans [41,43,44].…”

Implementation of a Neurotrauma Hotline for post‐hospital continuity of care

“…The results of a national survey of 35 Level I trauma centers in the United States showed that only 34% of centers referred patients with mTBI for further evaluation . An additional study showed that as many as 40% of patients do not receive follow‐up care within 3 months of their TBI . Studies have shown that 52% of patients with mTBI reported persistent, injury‐related deficits 12 months after the date of injury.…”

“…4 An additional study showed that as many as 40% of patients do not receive follow-up care within 3 months of their TBI. 5 Studies have shown that 52% of patients with mTBI reported persistent, injury-related deficits 12 months after the date of injury. Additionally, it is suggested that mTBI is associated with as much as a 75% increase in medical costs up to 3 years after injury 6 and that the lasting effects of TBI may also contribute to loss of employment, homelessness, and incarceration.…”