Geographical Variation in Traumatic Brain Injury Mortality by Proximity to the Nearest Neurosurgeon

Ratliff, Hunter T.; Korst, Genevieve; Moth, John; Jupiter, Daniel C.

doi:10.1016/j.jss.2020.09.004

Cited by 7 publications

(7 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Most of the studies were population-based retrospective cohort studies of ≥1 year in duration. Of the 36 studies, 15 were conducted in North America (14, 18, 20, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37) and nine in Australia and New Zealand (5, 6, 21, 22, 38, 39, 40, 41, 42). Additional information on study data sources, inclusion/exclusion criteria, and rural/urban classifications, can be found in Appendices 5-7.…”

Section: Resultsmentioning

confidence: 99%

“…A subgroup analysis also showed no statistically significant difference between the number of male patients in pediatric/adolescent or adult age groups between rural and urban populations (OR: 1.01, 95% CI [1.00, 1.03], p=0.13; and OR 1.16, 95% CI [0.82, 1.63], p=0.40, respectively) (Fig 3). Injuries of all severities were reported in 22 studies (5, 6, 14, 15, 18, 19, 20, 21, 26, 28, 29, 32, 33, 34, 36, 38, 40, 41, 44, 45, 46, 47), with the remaining studies reporting on either mild or severe traumatic head injury only (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Mortality was the major outcome measure reported in 16 studies (14, 15, 16, 18, 19, 20, 21, 22, 27, 32, 33, 34, 35, 41, 46, 49). Population-adjusted mortality rates and rate ratios were significantly higher in all rural cohorts, with further increases as level of rurality increased (Table 4) (14, 32, 33). However, meta-analysis of 11 studies including 32,984 patients which reported mortality events, failed to show a statistical difference between rural and urban populations (OR: 1.09, 95% CI [0.73, 1.61], p=0.67) (Fig 11A).…”

Section: Resultsmentioning

confidence: 99%

“…Limitations Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias). (14) Prospective collection (single tertiary hospital) Andelic et al (16) Analysis of data from prospective population-based multicentre study Asemota et al (26) HCUP-NIS Berry et al (5) AIHW NHMD Brown et al (18) CDC WISQARS Chan et al (43) Prospective collection (2 hospitals) Chapital et al (20) Queen's Medical Center trauma database Cheng et al (27) CDC WONDER Cheng et al (45) China DSP Chiang et al (46) Taiwan Head Injury Registry + hospital records (24 hospitals) Chiu et al (19) Prospective collection (26 hospitals) Daugherty et al (28) CDC NVSS Feigin et al (38) CT/MRI records, hospital discharge registers, private hospitals, GP practices, rehabilitation centres, outpatient clinics, coroner/autopsy records, rest homes, community health services, schools, sports centres, ambulance services, prison, ACC database, death certificates, hospital separation data Gabella et al (15) Colorado surveillance system (hospital discharge data + death certificate data) Gontkovsky et al (29) NIDRR TBI Model System + participant/family member interviews Graves et al (30) MarketScan CCAE Halldorsson et al (44) Icelandic hospitals + EDs + healthcare centres + death register Harradine et al (39) Prospective collection (11 rehabilitation units) Harrison et al (40) AIHW NHMD Johnstone et al (31) Missouri Division of Vocational Rehabilitation Karwat et al † (11,49) Lublin Regional Specialist Hospital records Leonhard et al (32) Oregon Trauma registry Maier et al (17) CT/MRI records (2 hospitals) Ponsford et al (6) Prospective collection (single rehabilitation centre) Pozzato et al (21) NSW Department of Health hospital data Ratliff et al (33) CDC WISQARS Reid et al (34) MDH TBI Registry + death certificates Ring et al (41) NSW Hospital Morbidity Statistics + hospital indices (133 hospitals) + death certificates…”

Section: -17mentioning

confidence: 99%

See 4 more Smart Citations

Epidemiology and outcomes of head trauma in rural and urban populations: A systematic review and meta-analysis

Chequer de Souza,

Dobson,

Lee

et al. 2023

Preprint

View full text Add to dashboard Cite

Objective: To identify and describe differences in demographics, injury characteristics, and outcomes between rural and urban head injury patients. Data Sources: CINAHL, Emcare, MEDLINE, and Scopus. Review Methods: A systematic review and meta-analysis of studies comparing epidemiology and outcomes of rural and urban head trauma was conducted in accordance with PRISMA and MOOSE guidelines. Results: 36 studies with ~2.5-million patients were included. Incidence of head injury was higher in males, regardless of location. Rates of transport-related head injuries, particularly involving motorized vehicles other than cars, were significantly higher in rural populations (OR:3.63, 95% CI[1.58,8.35], p=0.002), whereas urban residents had more fall-induced head trauma (OR:0.73, 95% CI[0.66,0.81], p<0.00001). Rural patients were 28% more likely to suffer severe injury, indicated by Glasgow Coma Scale (GCS)<8 (OR:1.28, 95% CI[1.04,1.58], p=0.02). There was no difference in mortality (OR:1.09, 95% CI[0.73,1.61], p=0.067), however, urban patients were twice as likely to be discharged with a good outcome (OR:0.52, 95% CI[0.41,0.67], p<0.00001). Conclusions: Rurality is associated with greater severity and poorer outcomes of traumatic head injury. Transport accidents disproportionally affect those travelling on rural roads. Future research recommendations include addition of prehospital data, adequate follow-up, standardized measures, and sub-group analyses of high-risk groups, e.g., Indigenous populations.

show abstract