Prehospital Helicopter Transport and Survival of Patients With Traumatic Brain Injury

Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A.

doi:10.1097/sla.0000000000000672

Cited by 60 publications

(36 citation statements)

References 28 publications

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“…27 In our study, 0.8% of the patients died, and in all the TBI had been classified as severe (with a GCS score of [3][4][5][6][7][8]. Twenty (87%) of the 23 deaths were graded as severe or critical systemic trauma by the ISS, and the 3 remaining deaths had an unknown ISS.…”

Section: Mortality Rates and Sports-related Tbimentioning

confidence: 99%

“…1). 5,6,34 The subgroup with sportsrelated mechanisms of injury was included in the present analysis on the basis of ICD-9 E-codes and stratified into the following 5 categories: FIC, roller skate/skateboard (roller sports), skiing/snowboarding, equestrian and related sports, and aquatic sports ( Table 1). The ICD-9 Ecodes in the NTDB do not identify individual sports, and the relative contributions of individual sports to each category are therefore unknown.…”

Section: Methodsmentioning

confidence: 99%

“…4 Fall on stairs/ladders in water transport injuring water skier 0 833. 5 Fall on stairs/ladders in water transport injuring swimmer in all age groups, and the proportion of TBIs due to FIC increased with age. Traumatic brain injuries due to roller sports showed an age-dependent increase from children 0-6 years old to those of older age.…”

Section: Patient Demographics and Injury Characteristicsmentioning

confidence: 99%

“…4 Other accidental submersion or drowning in water transport accident injuring water skier 3 832. 5 Other accidental submersion or drowning in water transport accident injuring swimmer 1 833. 4 Fall on stairs/ladders in water transport injuring water skier 0 833.…”

Section: Patient Demographics and Injury Characteristicsmentioning

confidence: 99%

“…Injuries from FIC represented the largest proportion of sports-related TBI 4 Accident to watercraft causing other injury to water skier 7 831. 5 Accident to watercraft causing other injury to swimmer 0 832. 4 Other accidental submersion or drowning in water transport accident injuring water skier 3 832.…”

Section: Patient Demographics and Injury Characteristicsmentioning

confidence: 99%

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Pediatric sports-related traumatic brain injury in United States trauma centers

Winkler

Yue

Burke

et al. 2016

FOC

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Neurosurg Focus 40 (4):E3, 2016S portS-related traumatic brain injury (TBI) is an important public health concern that is increasingly in the spotlight of both the lay press and the general public. Recent estimates suggest that 300,000 to 3.8 million sports-related TBIs occur in the United States annually, 11,17,32,40,49 resulting in more than 500,000 emergency department (ED) visits and over 60,000 hospitalizations. 31,44 In children older than 1 year, TBI is the leading cause of death and disability, 27 and roughly 60%-80% of sportsrelated TBI ED visits are by pediatric patients-predomiAbbreviAtioNs CCI = Charlson Comorbidity Index; ED = emergency department; FIC = fall or interpersonal contact; GCS = Glasgow Coma Scale; ICD-9 = International Classification of Diseases, Ninth Revision; ICU = intensive care unit; ISS = Injury Severity Score; LOS = length of stay; NSP = National Sample Program; NTDB = National Trauma Data Bank; TBI = traumatic brain injury. obJeCtive Traumatic brain injury (TBI) in children is a significant public health concern estimated to result in over 500,000 emergency department (ED) visits and more than 60,000 hospitalizations in the United States annually. Sports activities are one important mechanism leading to pediatric TBI. In this study, the authors characterize the demographics of sports-related TBI in the pediatric population and identify predictors of prolonged hospitalization and of increased morbidity and mortality rates. MethoDs Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from children (age 0-17 years) across 5 sports categories: fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged length of stay (LOS) in the hospital or intensive care unit (ICU), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at a < 0.05, and the Bonferroni correction (set at significance threshold p = 0.01) for multiple comparisons was applied in each outcome analysis. resUlts From 2003 to 2012, in total 3046 pediatric sports-related TBIs were recorded in the NTDB, and these injuries represented 11,614 incidents nationally after sample weighting. Fall or interpersonal contact events were the greatest contributors to sports-related TBI (47.4%). Mild TBI represented 87.1% of the injuries overall. Mean (± SEM) LOSs in the hospital and ICU were 2.68 ± 0.07 days and 2.73 ± 0.12 days, respectively. The overall mortality rate was 0.8%, and the prevalence of medical complications was 2.1% across all patients. Severities of head and extracranial injuries were significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Hypotension on admission to the ED was a significant predictor of failure to discharge to home (OR 0.05, 95% CI 0.03-0.07, p < 0.001). ...

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