Traumatic Brain Injuries Evaluated in U.S. Emergency Departments, 1992‐1994

Jager, Thomas E.; Weiss, Harold B.; Coben, Jeffrey H.; Pepe, Paul E.

doi:10.1111/j.1553-2712.2000.tb00515.x

Cited by 292 publications

(185 citation statements)

References 8 publications

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“…1,9,10,36 In comparison to the findings of the present study, higher estimates of nonfatal injury rates (approximately 12 per 100) and lower proportions in the home environment (approximately 25%) in young children have been reported using the National Health Interview Survey (NHIS) and the NHAMCS. 1,10,37,38 Scheidt et al also found slightly higher rates of medicallyattended home injury (16 events per 100 children) using the Child Health Supplement to the 1988 NHIS over a 12-month recall period. 9 The inclusion of office and non-ED visits in the NHIS contributed to the higher rate estimate for nonfatal injuries.…”

Section: Discussionmentioning

confidence: 99%

Residential Injuries in U.S. Children and Adolescents

et al. 2005

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SYNOPSISObjectives. Injuries are the leading cause of death and disability for U.S. children, but little research exists on injury in the home environment. The purpose of this study was to estimate the rate and severity of and trends in unintentional residential injury for U.S. children Ͻ20 years for 1993-1999.Methods. Data on emergency department (ED) visits were obtained from the National Hospital Ambulatory Medical Care Survey (NHAMCS). Rates and 95% confidence intervals (CIs) were calculated using SUDAAN. Chi-square analysis was used to test for differences among proportions. Time trends were analyzed using linear regression.Results. Residential injuries accounted for an average of 4.01 million (95% CI 3.50 million, 4.56 million) ED visits each year for U.S. children, representing 39% of unintentional injury ED visits. There were an average of 531,000 (95% CI 456,000, 606,000) visits with moderate-to-severe injuries, resulting in 73,680 (95% CI 59,715, 87,645) hospital admissions annually. The rate of residential injury visits (excluding unknown locations) was 5.6 per 100 (95% CI 4.9 per 100, 6.4 per 100). The visit rates for children Ͻ5 years of age were higher than those for children Ͼ9 years (pϽ0.0001). Males had a higher rate of visits than females (pϭ0.01). Falls were the leading mechanisms, resulting in 1.5 million ED visits per year (95% CI 1.3 million, 1.8 million). Residential injury rates decreased by 28% over time (pϽ0.02), from 6.3 per 100 (95% CI 3.4, 9.2) in 1993 to 4.5 per 100 (95% CI 2.3, 6.7) in 1999.Conclusions. The predominant location of injury for U.S. children is the home, accounting for 4.01 million ED visits and more than 70,000 hospitalizations each year. Efforts targeted to the home environment are needed to reduce morbidity and mortality from unintentional injury in U.S. children.

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Section: Discussionmentioning

confidence: 99%

Residential Injuries in U.S. Children and Adolescents

et al. 2005

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“…1 It has been estimated that at least 25% of persons experiencing a mild TBI (mTBI; often referred to as concussion) do not seek hospital care. 2 mTBI may result from a variety of insults, including a direct impact to the head, a rapid change in head motion (acceleration or deceleration), or an explosive blast, and can result in structural, physiological, and/or functional changes in the brain.…”

Section: Introductionmentioning

confidence: 99%

Analysis of Functional Pathways Altered after Mild Traumatic Brain Injury

Redell

Moore

Grill

et al. 2013

Journal of Neurotrauma

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Concussive injury (or mild traumatic brain injury; mTBI) can exhibit features of focal or diffuse injury patterns. We compared and contrasted the cellular and molecular responses after mild controlled cortical impact (mCCI; a focal injury) or fluid percussion injury (FPI; a diffuse injury) in rats. The rationale for this comparative analysis was to investigate the brain's response to mild diffuse versus mild focal injury to identify common molecular changes triggered by these injury modalities and to determine the functional pathways altered after injury that may provide novel targets for therapeutic intervention. Microarrays containing probes against 21,792 unique messenger RNAs (mRNAs) were used to investigate the changes in cortical mRNA expression levels at 3 and 24 h postinjury. Of the 354 mRNAs with significantly altered expression levels after mCCI, over 89% (316 mRNAs) were also contained within the mild FPI (mFPI) data set. However, mFPI initiated a more widespread molecular response, with over 2300 mRNAs differentially expressed. Bioinformatic analysis of annotated Gene Ontology molecular function and biological pathway terms showed a significant overrepresentation of genes belonging to inflammation, stress, and signaling categories in both data sets. We therefore examined changes in the protein levels of a panel of 23 cytokines and chemokines in cortical extracts using a Luminex-based bead immunoassay and detected significant increases in macrophage inflammatory protein (MIP)-1a (CCL3), GRO-KC (CXCL1), interleukin (IL)-1a, IL-1b, and IL-6. Immunohistochemical localization of MIP-1a and IL-1b showed marked increases at 3 h postinjury in the cortical vasculature and microglia, respectively, that were largely resolved by 24 h postinjury. Our findings demonstrate that both focal and diffuse mTBI trigger many shared pathobiological processes (e.g., inflammatory responses) that could be targeted for mechanism-based therapeutic interventions.

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“…Vários estudos têm examinado a associação entre a TC de crânio, a gravidade da lesão e o prognóstico (Gennarelli et al, 1982;Greene et al, 1995;Kido et al, 1992;Wardlaw et al, 2002 (Gennarelli et al, 1982;Eisenberg et al, 1990;Selladurai et al, 1992;Kakarieka et al, 1994;Greene et al, 1995;Greene et al, 1996;Chesnut et al, 2000;Ono et al, 2001;Servadei et al, 2002 (Annegers et al, 1980); em San Diego as maiores taxas foram constatadas na faixa etária de 16 a 25 anos (Kraus et al, 1984) e no Bronx, o pico de incidência foi verificado na faixa etária de 16 a 30 anos (Cooper et al, 1983 ( Durkin et al, 1998). No entanto, em um estudo científico realizado em Minnesota entre 1965 a 1972, incluindo todos os casos de TCE, de todas as faixas etárias, foi detectado que 15% dos casos encontrava-se na faixa etária de 0 a 1 ano, 17% na de 2 a 10 anos e 26% na faixa etária de 11 a 20 anos (Annegers et al, 1980 (Jager et al, 2000) e de 1,5:1 no período de 1995 a 1996 (Guerrero et al, 2000).…”

Section: Introductionunclassified

Traumatismo cranioencefálico: correlação entre dados demográficos, escala de Glasgow e tomografia computadorizada de crânio com a mortalidade em curto prazo na cidade de Maceió, Alagoas

Rocha¹

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Traumatic Brain Injuries Evaluated in U.S. Emergency Departments, 1992‐1994

Cited by 292 publications

References 8 publications

Residential Injuries in U.S. Children and Adolescents

Residential Injuries in U.S. Children and Adolescents

Analysis of Functional Pathways Altered after Mild Traumatic Brain Injury

Traumatismo cranioencefálico: correlação entre dados demográficos, escala de Glasgow e tomografia computadorizada de crânio com a mortalidade em curto prazo na cidade de Maceió, Alagoas

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