Validity of administrative data for characterizing traumatic brain injury-related hospitalizations

Shore, Andrew D.; McCarthy, Melissa L.; Serpi, Tracey; Gertner, Melanie

doi:10.1080/02699050400013568

Cited by 41 publications

(25 citation statements)

References 12 publications

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“…It has been reported that codification errors tend to under identify moderate to severe cases of TBI. 16 In our study, with ICD-9, it seems that the opposite happened. We may argue that some multiple trauma patients may have mild TBI or concussion that was neglected by the encoder faced with other more severe diagnosis.…”

Section: Final Remarksmentioning

confidence: 82%

Traumatic Brain Injury in Portugal: Trends in Hospital Admissions from 2000 to 2010

et al. 2014

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Introduction: Traumatic brain injury has a considerable socio-economic impact, being a major cause of morbi-mortality, often with permanent disability. We sought to characterize health resource utilization of adult traumatic brain injury patients in Portugal between 2000 and 2010. Material and Methods: Retrospective study of medical records of adult patients with ICD9 diagnostic code of traumatic brain injury included in the National Diagnosis Related Groups Database from 2000–2010. Descriptive statistical analysis was performed and trends during the decade were evaluated. Results: We analysed 72 865 admissions to 111 hospitals, 64.1% males, mean age 57.9 ± 21.8 years (18-107). We found a decrease in number of traumatic brain injury in younger patients and an increase in older ones. The number of traffic accidents decreased and the number of falls increased. There was an increase of moderate to severe traumatic brain injury admissions: 47.2% in 2000 / 80% in 2010. Patients admitted in Intensive Care have nearly doubled (15.8% vs 29.5%) as well as the number submitted to neurosurgical procedures (8.2% vs 15.2%). Total mortality increased from 7.1% to 10.6%. Discussion: The decrease of traumatic brain injury may be associated with the trauma prevention campaigns, road network improvement and health politics. The increase in mortality may be related to better pre-hospital care, enabling more severe cases to arrive in hospital alive, and although treated more frequently in Intensive Care and requiring more neurosurgical procedures, they end up having higher mortality. Also this may be due to an increase in patients’ age and worse pre-morbid status. Conclusion: Traumatic brain injury in Portugal is changing. Although hospital admissions due to global traumatic brain injury have decreased, mortality rate has increased. Keywords: Intensive Care Units; Brain Injuries; Hospitalization; Portugal.

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Section: Final Remarksmentioning

confidence: 82%

Traumatic Brain Injury in Portugal: Trends in Hospital Admissions from 2000 to 2010

et al. 2014

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“…24 We have minimized variability in reporting by using published methodologies for identifying patients with VTE and with TBI. 23,24,[26][27][28] This study likely represents symptomatic VTE, as active VTE screening in pediatric populations is less common than in adult clinical practice. 10 Another limitation is that with discharge-level data, we cannot identify children longitudinally if they were hospitalized multiple times.…”

Section: Discussionmentioning

confidence: 99%

“…The following ICD-9-CM codes representing TBI were used: fracture of the vault or base of the skull (800.0-801.9); other unqualified and multiple fractures of the skull (803.0-804.9); intracranial injury, including concussion, contusion, laceration, and hemorrhage (850.0-854.1); injury to the optic chiasm, optic pathways, or visual cortex (950.1-950.3); unspecified head injury (959.01); and shaken infant syndrome (995.55). 23,24 Discharge records associated with venous thromboembolism (VTE) were identified using the ICD- …”

Section: Patient Selectionmentioning

confidence: 99%

Venous thromboembolism in the setting of pediatric traumatic brain injury

Harris¹,

Lam²

2014

PED

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Object The risk of venous thromboembolism (VTE) in children with traumatic brain injury (TBI) has not been well characterized given its rarity in the pediatric population. Investigation of risk factors for VTE in this group requires the use of a large sample size. Using nationally representative hospital discharge data for 2009, the authors of this study characterize the incidence and risk factors for VTE in children hospitalized for TBI. Methods The authors conducted a cross-sectional study using data from the Healthcare Cost and Utilization Project Kids' Inpatient Database to examine VTE in TBI-associated hospitalizations for patients 20 years of age or younger during the year 2009. Results There were 58,529 children with TBI-related admissions, including 267 with VTE diagnoses. Venous thromboembolisms occurred in 4.6 per 1000 TBI-associated hospitalizations compared with 1.2 per 1000 pediatric hospitalizations overall. By adjusted logistic regression, patients significantly more likely to be diagnosed with VTE had the following: older age of 15–20 years (adjusted odds ratio [aOR] 3.7, 95% CI 1.8–8.0), venous catheterization (aOR 3.0, 95% CI 2.0–4.6), mechanical ventilation (aOR 1.9, 95% CI 1.2–2.9), tracheostomy (aOR 2.3, 95% CI 1.3–4.0), nonaccidental trauma (aOR 2.8, 95% CI 1.1–6.9), increased length of stay (aOR 1.02, 95% CI 1.01–1.03), orthopedic surgery (aOR 2.4, 95% CI 1.8–3.4), and cranial surgery (aOR 1.8, 95% CI 1.1–2.8). Conclusions Using the Kids' Inpatient Database, the authors found that risk factors for VTE in the setting of TBI in the pediatric population include older age, venous catheterization, nonaccidental trauma, increased length of hospital stay, orthopedic surgery, and cranial surgery.

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“…It is also possible that we underestimated TBI rates, because Shore et al 13 showed some underreporting, especially of mild TBIs, in hospital discharge data. As in other hospital discharge data-based studies, we could not detect patients who died before hospitalization or were not admitted as inpatients.…”

mentioning

confidence: 96%

Youth Motorcycle-Related Hospitalizations and Traumatic Brain Injuries in the United States in 2006

2010

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WHAT'S KNOWN ON THIS SUBJECT:Youth motorcycle traumatic brain injury (TBI) is one of the few areas in which rates of hospitalized TBI among children have been increasing rapidly, and we need a better understanding of the national burden. WHAT THIS STUDY ADDS:Our findings describe the burden of motorcycle-related injuries and TBIs in both traffic and non-traffic domains and describe the TBI burden on the basis of a very large sample, with the most-precise national estimates ever reported. abstract OBJECTIVES:The objectives were to provide national injury and health care cost estimates for youth motorcycle injuries in traffic and nontraffic settings and to focus on the burden of serious motorcyclerelated traumatic brain injuries (TBIs) in children and young adults. METHODS:The 2006 Kids' Inpatient Database is a sample of inpatient discharges for US patients Ͻ21 years of age from 38 states. This crosssectional analysis of the 2006 Kids' Inpatient Database included comparisons of TBI versus non-TBI and traffic versus nontraffic motorcyclerelated crashes for ages 12 to 20, with national estimates of hospital charges and costs, length of stay, severity, and long-term disability rates. RESULTS:Motorcycle-related crashes accounted for 5662 discharges (95% confidence interval: 5201-6122 discharges), which amounts to 3% of injury hospitalizations among youths and 5% of TBI diagnoses; two-thirds of cases were traffic-related, and one-third of patients sustained a TBI (1793 patients [95% confidence interval: 1631-1955 patients]). Among patients with TBIs, the overall probability of long-term disability was 24%. Patients with TBIs were 3.6 times more likely to be discharged to a rehabilitation facility and Ͼ10 times more likely to die in the hospital than were patients without TBIs. CONCLUSIONS:Motorcycle injuries are a substantial cause of youth injury hospitalizations. The large proportion, costs, and morbidity of TBI diagnoses in youth motorcycle crashes emphasize the need for effective crash prevention and head protection. The numbers of motorcycle deaths and injuries are increasing because of increased use of motorcycles for recreation, their appeal as a fuel-saving mode of travel, and repeals of state universal helmet laws. 1 Unfortunately, these trends also hold for young adults and children. The Centers for Disease Control and Prevention (CDC) reported that the motorcyclist death rate for ages 12 to 20 was 0.52 deaths per 100 000 population in 1999 and increased to 0.98 deaths per 100 000 population in 2006, an 88% increase. 2 In a recent review of trends in hospitalized traumatic brain injury (TBI) cases, Bowman et al 3 reported a significant increase in teenage male TBI hospitalization rates from 1998 to 2005 for motorcycle crashes, one of the very few TBI mechanisms that showed an increase over the study period.The purpose of this article is to describe more fully and to compare the national burden of motorcycle injuries and motorcycle-related TBIs in both traffic and nontraffic domains. This study describes the y...

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Validity of administrative data for characterizing traumatic brain injury-related hospitalizations

Abstract: TBI cases, especially mild ones, were under-reported by MHD data. MHD data are better at detecting anatomic injuries compared to TBI symptoms and sequella.

Cited by 41 publications

References 12 publications

Traumatic Brain Injury in Portugal: Trends in Hospital Admissions from 2000 to 2010

Traumatic Brain Injury in Portugal: Trends in Hospital Admissions from 2000 to 2010

Venous thromboembolism in the setting of pediatric traumatic brain injury

Youth Motorcycle-Related Hospitalizations and Traumatic Brain Injuries in the United States in 2006

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