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Hospitalizations and Emergency Department Visits for TBI in Ontario

Published online by Cambridge University Press:  23 September 2016

Angela Colantonio ,
Cristina Saverino ,
Brandon Zagorski ,
Bonnie Swaine ,
John Lewko ,
Susan Jaglal  and
Lee Vernich
Angela Colantonio*
Affiliation:
Acquired Brain Injury Research, Toronto, Rehabilitation Institute
Cristina Saverino
Affiliation:
Department of Occupational Therapy, Toronto, Rehabilitation Institute
Brandon Zagorski
Affiliation:
Department of Programming and Biostatistics, Institute for Clinical Evaluative Sciences, Toronto
Bonnie Swaine
Affiliation:
Physiotherapy Program, School of Rehabilitation, Université de Montréal, Montréal, Quebec, Canada
John Lewko
Affiliation:
Centre for Research in Human Development, Laurentian University, Sudbury, Ontario
Susan Jaglal
Affiliation:
Department of Physical Therapy, Toronto, Rehabilitation Institute
Lee Vernich
Affiliation:
Dalla Lana School of Public Health, Research Services, University of Toronto
*
Saunderson Family Chair in Acquired Brain Injury Research, Toronto Rehabilitation Institute, University of Toronto, 160-500 University Ave., Room 950, Toronto, Ontario, M5G 1V7, Canada
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Abstract

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Objective:

The aim of this study was to determine the number of annual hospitalizations and overall episodes of care that involve a traumatic brain injury (TBI) by age and gender in the province of Ontario. To provide a more accurate assessment of the prevalence of TBI, episodes of care included visits to the emergency department (ED), as well as admissions to hospital. Mechanisms of injury for overall episodes were also investigated.

Methods:

Traumatic brain injury cases from fiscal years 2002/03-2006/07 were identified by means of ICD-10 codes. Data were collected from the National Ambulatory Care Reporting System and the Discharge Abstract Database.

Results:

The rate of hospitalization was highest for elderly persons over 75 years-of-age. Males generally had higher rates for both hospitalizations and episodes of care than did females. The inclusion of ED visits to hospitalizations had the greatest impact on the rates of TBI in the youngest age groups. Episodes of care for TBI were greatest in youth under the age of 14 and elderly over the age of 85. Falls (41.6%) and being struck by or against an object (31.1%) were the most frequent causes for a TBI.

Conclusions:

The study provides estimates for TBI from the only Canadian province that has systematically captured ED visits in a national registry. It shows the importance of tracking ED visits, in addition to hospitalizations, to capture the burden of TBI on the health care system. Prevention strategies should include information on ED visits, particularly for those at younger ages.

Résumé

RésuméObjectif:

Le but de cette étude était de déterminer le nombre annuel d'hospitalisations et de demandes de soins en général motivés par une lésion cérébrale traumatique (LCT) selon l'âge et le sexe dans la province d'Ontario. Afin de fournir une évaluation plus exacte de la prévalence des LCT, les visites à l'urgence et les admissions à l'hôpital ont été comptabilisées comme demandes de soins. Les mécanismes du traumatisme pour tous les épisodes ont également été examinés.

Méthodologie:

Les cas de LCT survenus au cours des années fiscales 2002/03 - 2006/07 ont été identifiés au moyen des codes CIM-10. Les données ont été tirées du Système national d'information sur les soins ambulatoires et de la Base de données sur les congés des patients.

Résultats:

Le taux d'hospitalisation était plus élevé chez les personnes de plus de 75 ans. Les hommes avaient généralement des taux d'hospitalisations et d'épisodes de soins plus élevés que les femmes. Le fait de comptabiliser les visites à l'urgence avec les hospitalisations avait l'impact le plus grand sur les taux de LCT chez les groupes d'âges inférieurs. Les épisodes de soins pour LCT étaient plus élevés chez les jeunes de moins de 14 ans et chez les gens âgés de plus de 85 ans. Les chutes (41,6%) et le fait d'être frappé par ou contre un objet (31,1%) étaient les causes les plus fréquentes de LCT.

Conclusions:

Cette étude fournit des estimés de LCT dans la seule province canadienne qui inscrit a systématiquement les visites à l'urgence dans un registre nationale. Elle montre l'importance de faire le suivi des visites à l'urgence en plus des hospitalisations pour apprécier le fardeau que constitue la LCT sur le système de santé. Les stratégies de prévention devraient mentionner l'information sur les visites à l'urgence, particulièrement chez les jeunes.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 37 , Issue 6 , November 2010 , pp. 783 - 790
Copyright
Copyright © The Canadian Journal of Neurological 2010

References

1. Greenwald, BD, Burnett, DM, Miller, MA. Brain injury: epidemiology and pathophysiology. Arch Phys Med Rehab. 2003;84(3 Suppl 1):S3–7.Google Scholar
2. Pickett, W, Simpson, K, Brison, JR. Rates and external causes of blunt head trauma in Ontario: analysis and review of Ontario trauma registry datasets. Chronic Dis Can. 2004;25(1):32–41.AMBIGUOUS 15554610,15298486Google Scholar
3. Thurman, D, Guerrero, J. Trends in hospitalization associated with traumatic brain injury. JAMA. 1999;282(10):954–7.10.1001/jama.282.10.95410485680Google Scholar
4. Colantonio, A, Croxford, R, Farooq, S, Laporte, A, Coyote, P. Trends in hospitalization associated with traumatic brain injury, 1992–2002. J Trauma. 2009;66(1):179–83.10.1097/TA.0b013e3181715d6619131822Google Scholar
5. Rutland-Brown, W, Langlois, JA, Thomas, KE, Lily, YL. Incidence of traumatic brain injury in the United States, 2003. J Head Trauma Rehabil. 2006;21(6):544–8.10.1097/00001199-200611000-0000917122685Google Scholar
6. Selassie, AW, McCarthy, ML, Pickelsimer, EE. The influence of insurance, race, and gender on emergency department disposition. Acad Emerg Med. 2003;10(11):1260–70.10.1111/j.1553-2712.2003.tb00611.x14597503Google Scholar
7. Belanger, HG, Curtiss, G, Demery, JA, Lebowitz, BK, Vanderploeg, RD. Factors moderating neuropsychological outcomes following mild traumatic brain injury: a meta-analysis. J Int Neuropsychol Soc. 2005;11(3):215–27.15892898Google Scholar
8. Carroll, L, Cassidy, JD, Peloso, P, et al. Prognosis for mild traumatic brain injury: results of the WHO collaborating centre task force on mild traumatic brain injury. J Rehabil Med. 2004;36 Suppl 43:84–105.10.1080/16501960410023859Google Scholar
9. McCrea, M, Kelly, JP, Randolph, C, Cisler, R, Berger, L. Immediate neurocognitive effects of concussion. Neurosurgery. 2002;50(5):1032–40.11950406Google Scholar
10. Alexander, MP. Mild traumatic brain injury — pathophysiology, natural-history, and clinical management. Neurology. 1995;45(7):1253–60.10.1212/WNL.45.7.12537617178Google Scholar
11. Cicerone, KD, Kalmar, K. Persistent postconcussion syndrome: the structure of subjective complaints after mild traumatic brain injury. J Head Trauma Rehab. 1995;10(3):1–17.Google Scholar
12. Rimel, RW, Giordani, B, Barth, JT, Boll, TJ, Jane, JA. Disability caused by minor head-injury. Neurosurgery.1981;9(3):221–8.10.1227/00006123-198109000-00001Google Scholar
13. O’Connor, C, Colantonio, A, Polatajko, H. Long term symptoms and activity limitations after traumatic brain injury: a ten year follow-up. Psychol Rep. 2005;97(1):169–79.Google Scholar
14. Vanderploeg, RD, Curtiss, G, Luis, CA, Salazar, AM. Long-term morbidities following self-reported mild traumatic brain injury. J Clin Exp Neuropsychol. 2007;29(6):585–98.10.1080/13803390600826587Google Scholar
15. Pickett, W, Ardern, C, Brison, JR. A population-based study of potential brain injuries requiring emergency care. CMAJ. 2001;165(3):288–92.Google Scholar
16. The burden of neurological diseases, disorders and injuries in Canada: Head injury [Internet]. Ottawa: The Canadian Institute of Heath Information (CIHI); 2007 [cited 2008 Jan 20]. Available from: http://www.icis.ca/cihiweb/dispPage.jsp?cw_page=AR_1689_E.Google Scholar
17. Data quality documentation: discharge abstract database 2002–2003 [Internet]. Ottawa: The Canadian Institute of Heath Information (CIHI); 2007 [cited 2008 Jan 20] Available from: http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=GR_1869_E.Google Scholar
18. Juurlink, D, Preyra, C, Croxford, R, et al. Canadian Institute for Health Information Discharge Abstract Database: a validation study. Toronto (ON): ICES; 2006.Google Scholar
19. Richard, J, Brown, A, Homan, C. The data quality study of the Canadian discharge abstract database. In: Proceedings of Statistics Canada International Symposium Series. Achieving data quality in a statistical agency: a methodological perspective. Ottawa (ON): Statistics Canada; 2001.Google Scholar
20. Data Quality Study of Emergency Department Visits for 2004–2005: Volume II of IV – Main Study Findings. Ottawa (ON): CIHI; 2008.Google Scholar
21. Marr, A, Coronado, V. Central nervous system surveillance data submission standards [Internet]. Atlanta: Centre for Disease Control and Prevention, National Center for Injury Prevention and Control; 2002 [cited 2008 March 15]. Available from: http://www.cdc.gov/ncipc/dir/2002cnsistrds.pdf.Google Scholar
22. Bazarian, JJ, McClung, J, Shah, MN, Cheng, YT, Flesher, W, Kraus, J. Mild traumatic brain injury in the United States, 1998--2000. Brain Inj. 2005;19(2):85–91.10.1080/02699050410001720158Google Scholar
23. International Collaborative Effort on Injury Statistics. Atlanta: Centre for Disease Control and Prevention, National Center for Injury Prevention and Control; 2007 [cited 2002 December 2]. Available from: http://www.cdc.gov/nchs/injury.htm. Google Scholar
24. Statscan. [cited 2008 Jan 10] Available from: http://wwwstatcan.gc.ca. Google Scholar
25. Day, H, Roesler, J, Gaichas, A, Kinde, M. Epidemiology of emergency department-treated traumatic brain injury in Minnesota. Minn Med. 2006;89(5):40–4.Google Scholar
26. Guerrero, JL, Thurman, DJ, Sniezek, JE. Emergency department visits associated with traumatic brain injury: United States, 1995–1996. Brain Inj. 2000;14(2):181–6.10.1080/026990500120835Google Scholar
27. Jager, TE, Weiss, HB, Coben, JH, Pepe, PE. Traumatic brain injuries evaluated in U.S. emergency departments, 1992–1994. Acad Emerg Med. 2000;7(2):134–40.10.1111/j.1553-2712.2000.tb00515.x10691071Google Scholar
28. Schootman, M, Fuortes, LJ. Ambulatory care for traumatic brain injuries in the US, 1995–1997. Brain Inj. 2000;14(4):373–81.10.1080/02699050012066410815845Google Scholar
29. Baldo, V, Marcolongo, A, Floreani, A, et al. Epidemiological aspect of traumatic brain injury in northeast Italy. Eur J Epidemiol. 2003;18(11):1059–63.10.1023/A:102619202096314620940Google Scholar
30. Hillier, SL, Hiller, JE, Metzer, J. Epidemiology of traumatic brain injury in South Australia. Brain Inj. 1997;11(9):649–59.10.1080/0269905971232059376833Google Scholar
31. Peloso, PM, von Holst, H, Borg, J. Mild traumatic brain injuries presenting to Swedish hospitals in 1987–2000. J Rehabil Med.2004;36 Suppl 43: 22–7.Google Scholar
32. Jacobsson, LJ, Westerberg, M, Lexell, J. Demographics, injury characteristics and outcome of traumatic brain injuries in northern Sweden. Acta Neuro Scan. 2007;116(5):300–6.10.1111/j.1600-0404.2007.00896.xGoogle Scholar
33. Koskinen, S, Alaranta, H. Traumatic brain injury in Finland 1991–2005: a nationwide register study of hospitalized and fatal TBI. Brain Inj. 2008;22(3):205–14.10.1080/0269905080193897518297592Google Scholar
34. Boswell, JE, McErlean, M, Verdile, VP. Prevalence of traumatic brain injury in an ED population. Am J Emerg Med. 2002;20(3):177–80.10.1053/ajem.2002.3264111992336Google Scholar
35. Injury prevention [Internet]. Ottawa: Public Health Agency of Canada (PHAC); 2002 [cited 2008 Dec 10]. Available from: http://www.phac-aspc.gc.ca/inj-bles/index-eng.php. Google Scholar
36. Deb, S. ICD-10 codes detect only a proportion of all head injury admissions. Brain Inj. 1999;13(5):369–73.10.1080/02699059912155710367147Google Scholar
37. Ryu, WHA, Feunstein, A, Colantonio, A, Streiner, DL, Dawson, D. Early identification and incidence of mild TBI in Ontario. Can J Neurol Sci. 2009;36(4):429–35.10.1017/S031716710000774519650352Google Scholar
38. Kostylova, A, Swaine, B, Feldman, D. Concordance between childhood injury diagnoses from two sources: an injury surveillance system and a physician billing claims database. Inj Prev. 2005;11(3):186–90.10.1136/ip.2004.00658515933413Google Scholar
39. Bazarian, JJ, Veazie, P, Mookerjee, S, Lerner, EB. Accuracy of mild traumatic brain injury case ascertainment using ICD-9 codes. Acad Emerg Med. 2006;13(1):31–8.10.1111/j.1553-2712.2006.tb00981.x16365331Google Scholar