Increased Rates of Mild Traumatic Brain Injury Among Older Adults in US Emergency Departments, 2009-2010

Jennifer S. Albrecht, Jon Mark Hirshon, Maureen McCunn, Kathleen Bechtold Kortte, Vani A Rao, Linda Simoni-Wastila, Gordon S. Smith

Research output: Contribution to journalArticle

Abstract

OBJECTIVE:: To estimate rates of emergency department (ED) visits for mild traumatic brain injury (TBI) among older adults. We defined possible mild TBI cases to assess underdiagnoses. DESIGN:: Cross-sectional. SETTING:: National sample of ED visits in 2009-2010 captured by the National Hospital Ambulatory Medical Care Survey. PARTICIPANTS:: Aged 65 years and older. MEASUREMENTS:: Mild TBI defined by International Classification of Diseases, Ninth Revision, Clinical Modification, codes (800.0x-801.9x, 803.xx, 804.xx, 850.xx-854.1x, 950.1x-950.3x, 959.01) and a Glasgow Coma Scale score of 14 or more or missing, excluding those admitted to the hospital. Possible mild TBI was defined similarly among those without mild TBI and with a fall or motor vehicle collision as cause of injury. We calculated rates of mild TBI and examined factors associated with a diagnosis of mild TBI. RESULTS:: Rates of ED visits for mild TBI were 386 per 100 000 among those aged 65 to 74 years, 777 per 100 000 among those aged 75 to 84 years, and 1205 per 100 000 among those older than 84 years. Rates for women (706/100 000) were higher than for men (516/100 000). Compared with a possible mild TBI, a diagnosis of mild TBI was more likely in the West (odds ratio = 2.31; 95% confidence interval, 1.02-5.24) and less likely in the South/Midwest (odds ratio = 0.52; 95% confidence interval, 0.29-0.96) than in the Northeast. CONCLUSIONS:: This study highlights an upward trend in rates of ED visits for mild TBI among older adults.

Original languageEnglish (US)
JournalJournal of Head Trauma Rehabilitation
DOIs
StateAccepted/In press - Oct 16 2015

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Brain Concussion
Hospital Emergency Service
Odds Ratio
Confidence Intervals
Health Care Surveys
Glasgow Coma Scale
International Classification of Diseases
Motor Vehicles

ASJC Scopus subject areas

  • Rehabilitation
  • Clinical Neurology
  • Physical Therapy, Sports Therapy and Rehabilitation

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Increased Rates of Mild Traumatic Brain Injury Among Older Adults in US Emergency Departments, 2009-2010. / Albrecht, Jennifer S.; Hirshon, Jon Mark; McCunn, Maureen; Kortte, Kathleen Bechtold; Rao, Vani A; Simoni-Wastila, Linda; Smith, Gordon S.

In: Journal of Head Trauma Rehabilitation, 16.10.2015.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE:: To estimate rates of emergency department (ED) visits for mild traumatic brain injury (TBI) among older adults. We defined possible mild TBI cases to assess underdiagnoses. DESIGN:: Cross-sectional. SETTING:: National sample of ED visits in 2009-2010 captured by the National Hospital Ambulatory Medical Care Survey. PARTICIPANTS:: Aged 65 years and older. MEASUREMENTS:: Mild TBI defined by International Classification of Diseases, Ninth Revision, Clinical Modification, codes (800.0x-801.9x, 803.xx, 804.xx, 850.xx-854.1x, 950.1x-950.3x, 959.01) and a Glasgow Coma Scale score of 14 or more or missing, excluding those admitted to the hospital. Possible mild TBI was defined similarly among those without mild TBI and with a fall or motor vehicle collision as cause of injury. We calculated rates of mild TBI and examined factors associated with a diagnosis of mild TBI. RESULTS:: Rates of ED visits for mild TBI were 386 per 100 000 among those aged 65 to 74 years, 777 per 100 000 among those aged 75 to 84 years, and 1205 per 100 000 among those older than 84 years. Rates for women (706/100 000) were higher than for men (516/100 000). Compared with a possible mild TBI, a diagnosis of mild TBI was more likely in the West (odds ratio = 2.31; 95{\%} confidence interval, 1.02-5.24) and less likely in the South/Midwest (odds ratio = 0.52; 95{\%} confidence interval, 0.29-0.96) than in the Northeast. CONCLUSIONS:: This study highlights an upward trend in rates of ED visits for mild TBI among older adults.",
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AU - Rao, Vani A

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