Revisits, readmissions, and outcomes for pediatric traumatic brain injury in California, 2005-2014


Autoři: Renee Y. Hsia aff001;  Rebekah C. Mannix aff003;  Joanna Guo aff001;  Aaron E. Kornblith aff001;  Feng Lin aff005;  Peter E. Sokolove aff001;  Geoffrey T. Manley aff006
Působiště autorů: Department of Emergency Medicine, University of California, San Francisco, California, United States of America aff001;  Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, California, United States of America aff002;  Division of Emergency Medicine, Boston Children’s Hospital, Boston, Massachusetts, United States of America aff003;  Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America aff004;  Department of Biostatistics and Epidemiology, University of California, San Francisco, California, United States of America aff005;  Brain and Spinal Injury Center (BASIC), University of California, San Francisco, California, United States of America aff006;  Department of Neurological Surgery, University of California, San Francisco, California, United States of America aff007
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227981

Souhrn

Long-term outcomes related to emergency department revisit, hospital readmission, and all-cause mortality, have not been well characterized across the spectrum of pediatric traumatic brain injury (TBI). We evaluated emergency department visit outcomes up to 1 year after pediatric TBI, in comparison to a referent group of trauma patients without TBI. We performed a longitudinal, retrospective study of all pediatric trauma patients who presented to emergency departments and hospitals in California from 2005 to 2014. We compared emergency department visits, dispositions, revisits, readmissions, and mortality in pediatric trauma patients with a TBI diagnosis to those without TBI (Other Trauma patients). We identified 208,222 pediatric patients with an index diagnosis of TBI and 1,314,064 patients with an index diagnosis of Other Trauma. Population growth adjusted TBI visits increased by 5.6% while those for Other Trauma decreased by 40.7%. The majority of patients were discharged from the emergency department on their first visit (93.2% for traumatic brain injury vs. 96.5% for Other Trauma). A greater proportion of TBI patients revisited the emergency department (33.4% vs. 3.0%) or were readmitted to the hospital (0.9% vs. 0.04%) at least once within a year of discharge. The health burden within a year after a pediatric TBI visit is considerable and is greater than that of non-TBI trauma. These data suggest that outpatient strategies to monitor for short-term and longer-term sequelae after pediatric TBI are needed to improve patient outcomes, lessen the burden on families, and more appropriately allocate resources in the healthcare system.

Klíčová slova:

California – Critical care and emergency medicine – Diagnostic medicine – Hospitals – Inpatients – Insurance – Pediatrics – Traumatic brain injury


Zdroje

1. Taylor CA, Bell JM, Breiding MJ, Xu L. Traumatic brain injury-related emergency department visits, hospitalizations, and deaths—United States, 2007 and 2013. MMWR. 2017;66(9):1–16. doi: 10.15585/mmwr.ss6609a1 28301451

2. National Center for Injury Prevention and Control. Report to congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta, GA: Centers for Disease Control and Prevention; 2003. https://www.cdc.gov/traumaticbraininjury/pdf/mtbireport-a.pdf

3. Lumba-Brown A, Yeates KO, Sarmiento K, Breiding MJ, Haegerich TM, Gioia GA, et al. Diagnosis and management of mild traumatic brain injury in children: a systematic review. JAMA Pediatr. 2018;30341: e182847.

4. Schneier AJ, Shields BJ, Hostetler SG, Xiang H, Smith GA. Incidence of pediatric traumatic brain injury and associated hospital resource utilization in the United States. Pediatrics. 2006;118(2): 483–92. doi: 10.1542/peds.2005-2588 16882799

5. Lloyd J, Wilson ML, Tenovuo O, Saarijarvi S. Outcomes from mild and moderate traumatic brain injuries among children and adolescents: a systematic review of studies from 2008–2013. Brain Inj. 2015;29(5): 539–49. doi: 10.3109/02699052.2014.1002003 25790086

6. Van Beek L, Ghesquiere P, Lagae L, De Smedt B. Mathematical difficulties and white matter abnormalities in subacute pediatric mild traumatic brain injury. J Neurotrauma. 2015;32(20): 1567–78. doi: 10.1089/neu.2014.3809 25915107

7. Wade SL, Zhang N, Yeates KO, Stancin T, Taylor HG. Social environmental moderators of long-term functional outcomes of early childhood brain injury. JAMA Pediatr. 2016;170(4): 343–9. doi: 10.1001/jamapediatrics.2015.4485 26902662

8. Ryan NP, Anderson V, Godfrey C, Beauchamp MH, Coleman L, Eren S, et al. Predictors of very-long-term sociocognitive function after pediatric traumatic brain injury: evidence for the vulnerability of the immature “social brain”. J Neurotrauma. 2014;31(7): 649–57. doi: 10.1089/neu.2013.3153 24147615

9. Prasad MR, Swank PR, Ewing-Cobbs L. Long-term school outcomes of children and adolescents with traumatic brain injury. J Head Trauma Rehabil. 2017;32(1): E24–32. doi: 10.1097/HTR.0000000000000218 26828713

10. Hessen E, Nestvold K, Anderson V. Neuropsychological function 23 years after mild traumatic brain injury: a comparison of outcome after paediatric and adult head injuries. Brain Inj. 2007;21(9): 963–79. doi: 10.1080/02699050701528454 17729049

11. Huebner ARS, Cassedy A, Brown TM, Taylor HG, Stancin T, Kirkwood MW, et al. Use of mental health services by adolescents after traumatic brain injury: a secondary analysis of a randomized controlled trial. PM R. 2018;10(5): 462–71. doi: 10.1016/j.pmrj.2017.10.004 29097272

12. Karver CL, Kurowski B, Semple EA, Stancin T, Taylor HG, Yeates KO, et al. Utilization of behavioral therapy services long-term after traumatic brain injury in young children. Arch Phys Med Rehabil. 2014;95(8): 1556–63. doi: 10.1016/j.apmr.2014.03.030 24755047

13. Slomine BS, McCarthy ML, Ding R, MacKenzie EJ, Jaffe KM, Aitken ME, et al. Health care utilization and needs after pediatric traumatic brain injury. Pediatrics. 2006;117(4): e663–74. doi: 10.1542/peds.2005-1892 16533894

14. Fuentes MM, Wang J, Haarbauer-Krupa J, Yeates KO, Durbin D, Zonfrillo MR, et al. Unmet rehabilitation needs after hospitalization for traumatic brain injury. Pediatrics. 2018;141(5).

15. Max JE. Neuropsychiatry of pediatric traumatic brain injury. Psychiatric Clin North Am. 2014;37(1): 125–40.

16. Olsen AB, Hetz RA, Xue H, Aroom KR, Bhattarai D, Johnson E, et al. Effects of traumatic brain injury on intestinal contractility. Neurogastroenterol Motil. 2013;25(7): 593–e463. doi: 10.1111/nmo.12121 23551971

17. Purcell LK. Sport-related concussion: evaluation and management. Paediatr Child Health. 2014;19(3): 153–65. doi: 10.1093/pch/19.3.153 24665227

18. Aitken ME, McCarthy ML, Slomine BS, Ding R, Durbin DR, Jaffe KM, et al. Family burden after traumatic brain injury in children. Pediatrics. 2009;123(1): 199–206. doi: 10.1542/peds.2008-0607 19117883

19. McCrea M, Manley G. State of the science on pediatric mild traumatic brain injury: progress toward clinical translation. JAMA Pediatr. 2018;172(11): e182846. doi: 10.1001/jamapediatrics.2018.2846 30193296

20. Babikian T, Satz P, Zaucha K, Light R, Lewis RS, Asarnow RF. The UCLA longitudinal study of neurocognitive outcomes following mild pediatric traumatic brain injury. J Int Neuropsychol Soc. 2011;17(5): 886–95. doi: 10.1017/S1355617711000907 21813031

21. Sesma HW, Slomine BS, Ding R, McCarthy ML. Executive functioning in the first year after pediatric traumatic brain injury. Pediatrics. 2008;121(6): e1686–95. doi: 10.1542/peds.2007-2461 18519472

22. National Center for Injury Prevention and Control. WISQARS cost of injury reports help menu: section 3.2 mechanism (cause) of injury. Atlanta, GA; 2014. https://www.cdc.gov/injury/wisqars/cost_help/mechanism_injury.html

23. Geiger AA, DeRoon-Cassini T, Brasel KJ. Considering the patient’s perspective in the injury severity score. J Surg Res. 2011;170(1): 133–8. doi: 10.1016/j.jss.2011.03.026 21550062

24. Bolorunduro OB, Villegas C, Oyetunji TA, Haut ER, Stevens KA, Chang DC, et al. Validating the injury severity score (ISS) in different populations: ISS predicts mortality better among Hispanics and females. J Surg Res. 2011;166(1): 40–4. doi: 10.1016/j.jss.2010.04.012 20828742

25. Vashi AA, Fox JP, Carr BG, D’Onofrio G, Pines JM, Ross JS, et al. Use of hospital-based acute care among patients recently discharged from the hospital. JAMA. 2013;309(4): 364. doi: 10.1001/jama.2012.216219 23340638

26. Sabbatini AK, Kocher KE, Basu A, Hsia RY. In-hospital outcomes and costs among patients hospitalized during a return visit to the emergency department. JAMA. 2016;315(7): 663. doi: 10.1001/jama.2016.0649 26881369

27. Gabayan GZ, Asch SM, Hsia RY, Zingmond D, Liang L-J, Han W, et al. Factors associated with short-term bounce-back admissions after emergency department discharge. Ann Emerg Med. 2013;62(2): 136–144.e1. doi: 10.1016/j.annemergmed.2013.01.017 23465554

28. Hsia RY, Markowitz AJ, Lin F, Guo J, Madhok DY, Manley GT. Ten-year trends in traumatic brain injury: an evaluation of California emergency department and hospital revisits and readmissions. BMJ Open. 2018;8(12): e022297. doi: 10.1136/bmjopen-2018-022297 30552250

29. Sarmiento K, Hoffman R, Dmitrovsky Z, Lee R. A 10-year review of the Centers for Disease Control and Prevention’s Heads Up initiatives: bringing concussion awareness to the forefront. J Safety Res. 2014;50: 143–7. doi: 10.1016/j.jsr.2014.05.003 25142371

30. Cho CS, Shapiro DJ, Cabana MD, Maselli JH, Hersh AL. A national depiction of children with return visits to the emergency department within 72 hours, 2001–2007. Pediatr Emerg Care. 2012;28(7): 606–10. doi: 10.1097/PEC.0b013e31825cf7cf 22743754

31. Alpern ER, Clark AE, Alessandrini EA, Gorelick MH, Kittick M, Stanley RM, et al. Recurrent and high-frequency use of the emergency department by pediatric patients. Acad Emerg Medicine. 2014;21(4): 365–73.

32. Duseja R, Bardach NS, Lin GA, Yazdany J, Dean ML, Clay TH, et al. Revisit rates and associated costs after an emergency department encounter: a multistate analysis. Ann Intern Med. 2015;162(11): 750–6. doi: 10.7326/M14-1616 26030633

33. Seabury SA, Gaudette É, Goldman DP, Markowitz AJ, Brooks J, McCrea MA, et al. Assessment of follow-up care after emergency department presentation for mild traumatic brain injury and concussion: results from the TRACK-TBI study. JAMA Netw Open. 2018;1(1): e180210. doi: 10.1001/jamanetworkopen.2018.0210 30646055


Článek vyšel v časopise

PLOS One


2020 Číslo 1