Online Program

285342
Examination of multiple injuries and comorbidities in persons hospitalized with traumatic brain injury using national-level data — United States, 2006–2010


Wednesday, November 6, 2013

Christopher Taylor, PhD, Alzheimer's Disease and Healthy Aging Program, Centers for Disease Control and Prevention (CDC), Atlanta, GA
Jeneita Bell, MD, MPH, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Victor Coronado, MD, MPH, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Juliet Haarbauer-Krupa, PhD, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Michael Lionbarger, MPH, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
Lisa McGuire, PhD, Division of Population Health, Centers for Disease Control and Prevention, Chamblee, GA
Likang Xu, MD, MS, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA
David Sugerman, MD, MPH, Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control, Atlanta, GA
Background: In persons with traumatic brain injury (TBI), the presence of either non-TBI co-occurring injuries or comorbidities may increase hospitalization lengths of stay or complicate recovery. Co-occurring injuries and comorbidities among persons hospitalized with TBI have not been described at a national level in the US. Methods: Data from the 2006–2010 Healthcare Cost and Utilization Project, Nationwide Inpatient Sample were analyzed for hospitalizations with TBI listed as the principal or secondary diagnosis. Both co-occurring injuries and comorbidities were identified. Co-occurring injuries were categorized using the Barell Injury Diagnosis Matrix. Comorbidities were classified using Elixhauser categories. Data are presented as averages over the study period. Results: Co-occurring injuries were present in 65.2% of 315,619 TBI hospitalizations. The most common co-occurring injuries were open wounds of the head and neck (N=75,757), extremity fractures (N=55,257), head and neck contusions and superficial injuries (N=44,809), and non-TBI head and neck fractures (N=43,343). Depending on their age group, between 75%–90% of persons with transportation-related TBIs had co-occurring injuries. Comorbidities were diagnosed in 68.7% of TBI hospitalizations. The most common comorbid diseases included hypertension (33.7%), fluid and electrolyte disorders (17.2%), alcohol abuse (15.2%), uncomplicated diabetes (10.8%), and chronic pulmonary disease (9.5%). Other comorbid diseases also included other neurologic disorders (5.2%) and drug abuse (5.1%). Conclusions: Additional injuries and non-injury comorbid diseases were frequently found among persons hospitalized and diagnosed with TBI. Medical and public health professionals should understand how these conditions may affect outcomes in persons with TBI.

Learning Areas:

Epidemiology

Learning Objectives:
Describe hospitalizations associated with traumatic brain injury with and without co-occurring injuries or comorbidities using national-level data.

Keyword(s): Injury, Traumatic Brain Injury

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have several years experience related to traumatic brain injury research as well as invaluable experience as a physician treated injured persons in an Emergency Department setting.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.