CDC's efforts to improve traumatic brain injury surveillance

Bell, Jeneita M.; Breiding, Matthew J.; DePadilla, Lara

doi:10.1016/j.jsr.2017.04.002

Cited by 43 publications

(47 citation statements)

References 12 publications

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“…The prevalence of concussions in the current study is higher than estimates based on emergency department data (e.g., 622.5 visits per 100,000 population aged 10–14 years) ( 5 ) and athletic trainer reports (e.g., 1.8 per 100 high school and college athletes for an average season) ( 6 ). Emergency department data miss concussions treated elsewhere, and athletic trainer reports miss concussions sustained outside of school-based sports; both sources miss medically untreated concussions ( 2 ). …”

Section: Discussionmentioning

confidence: 99%

“…This study, and state-level YRBS data ( 4 ), support this conclusion by suggesting that many concussions among youths are not being counted and might also indicate that similar comprehensive estimates below the high school level are needed. To that end, CDC is working toward developing a National Concussion Surveillance System to determine the incidence and identify the circumstances of concussions, and all traumatic brain injuries, across the lifespan ( 2 ). …”

Section: Discussionmentioning

confidence: 99%

“…Surveillance methods used to monitor concussions among youths likely underestimate the prevalence. Estimates assessed from emergency departments miss concussions treated outside hospitals, those generated using high school athletic trainer reports miss concussions sustained outside of school-based sports ( 2 ), and both sources miss medically untreated concussions. To estimate the prevalence of concussions among U.S. high school students related to playing a sport or being physically active, CDC analyzed data from the 2017 national Youth Risk Behavior Survey (YRBS).…”

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confidence: 99%

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Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017

DePadilla¹,

Miller²,

Jones³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017

DePadilla¹,

Miller²,

Jones³

et al. 2018

MMWR Morb. Mortal. Wkly. Rep.

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“…In the absence of a national surveillance system, current efforts to collect data about the incidence of concussion via athlete self-report is needed (Bell, Breiding, & DePadilla, 2017). Wojtowicz, Iverson, Silverberg, Mannix, et al (2017) found that high school athletes reliably and consistently reported their concussion histories when they were surveyed during high school.…”

Section: Discussionmentioning

confidence: 99%

“…The CDC is currently pilot testing a concussion surveillance system to track, monitor, and accurately determine how many Americans sustain a concussion each year and how the injury happened (Bell et al, 2017). After a planned pilot phase is complete, the hope is to scale up to a national concussion surveillance system that will be administered on an ongoing basis.…”

Section: Discussionmentioning

confidence: 99%

Concussion attitudes, behaviors, and education among youth ages 12–17: Results from the 2014 YouthStyles survey

Donnell

Hoffman

Sarmiento

et al. 2018

Journal of Safety Research

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Introduction: This study assessed young athletes’ (ages 12 to 17) concussion attitudes and behaviors, particularly their self-reported experience learning about concussion and intentions to report a concussion and disparities in these experiences. Methods: We used data from Porter Novelli’s 2014 YouthStyles survey that is conducted each year to gather insights about American consumers. Results: Of the 1,005 respondents, 57% reported sports participation. Fourteen percent reported they may have had a previous concussion, and among them 41% reported having a concussion more than once while playing sports. Males (17.7%) were significantly more likely to report having a concussion than females (10.0%; χ2 (1) = 7.01, p = 0.008). Fifty-five percent of respondents reported having learned about what to do if they think they may have a concussion, and 92% reported that they would tell their coach if they thought they sustained a concussion while playing youth or high school sports. Youth from higher income families ($75,000–$124,999) were significantly more likely than youth from lower income families (less than $35,000) to report that they learned about what do if they suspected that they had a concussion. Conclusion: Age of athlete, parental income level, athlete’s sex, and living in a metro versus non-metro area led to disparities in athletes’ concussion education. There is a need for increased access to concussion education and an emphasis on customizing concussion education efforts to meet the needs of different groups. Practical application: We identified athletes’ self-reported previously sustained concussions and predictors of education related to concussion. Further research is needed to explore the age, gender and income gaps in concussion education among athletes.

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Incidence of Traumatic Brain Injury in a Longitudinal Cohort of Older Adults

Kornblith,

Diaz-Ramirez,

Yaffe

et al. 2024

JAMA Netw Open

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ImportanceTraumatic brain injury (TBI) occurs at the highest rate in older adulthood and increases risk for cognitive impairment and dementia.ObjectivesTo update existing TBI surveillance data to capture nonhospital settings and to explore how social determinants of health (SDOH) are associated with TBI incidence among older adults.Design, Setting, and ParticipantsThis nationally representative longitudinal cohort study assessed participants for 18 years, from August 2000 through December 2018, using data from the Health and Retirement Study (HRS) and linked Medicare claims dates. Analyses were completed August 9 through December 12, 2022. Participants were 65 years of age or older in the HRS with survey data linked to Medicare without a TBI prior to HRS enrollment. They were community dwelling at enrollment but were retained in HRS if they were later institutionalized.ExposuresBaseline demographic, cognitive, medical, and SDOH information from HRS.Main Outcomes and MeasuresIncident TBI was defined using inpatient and outpatient International Classification of Diseases, Ninth or Tenth Revision, diagnosis codes received the same day or within 1 day as the emergency department (ED) visit code and the computed tomography (CT) or magnetic resonance imaging (MRI) code, after baseline HRS interview. A cohort with TBI codes but no ED visit or CT or MRI scan was derived to capture diagnoses in nonhospital settings. Descriptive statistics and bivariate associations of TBI with demographic and SDOH characteristics used sample weights. Fine-Gray regression models estimated associations between covariates and TBI, with death as a competing risk. Imputation considering outcome and complex survey design was performed by race and ethnicity, sex, education level, and Area Deprivation Index percentiles 1, 50, and 100. Other exposure variables were fixed at their weighted means.ResultsAmong 9239 eligible respondents, 5258 (57.7%) were female and 1210 (9.1%) were Black, 574 (4.7%) were Hispanic, and 7297 (84.4%) were White. Mean (SD) baseline age was 75.2 (8.0) years. During follow-up (18 years), 797 (8.9%) of respondents received an incident TBI diagnosis with an ED visit and a CT code within 1 day, 964 (10.2%) received an incident TBI diagnosis and an ED code, and 1148 (12.9%) received a TBI code with or without an ED visit and CT scan code. Compared with respondents without incident TBI, respondents with TBI were more likely to be female (absolute difference, 7.0 [95% CI, 3.3-10.8]; P &lt; .001) and White (absolute difference, 5.1 [95% CI, 2.8-7.4]; P &lt; .001), have normal cognition (vs cognitive impairment or dementia; absolute difference, 6.1 [95% CI, 2.8-9.3]; P = .001), higher education (absolute difference, 3.8 [95% CI, 0.9-6.7]; P &lt; .001), and wealth (absolute difference, 6.5 [95% CI, 2.3-10.7]; P = .01), and be without baseline lung disease (absolute difference, 5.1 [95% CI, 3.0-7.2]; P &lt; .001) or functional impairment (absolute difference, 3.3 [95% CI, 0.4-6.1]; P = .03). In adjusted multivariate models, lower education (subdistribution hazard ratio [SHR], 0.73 [95% CI, 0.57-0.94]; P = .01), Black race (SHR, 0.61 [95% CI, 0.46-0.80]; P &lt; .001), area deprivation index national rank (SHR 1.00 [95% CI 0.99-1.00]; P = .009), and male sex (SHR, 0.73 [95% CI, 0.56-0.94]; P = .02) were associated with membership in the group without TBI. Sensitivity analyses using a broader definition of TBI yielded similar results.Conclusions and RelevanceIn this longitudinal cohort study of older adults, almost 13% experienced incident TBI during the 18-year study period. For older adults who seek care for TBI, race and ethnicity, sex, and SDOH factors may be associated with incidence of TBI, seeking medical attention for TBI in older adulthood, or both.

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CDC's efforts to improve traumatic brain injury surveillance

Cited by 43 publications

References 12 publications

Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017

Self-Reported Concussions from Playing a Sport or Being Physically Active Among High School Students — United States, 2017

Concussion attitudes, behaviors, and education among youth ages 12–17: Results from the 2014 YouthStyles survey

Incidence of Traumatic Brain Injury in a Longitudinal Cohort of Older Adults

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