2016
DOI: 10.3109/10903127.2016.1149651
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Hospitalized Traumatic Brain Injury: Low Trauma Center Utilization and High Interfacility Transfers among Older Adults

Abstract: Objective Guidelines suggest that Traumatic Brain Injury (TBI) related hospitalizations are best treated at Level I or II trauma centers because of continuous neurosurgical care in these settings. This population-based study examines TBI hospitalization treatment paths by age groups. Methods Trauma center utilization and transfers by age groups were captured by examining the total number of TBI hospitalizations from National Inpatient Sample (NIS) and the number of TBI hospitalizations and transfers in the T… Show more

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Cited by 42 publications
(33 citation statements)
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“…19-22 In addition, older adults are more frequently undertriaged to non-trauma centers than younger adults with similar injuries. 23,24 In response to these issues involving older adults with head injury, particularly those who are anticoagulated, the most recent field triage guidelines revised the special considerations criteria (Step 4) to include additional language for patients taking anticoagulants (including both anticoagulant and antiplatelet medications), stating “Patients with head injury are at high risk for rapid deterioration”. 18 The characteristics of EMS transport decisions and clinical outcomes in head injured patients meeting only Step 4 triage criteria, however, have not been previously described.…”
Section: Introductionmentioning
confidence: 99%
“…19-22 In addition, older adults are more frequently undertriaged to non-trauma centers than younger adults with similar injuries. 23,24 In response to these issues involving older adults with head injury, particularly those who are anticoagulated, the most recent field triage guidelines revised the special considerations criteria (Step 4) to include additional language for patients taking anticoagulants (including both anticoagulant and antiplatelet medications), stating “Patients with head injury are at high risk for rapid deterioration”. 18 The characteristics of EMS transport decisions and clinical outcomes in head injured patients meeting only Step 4 triage criteria, however, have not been previously described.…”
Section: Introductionmentioning
confidence: 99%
“…Worldwide, 26-67% of patients with a severe head injury are not transported to a higher-level trauma centre [9][10][11]20,24]. The percentage depends greatly on the inclusion criteria, i.e.…”
Section: Discussionmentioning
confidence: 99%
“…Previous studies show that many patients with severe head trauma are not transported to a higher-level trauma centre [9][10][11][12][13]. The ability of EMS providers to accurately identify patients with a head injury is Correspondence unknown.…”
Section: Introductionmentioning
confidence: 99%
“…However, it should be noted that inter-facility triage patterns may vary with specific injuries; Faul et al using data from the National Inpatient Sample (NIS) and the National Trauma Data Bank (NTDB), observed a higher proportion of inter-facility transfers to Level I/II among older adults with traumatic brain injury (TBI). 27 …”
Section: Discussionmentioning
confidence: 99%