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Study shows spike in emergency room visits for TBI

PITTSBURGH — From 2006 to 2010, the rate of visits to emergency departments across the United States for traumatic brain injury increased by nearly 30 percent, according to a new study led by a Pittsburgh physician.

The findings, which are published in the recent issue of the Journal of the American Medical Association, might be attributable to factors such as greater awareness and more diagnoses of TBI, among other things, according to lead author Dr. Jennifer R. Marin.

“Is it that more people are coming in with concussions … or these injuries?” Marin, a pediatric emergency medicine physician at Children’s Hospital of Pittsburgh of UPMC, said in an interview Tuesday. "Is it that patients are just more aware or more vigilant?”

Another reason for the increase could be that physicians now are more likely to record a TBI in a patient’s medical record even if it’s not the primary reason for the visit, Marin explained, noting that it also could be a combination of the factors.

Marin, who also is an assistant professor of pediatrics and emergency medicine at the University of Pittsburgh School of Medicine, said researchers were driven by the question of whether visits to emergency departments for TBI have changed in recent years, given an increase in attention to these types of injuries.

Federal and state legislation, activism on the part of the National Football League and campaigns led by various medical professional societies are only a few of the efforts that have shined a light on TBI over the past decade, Marin pointed out.

For the study, the team looked at data from the Nationwide Emergency Department Sample database to determine national trends in emergency department visits for TBI from 2006 through 2010, and also compared the findings to the total visits for all emergencies. The data did not include VA hospitals or the military health system, Marin said.

While TBI visits increased 29 percent, total emergency department visits increased only 3.6 percent during the study time frame.

“What we found was, in fact, the visit rate did increase rather dramatically compared to the emergency department visits in general,” Marin said. “In fact, it’s not just that more people came [to emergency departments], it’s that more people with TBI came.”

The findings underscore the need for more evaluation into why and how to reverse the trend and minimize the incidence of TBI, which is an “important cause” of injury and death each year, Marin said in a news release.

While TBI rates increased significantly among all age groups, the study also showed that the greatest increases occurred among children younger than 3 and adults older than 60. Most of the visits examined in the study were for minor injuries. And the majority of the increase in the incidence of TBI was seen in visits recorded as concussions — considered a “mild” or “minor” TBI — or unspecified head injuries.

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