Discordance between Documented Criteria and Documented Diagnosis of Traumatic Brain Injury in the Emergency Department
| Autor: | L. Christine Turtzo, Katie C Bittner, Martin R Cota, Ramon Diaz-Arrastia, Lawrence L. Latour, Neekita Jikaria, Anita D Moses |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Adolescent Traumatic brain injury Young Adult 03 medical and health sciences 0302 clinical medicine Brain Injuries Traumatic medicine Humans Aged Retrospective Studies business.industry Original Articles Emergency department Middle Aged medicine.disease nervous system diseases nervous system Neurology Emergency medicine Female Neurology (clinical) Emergency Service Hospital 0305 other medical science business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Neurotrauma. 36:1335-1342 |
| ISSN: | 1557-9042 0897-7151 |
| Popis: | Accurate diagnosis of traumatic brain injury (TBI) is critical to ensure that patients receive appropriate follow-up care, avoid risk of subsequent injury, and are aware of possible long-term consequences. However, diagnosis of TBI, particularly in the emergency department (ED), can be difficult because the symptoms of TBI are vague and nonspecific, and patients with suspected TBI may present with additional injuries that require immediate medical attention. We performed a retrospective chart review to evaluate accuracy of TBI diagnosis in the ED. Records of 1641 patients presenting to the ED with suspected TBI and a head computed tomography (CT) were reviewed. We found only 47% of patients meeting the American Congress of Rehabilitation Medicine criteria for TBI received a documented ED diagnosis of TBI in medical records. After controlling for demographic and clinical factors, patients presenting at a level I trauma center, with cause of injury other than fall, without CT findings of TBI, and without loss of consciousness were more likely to lack documented diagnosis despite meeting diagnostic criteria for TBI. A greater proportion of patients without documented ED diagnosis of TBI were discharged home compared to those with a documented diagnosis of TBI (58% vs. 40%; p |
| Databáze: | OpenAIRE |
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