Yasamin Daneshvar, A. Mazzuoccolo, John Slish, Marie-Carmelle Elie-Turenne, Sudeep Kuchibhotla, Tricia Falgiani, Andrea Gabrielli, Kelsey Hatchitt, Robyn M. Hoelle, Lawrence Lottenberg, J. Adrian Tyndall, Christa Pulvino, Bayard Miller, Michael Falgiani, Latha G. Stead, Abhijna Vedula, Aakash Bodhit, Keith R. Peters, and Pratik Patel
Background To characterize the patterns of presentation of adults with head injury to the Emergency Department. Methods This is a cohort study that sought to collect injury and outcome variables with the goal of characterizing the very early natural history of traumatic brain injury in adults. This IRB-approved project was conducted in collaboration with our Institution’s Center for Translational Science Institute. Data were entered in REDCap, a secure database. Statistical analyses were performed using JMP 10.0 pro for Windows. Results The cohort consisted of 2,394 adults, with 40% being women and 79% Caucasian. The most common mechanism was fall (47%) followed by motor vehicle collision (MVC) (36%). Patients sustaining an MVC were significantly younger than those whose head injury was secondary to a fall (P < 0.0001). Ninety-one percent had CT imaging; hemorrhage was significantly more likely with worse severity as measured by the Glasgow Coma Score (chi-square, P < 0.0001). Forty-four percent were admitted to the hospital, with half requiring ICU admission. In-hospital death was observed in 5.4%, while neurosurgical intervention was required in 8%. For all outcomes, worse TBI severity per GCS was significantly associated with worse outcomes (logistic regression, P < 0.0001, adjusted for age). Conclusion These cohort data highlight the burden of TBI in the Emergency Department and provide important demographic trends for further research.