Predictors of traumatic brain injury morbidity and mortality: Examination of data from the national trauma data bank: Predictors of TBI morbidity & mortality. Issue 5 (May 2021) - Miller, Gabrielle F.
Highlights: Among patients with a TBI, unintentional injury contributed to most visits in U.S. trauma centers. Falls were the leading mechanism of injury. Length of hospital stay and mortality risk were closely associated with a patient's ageand injury intent. Patients who received care for a TBI at a Level I trauma center were more likely to survive following their injury. Patients who identified as self-pay or who were non-Hispanic Black were at increased risk for death following a TBI. Targeted TBI prevention efforts and adaptation of evidence-based programs for TBI patients may be helpful in reducing health disparities. Abstract: Background: There is evidence to suggest that traumatic brain injuries (TBI) are increasing in the United States. It is important to examine predictors of TBI outcomes to formulate better prevention and care strategies. Research design: National Trauma Data Bank (NTDB) data from 2016 were used to report the percentage of TBI by age, sex, race/ethnicity, health insurance status, intent/mechanism of injury, Glasgow Coma Scale (GCS), disposition at emergency department, and trauma center level. Logistic regression models were run to estimate the adjusted odds ratios of patient and facility characteristics on length of hospital stay and in-hospital mortality (analyzed in 2020). Results: There were 236, 873 patients with TBI in the NTDB in 2016. Most patients with a TBI were male, non-Hispanic white, and had sustained a TBI due to an unintentional injury. After adjusting for other factors, individuals age 0-17, those who self-pay, and those with intentional injuries had increased odds of a shorter hospital stay. Older individuals, non-Hispanic black or Hispanic patients, those who had sustained an intentional injury, and those who were not seen in a Level I trauma center had higher odds of mortality following their TBI. Conclusions: Public health professionals' promotion of fall and other TBI prevention efforts and the development of strategies to improve access to Level I trauma centers, may decrease adverse TBI health outcomes. This may be especially important for older adults and other vulnerable populations.