Evidence map›Paper›PMID 30234165›Full record

ArticleTrauma surgery & acute care open2018

Defining severe traumatic brain injury readmission rates and reasons in a rural state.

James Gardner, Kevin W Sexton, John Taylor, William Beck, Mary Katherine Kimbrough, Ben Davis, Avi Bhavaraju, Saleema Karim, Austin Porter

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Trauma surgery & acute care open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

James GardnerDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.
Kevin W SextonDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.ORCID 0000-0002-1460-9867
John TaylorDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.
William BeckDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.
Mary Katherine KimbroughDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.
Ben DavisDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.
Avi BhavarajuDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Arkansas for Medical Sciences (UAMS), Little Rock, Arkansas, USA.
Saleema KarimDepartment of Health Policy and Management, UAMS Medical Center, Little Rock, Arkansas, USA.
Austin PorterDepartment of Health Policy and Management, UAMS Medical Center, Little Rock, Arkansas, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReadmissions after a traumatic brain injury (TBI) have significant impact on long-term patient outcomes through interruption of rehabilitation. This study examined readmissions in a rural population, hypothesizing that readmitted patients after TBI will be older and have more comorbidities than those not readmitted.

methodsDischarge data on all patients 15 years and older who were admitted to an Arkansas-based hospital for TBI were obtained from the Arkansas Hospital Discharge Data System from 2010 to 2014. This data set includes diagnoses (principal discharge diagnosis, up to 3 external cause of injury codes, 18 diagnosis codes using the International Classification of Disease, 9th Edition, Clinical Modifications), age, gender, and inpatient costs. Hospital Cost and Utilization Project Clinical Classification and Chronic Condition Indicator were used to identify chronic disease and body systems affected in principal diagnosis.

resultsOf the 3114 cases of significant head trauma, more than two-thirds were attributed to fall injuries, with motor vehicle crashes accounting for 20% of the remainder. The mean length of stay was 6.5 days. 691 of these patients were admitted to an Arkansas hospital in the following year, totaling 1368 readmissions. Of the readmissions, 16.4% of patients were admitted for altered mental status, 12.9% with shortness of breath (SOB), and 9.4% with chest pain. Mental disorders (psychosis, dementia, and depression) and organic nervous symptoms (Alzheimer's disease, encephalopathy, and epilepsy) were the primary source of readmissions. More than one-third of the patients were admitted in the following year for chronic diseases such as heart failure (8.6%), psychosis (5.2%), and cerebral artery occlusion (4.1%). DISCUSSION: This study showed that there is a significant rate of readmissions in the year after a diagnosis of TBI. Complications with existing chronic diseases are among the most reported reasons for admission in this time period, demonstrating the effect severe head trauma has on long-term treatment. LEVEL OF EVIDENCE: Level IV, Retrospective epidemiological study.

Indexed as

ReadmissionRural Traumatraumatic brain injury

Identifiers

PMID30234165
PMCPMC6135415

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