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Learning Objective 1: The learner will be able to describe the moderate traumatic brain injured patient treated at a Level 1 trauma center.
Learning Objective 2: The learner will be able to list significant discharge predictors of the moderate brain injured patient to acute rehabilitation.
Traumatic brain injury (TBI) is a leading cause of death and disability in the United States and the world. The Centers for Disease Control and Prevention (CDC) reported in 2006 that each year at least 1.7 million Americans sustain a TBI with 275,000 of them severe enough to require hospitalization.
Advancements in emergency medical care have created greater TBI survival rates and resulting in approximately 2% of the U.S. population to be living with a TBI-related disability. The total lifetime costs of TBI, including productivity losses, were estimated at $60.4 billion in the year 2000.
A gap in the literature has been research on the moderate TBI patient. This group of TBI patients has no definitive treatment guidelines; is not well described or understood; and appropriate discharge disposition remains unclear. Studies have shown that moderate TBI patients who do not receive rehabilitation are at risk for long-term cognitive, emotional, and functional limitations.
METHODS
The study setting will be a Level 1 trauma center serving the Washington DC area.
The sample size will be based on a minimum of 10 subjects per predictor for a minimum of 130 subjects between ages of 18-64.
A retrospective, cross-sectional, descriptive design will be used. Descriptive statistics will be used to describe the demographic, clinical, and financial characteristics of the moderate brain injured patient. Logistic regression will be utilized to determine the predictors of discharge to acute rehabilitation.
A query using ICD-9 codes for TBI and Glasgow Coma Scale (GCS) of 9 to 12 for patients between ages 18-64 will be pulled from trauma registry. Medical records of each subject in that group will be reviewed to verify moderate brain injury and to collect remaining variables.
RESULTS
Data will be analyzed using the SPSS™ for Windows statistical package with conclusions to follow.