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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
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1 to 25 of 57 Research Studies Displayed
Greenberg JK, Ahluwalia R, Hill M
Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries.
This study's objectives were to develop a new risk model with improved sensitivity compared to the CHIIDA model for the post-neuroimaging management of children with mild traumatic brain injuries (mTBI) and intracranial injuries and further to validate externally the new model and CHIIDA model in a multicenter data set. Findings showed that the KIIDS-TBI model had high sensitivity and moderate specificity for risk stratifying children with mTBI and intracranial injuries. The researchers concluded that the use of their clinical decision support tool may help improve the safe, resource-efficient management of this important patient population.
AHRQ-funded; HS027075.
Citation:
Greenberg JK, Ahluwalia R, Hill M .
Development and external validation of the KIIDS-TBI tool for managing children with mild traumatic brain injury and intracranial injuries.
Acad Emerg Med 2021 Dec;28(12):1409-20. doi: 10.1111/acem.14333..
Keywords:
Children/Adolescents, Brain Injury, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT)
Holding EZ, Turner EM, Hall TA
The association between functional status and health-related quality of life following discharge from the pediatric intensive care unit.
This study investigated the association between new functional impairments, measured by the Functional Status Scale (FSS), and health-related quality of life (HRQOL) in pediatric patients with acquired brain injury (ABI) after critical care. This secondary analysis was conducted using children aged 2 months to 18 years with ABI. Complete data were analyzed for 195 children, including 127 with traumatic brain injury. New functional impairment was common with 32 patients experiencing FSS ≥ 3, 50 (26%) patients with FSS increases of 1-2 points, and 113 (58%) patients with no change from prehospital baseline. The majority of children (63%) demonstrated HRQOL ratings ≥ 1 standard deviation below healthy age-based standards.
AHRQ-funded; HS022981.
Citation:
Holding EZ, Turner EM, Hall TA .
The association between functional status and health-related quality of life following discharge from the pediatric intensive care unit.
Neurocrit Care 2021 Oct;35(2):347-57. doi: 10.1007/s12028-021-01271-8..
Keywords:
Children/Adolescents, Quality of Life, Brain Injury, Intensive Care Unit (ICU)
Marin JR, Rodean J, Mannix RC
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
The objective of this study was to examine whether the presence of clinical guidelines and clinical decision support (CDS) for mild traumatic brain injury (mTBI) were associated with lower head computed tomography (CT) use. The investigators concluded that clinical guidelines for mTBI, and particularly CDS, were associated with lower rates of head CT use without adverse clinical outcomes.
AHRQ-funded; HS026006.
Citation:
Marin JR, Rodean J, Mannix RC .
Association of clinical guidelines and decision support with CT use in pediatric mild traumatic brain injury.
J Pediatr 2021 Aug;235:178-83.e1. doi: 10.1016/j.jpeds.2021.04.026..
Keywords:
Children/Adolescents, Clinical Decision Support (CDS), Decision Making, Health Information Technology (HIT), Brain Injury, Guidelines, Evidence-Based Practice, Imaging
Bradbury KR, Williams C, Leonard S
Emotional aspects of pediatric post-intensive care syndrome following traumatic brain injury.
This study assessed parent-reported emotional functioning in children with traumatic brain injury (TBI) and identified risk factors for emotional sequelae in the acute recovery phase. Results from logistic regression indicated that only elevated parent PTSD symptoms were a significant predictor for child anxiety and depressive symptoms. Anxiety and depressive symptoms were prevalent in the acute recovery phase of TBI. Consistent with previous research, elevations in anxiety and depressive symptoms were more related to psychosocial factors than to injury severity.
AHRQ-funded; HS022981.
Citation:
Bradbury KR, Williams C, Leonard S .
Emotional aspects of pediatric post-intensive care syndrome following traumatic brain injury.
J Child Adolesc Trauma 2021 Jun;14(2):177-87. doi: 10.1007/s40653-020-00332-y..
Keywords:
Children/Adolescents, Brain Injury, Trauma, Neurological Disorders
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
AHRQ-funded; HS000011.
Citation:
Anderson MC, Evans E, Zonfrillo MR .
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords:
Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
Greenberg JK, Otun A, Nasraddin A
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
This paper discusses the development of an evidence-based clinical decision support (CDS) for management of children with minor head trauma (MHT) and evaluates the sociotechnical environment impacting the implementation of electronic CDS, including workflow and communication, institutional culture, and hardware and software infrastructure. Semi-structured qualitative focus group interviews were conducted with 28 physicians and four information technology specialists between March and May 2020. Five primary themes were identified through inductive thematic analysis: 1) clinical impact; 2) stakeholders and users; 3) tool content; 4) clinical practice integration; and 5) post-implementation evaluation measures. Participants generally supported CDS use to determine an appropriate level-of-care. However, some had mixed feelings regarding how the tool could best be used by neurosurgeons versus non-neurosurgeons. Feedback helped refine the tool content and highlighted potential technical and workflow barriers to address prior to implementation.
AHRQ-funded; HS027075.
Citation:
Greenberg JK, Otun A, Nasraddin A .
Electronic clinical decision support for children with minor head trauma and intracranial injuries: a sociotechnical analysis.
BMC Med Inform Decis Mak 2021 May 19;21(1):161. doi: 10.1186/s12911-021-01522-w.
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Keywords:
Children/Adolescents, Clinical Decision Support (CDS), Brain Injury, Health Information Technology (HIT), Evidence-Based Practice, Decision Making
Albrecht JS, Wickwire EM
Healthcare utilization following traumatic brain injury in a large national sample.
Investigators sought to evaluate the impact of traumatic brain injury (TBI) on healthcare utilization (HCU) over a 1-year period in a large national sample of individuals diagnosed with TBI across multiple care settings. They found that, in this population of individuals who maintained insurance coverage following TBI, results suggested that TBI may have a limited impact on non-rehabilitation HCU at the population level.
AHRQ-funded; HS024560.
Citation:
Albrecht JS, Wickwire EM .
Healthcare utilization following traumatic brain injury in a large national sample.
J Head Trauma Rehabil 2021 May-Jun;36(3):E147-e54. doi: 10.1097/htr.0000000000000625..
Keywords:
Brain Injury, Healthcare Utilization
Evans E, Gutman R, Resnik L
Successful community discharge among older adults with traumatic brain injury in skilled nursing facilities.
The purpose of this retrospective cohort study was to identify patient, injury, and functional status characteristics associated with successful discharge to the community following a skilled nursing facility (SNF) stay among older adults hospitalized following traumatic brain injury (TBI). Participants were Medicare fee-for-service beneficiaries admitted to an SNF after hospitalization for TBI. Findings showed that among older adults with TBI who discharge to an SNF, sociodemographic and functional status characteristics are associated with successful discharge and may be useful to clinicians for discharge planning.
AHRQ-funded; HS000011.
Citation:
Evans E, Gutman R, Resnik L .
Successful community discharge among older adults with traumatic brain injury in skilled nursing facilities.
J Head Trauma Rehabil 2021 May-Jun;36(3):E186-e98. doi: 10.1097/htr.0000000000000638..
Keywords:
Elderly, Brain Injury, Transitions of Care, Nursing Homes
Luther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
AHRQ-funded; HS022981.
Citation:
Luther M, Poppert Cordts KM, Williams CN .
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords:
Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Porter A, Brown CC, Tilford JM
Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury.
This study’s objective was to determine if a health insurance disparity exists among pediatric patients with severe traumatic brain injury using data from the National Trauma Data Bank. The Bank contains data from more than 800 trauma centers in the United States. Isolated traumatic brain injury was defined as patients with a head Abbreviated Injury Scale score of 3+. Procedure codes were used to identify four primary treatment approaches combined into 2 classifications: craniotomy or craniectomy and external or intracranial ventricular draining. Condition at admission was defined including hypotension, Glasgow Coma Scale, mechanism and intent of injury, and Injury Severity Scale. Among the cohort of 12,449 patients, 91% had insurance and 9% were uninsured. Children without insurance had worse condition at admission with higher rates of hypotension and higher Injury Severity Score when compared with publicly and privately insured patients. Having insurance was associated with a 32% increase in the odds of cranial procedures, and 54% increase in the odds of monitor placement. Insurance coverage was associated 25% lower odds of inpatient mortality. Further study is needed to determine what factors lead to worse condition at admission.
Citation:
Porter A, Brown CC, Tilford JM .
Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury.
Crit Care Med 2020 Jul;48(7):e584-e91. doi: 10.1097/ccm.0000000000004398..
Keywords:
Children/Adolescents, Brain Injury, Trauma, Health Insurance, Access to Care, Uninsured, Outcomes
Henry MK, Feudtner C, Fortin K
Occult head injuries in infants evaluated for physical abuse.
Abusive head injuries in infants may be occult but clinically or forensically important. Data conflict regarding yield of neuroimaging in detecting occult head injuries in infants evaluated for physical abuse, with prior studies identifying yields of 4.3-37.3 %. The objectives of this study were (1) To quantify yield of computed tomography or magnetic resonance imaging in identification of occult head injuries in infants with concerns for physical abuse and (2) To evaluate risk factors for occult head injuries.
AHRQ-funded; HS024194.
Citation:
Henry MK, Feudtner C, Fortin K .
Occult head injuries in infants evaluated for physical abuse.
Child Abuse Negl 2020 May;103:104431. doi: 10.1016/j.chiabu.2020.104431..
Keywords:
Newborns/Infants, Brain Injury, Domestic Violence, Imaging, Diagnostic Safety and Quality, Injuries and Wounds
Probst MA, Gupta M, Hendey GW
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
In this study, the investigators determined the prevalence of significant intracranial injury among adults with blunt head trauma who are receiving preinjury anticoagulant or antiplatelet medications. The investigators concluded that patients receiving preinjury warfarin or a combination of aspirin and clopidogrel were at increased risk for significant intracranial injury, but not those receiving aspirin alone. They suggested that clinicians should have a low threshold for neuroimaging when evaluating patients receiving warfarin or a combination of aspirin and clopidogrel.
AHRQ-funded; HS009699.
Citation:
Probst MA, Gupta M, Hendey GW .
Prevalence of intracranial injury in adult patients with blunt head trauma with and without anticoagulant or antiplatelet use.
Ann Emerg Med 2020 Mar;75(3):354-64. doi: 10.1016/j.annemergmed.2019.10.004..
Keywords:
Brain Injury, Injuries and Wounds, Blood Thinners, Medication, Medication: Safety, Adverse Drug Events (ADE), Adverse Events, Risk
Williams CN, Hartman ME, McEvoy CT
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Sleep-wake disturbances are underevaluated among children with acquired brain injury surviving critical care. In this prospective cohort study, the investigators aimed to quantify severity, phenotypes, and risk factors for sleep-wake disturbances. The investigators concluded that over half of children surviving critical care with acquired brain injury have sleep-wake disturbances. They indicated that many sleep-wake disturbances phenotypes were identified, but most children had disturbance in initiation and maintenance of sleep.
AHRQ-funded; HS022981.
Citation:
Williams CN, Hartman ME, McEvoy CT .
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Pediatr Neurol 2020 Feb;103:43-51. doi: 10.1016/j.pediatrneurol.2019.08.010..
Keywords:
Children/Adolescents, Brain Injury, Critical Care, Sleep Problems, Trauma, Injuries and Wounds, Neurological Disorders
Simon KC, Reams N, Beltran E
Optimizing the electronic medical record to improve patient care and conduct quality improvement initiatives in a concussion specialty clinic.
The purpose of this study was to use the electronic medical record (EMR) to optimize patient care, facilitate documentation, and support quality improvement and practice-based research in a concussion (mild traumatic brain injury; mTBI) clinic. The investigators built a customized structured clinical documentation support (SCDS) toolkit for patients in a concussion specialty clinic. The toolkit collected hundreds of fields of discrete,
AHRQ-funded; HS024057.
Citation:
Simon KC, Reams N, Beltran E .
Optimizing the electronic medical record to improve patient care and conduct quality improvement initiatives in a concussion specialty clinic.
Brain Inj 2020;34(1):62-67. doi: 10.1080/02699052.2019.1680867..
Keywords:
Electronic Health Records (EHRs), Health Information Technology (HIT), Brain Injury, Neurological Disorders
Adediran T, Drumheller BC, McCunn M
Sex differences in in-hospital complications among older adults after traumatic brain injury.
This study examined sex differences in in-hospital complications among older adults after traumatic brain injury (TBI). Previous evidence has suggested that women have better outcomes than men after TBI. A retrospective cohort study was conducted of adults aged 65 years and older treated for moderate to severe TBI at R. Adams Cowley Shock Trauma Center from 1996 to 2012. The investigators identified TBI using ICD-9 CM codes and inclusion in the study required an abbreviated injury scale head score of 3 or greater, abbreviated injury scale scores for other body regions of 2 or greater, and a blunt injury mechanism. Out of 2511 patients, 51.1% were men, and 25.1% developed an in-hospital complication. Men had a complication rate of 28.1% versus 22.0% for women.
AHRQ-funded; HS024560.
Citation:
Adediran T, Drumheller BC, McCunn M .
Sex differences in in-hospital complications among older adults after traumatic brain injury.
J Surg Res 2019 Nov;243:427-33. doi: 10.1016/j.jss.2019.05.053..
Keywords:
Elderly, Sex Factors, Adverse Events, Hospitalization, Brain Injury
Vadlamani A, Perry JA, McCunn M
Racial differences in discharge location after a traumatic brain injury among older adults.
The purpose of this retrospective cohort study was to determine if there were racial differences in discharge location among older adults treated for traumatic brain injury (TBI) at a level 1 trauma center. The authors concluded that in this group of Medicare-eligible older adults, blacks were more likely to be discharged to inpatient rehabilitation compared to whites.
AHRQ-funded; HS024560.
Citation:
Vadlamani A, Perry JA, McCunn M .
Racial differences in discharge location after a traumatic brain injury among older adults.
Arch Phys Med Rehabil 2019 Sep;100(9):1622-28. doi: 10.1016/j.apmr.2019.03.008.
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Keywords:
Racial / Ethnic Minorities, Brain Injury, Trauma, Elderly, Hospital Discharge, Rehabilitation, Medicare
Glass NE, Vadlamani A, Hwang F
Bleeding and thromboembolism after traumatic brain injury in the elderly: a real conundrum.
The objectives of this study were to evaluate the incidence of bleeding, recurrent traumatic brain injury (TBI), and thromboembolic (TE) events after an initial TBI in older adults and to identify which factors contribute to this risk. The researchers found that, among Medicare patients hospitalized with TBI, the incidence of TE events was significantly higher than that of bleeding or recurrent TBI. They identified specific risk factors of bleeding and TE events, which may guide care of older adults after TBI.
AHRQ-funded; HS024560.
Citation:
Glass NE, Vadlamani A, Hwang F .
Bleeding and thromboembolism after traumatic brain injury in the elderly: a real conundrum.
J Surg Res 2019 Mar;235:615-20. doi: 10.1016/j.jss.2018.10.021..
Keywords:
Brain Injury, Blood Clots, Elderly, Trauma, Injuries and Wounds, Risk, Adverse Events
Albrecht JS, Barbour L, Abariga SA
Risk of depression after traumatic brain injury in a large national sample.
The goal of this study was to estimate the risk of depression post-traumatic brain injury (TBI) among adults 18 years of age and older and to identify risk factors associated with developing depression post-TBI. Claims data for privately insured and Medicare Advantage enrollees was used. Results showed that history of neuropsychiatric disturbances pre-TBI was the strongest predictor of depression post-TBI. The risk of depression increases substantially post-TBI. Groups at increased risk include those with a history of neuropsychiatric disturbances, older adults, and men. This study highlights the importance of long-term monitoring for depression post-TBI.
AHRQ-funded; HS024560.
Citation:
Albrecht JS, Barbour L, Abariga SA .
Risk of depression after traumatic brain injury in a large national sample.
J Neurotrauma 2019 Jan 15;36(2):300-07. doi: 10.1089/neu.2017.5608..
Keywords:
Depression, Behavioral Health, Brain Injury, Trauma, Risk
Piantino JA, Lin A, Crowder D
Early heart rate variability and electroencephalographic abnormalities in acutely brain-injured children who progress to brain death.
This study retrospective case-control study explored the hypothesis that lower heart rate variability in brain-injured children is an early indicator of autonomic system failure and predicts progression to brain death. The association between heart rate variability and markers of brain dysfunction between brain-injured children who progressed to brain death and those who survived is also examined. Heart rate variability in patients was estimated using 5-minute electrocardiogram segments. Patients who progressed to brain death exhibited significantly lower heart rate variability in the time and frequency domains. Heart rate variability was significantly lower in those patients with discontinuous or attenuated/featureless electroencephalogram than those with slow/disorganized background. The researchers conclude that these findings support the concept of autonomic system failure as an early indicator of impending brain death, and that decreased heart rate variability is associated with markers of central nervous system dysfunction, such as electroencephalogram abnormalities.
AHRQ-funded; HS022981.
Citation:
Piantino JA, Lin A, Crowder D .
Early heart rate variability and electroencephalographic abnormalities in acutely brain-injured children who progress to brain death.
Pediatr Crit Care Med 2019 Jan;20(1):38-46. doi: 10.1097/pcc.0000000000001759..
Keywords:
Brain Injury, Children/Adolescents, Neurological Disorders, Outcomes
Albrecht JS, Al Kibria G, Gruber-Baldini A
Risk of mortality in individuals with hip fracture and traumatic brain injury.
Researchers estimated the prevalence of TBI (traumatic brain injury) with individuals hospitalized with hip fracture and their all-cause mortality. The population studied were Medicare beneficiaries aged 65 and older from 2006 to 2010. They concluded that there was a higher risk of death with individuals who had TBI than those who had only a hip fracture.
AHRQ-funded; HS024560.
Citation:
Albrecht JS, Al Kibria G, Gruber-Baldini A .
Risk of mortality in individuals with hip fracture and traumatic brain injury.
J Am Geriatr Soc 2019 Jan;67(1):124-27. doi: 10.1111/jgs.15661..
Keywords:
Brain Injury, Injuries and Wounds, Mortality, Risk, Trauma
Wickwire EM, Schnyer DM, Germain A
Sleep, sleep disorders, and circadian health following mild traumatic brain injury in adults: review and research agenda.
A rapidly expanding scientific literature supports the frequent co-occurrence of sleep and circadian disturbances following mild traumatic brain injury (mTBI). In this paper, the authors review relevant literature and present a research agenda to 1) advance understanding of the reciprocal relationships between sleep and circadian factors and mTBI sequelae and 2) advance rapidly the development of sleep-related treatments in this population.
AHRQ-funded; HS024560.
Citation:
Wickwire EM, Schnyer DM, Germain A .
Sleep, sleep disorders, and circadian health following mild traumatic brain injury in adults: review and research agenda.
J Neurotrauma 2018 Nov 15;35(22):2615-31. doi: 10.1089/neu.2017.5243..
Keywords:
Sleep Problems, Brain Injury, Evidence-Based Practice
Albrecht JS, Perfetto EM, Daniel Mullins C
Safety of antidepressant classes used following traumatic brain injury among Medicare beneficiaries: a retrospective cohort study.
The objective of this study was to compare the risk of several adverse events associated with use of the three most commonly used classes of antidepressants following Traumatic Brain Injury (TBI) in older adults. One of the study’s conclusions was that compared to tricyclic antidepressants, selective serotonin reuptake inhibitor use was associated with increased risk of hemorrhagic stroke.
AHRQ-funded; HS024560
Citation:
Albrecht JS, Perfetto EM, Daniel Mullins C .
Safety of antidepressant classes used following traumatic brain injury among Medicare beneficiaries: a retrospective cohort study.
Drugs Aging 2018 Aug;35(8):763-72. doi: 10.1007/s40266-018-0570-2..
Keywords:
Adverse Events, Medication, Brain Injury, Elderly, Patient Safety
Sander AM, Lequerica AH, Ketchum JM
Race/ethnicity and retention in traumatic brain injury outcomes research: a traumatic brain injury model systems national database study.
The purpose of this study was to investigate the contribution of race/ethnicity to retention in traumatic brain injury (TBI) research at 1 to 2 years postinjury. The findings emphasized the importance of investigating retention rates separately for blacks and Hispanics rather than combining them or grouping either with other races or ethnicities. The results also suggested the need for implementing procedures to increase retention of Hispanics in longitudinal TBI research.
AHRQ-funded; HS022134.
Citation:
Sander AM, Lequerica AH, Ketchum JM .
Race/ethnicity and retention in traumatic brain injury outcomes research: a traumatic brain injury model systems national database study.
J Head Trauma Rehabil 2018 Jul/Aug;33(4):219-27. doi: 10.1097/htr.0000000000000395..
Keywords:
Brain Injury, Racial / Ethnic Minorities, Outcomes, Patient-Centered Outcomes Research, Research Methodologies
Chen C, Peng J, Sribnick EA
Trend of age-adjusted rates of pediatric traumatic brain injury in U.S. emergency departments from 2006 to 2013.
The objective of this study was to use the 2006(-)2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of age-adjusted rates of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments. The investigators found that the overall age-adjusted rates of pediatric TBI-related emergency department (ED) visits increased from 2006 to 2013, which was largely caused by pediatric mild TBIs, especially unspecified injury to the head (ICD-9-CM code 959.01) and concussion.
AHRQ-funded; HS024263.
Citation:
Chen C, Peng J, Sribnick EA .
Trend of age-adjusted rates of pediatric traumatic brain injury in U.S. emergency departments from 2006 to 2013.
Int J Environ Res Public Health 2018 Jun 5;15(6). doi: 10.3390/ijerph15061171..
Keywords:
Brain Injury, Children/Adolescents, Emergency Department, Healthcare Cost and Utilization Project (HCUP), Trauma
Mahmoud L, Zullo AR, Thompson BB
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Researchers conducted a retrospective cohort study of 1197 mechanically ventilated patients admitted to a 12-bed neurocritical care unit (NCCU) over four years in order to evaluate the effect of an analgesia-based sedation protocol on medication use and costs in the NCCU. The protocol resulted in increased in fentanyl use and decreased in propofol use, but their findings indicate no effect on healthcare utilization, healthcare costs, or in-hospital mortality. Based on these results, the researchers suggest that similar NCCUs should consider using population-specific protocols to manage analgesia and sedation.
AHRQ-funded; HS022998.
Citation:
Mahmoud L, Zullo AR, Thompson BB .
Outcomes of protocolised analgesia and sedation in a neurocritical care unit.
Brain Inj 2018;32(7):941-47. doi: 10.1080/02699052.2018.1469167..
Keywords:
Care Management, Brain Injury, Critical Care, Healthcare Costs, Intensive Care Unit (ICU), Medication, Neurological Disorders, Outcomes, Patient-Centered Outcomes Research, Value
