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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.
Results1 to 8 of 8 Research Studies Displayed
Greenberg JK, Olsen MA, Johnson GW
Measures of intracranial injury size do not improve clinical decision making for children with mild traumatic brain injuries and intracranial injuries.
This study evaluated whether measuring traumatic brain injury size (eg, hematoma size) in children with mild traumatic brain injuries (mTBIs) and intracranial injuries (ICIs) improves risk prediction compared with the KIIDS intracranial injury decision support tool for traumatic brain injury (KIIDS-TBI) model. The cohort included children ≤18 years who presented to 1 of the 5 centers within 24 hours of TBI, had Glasgow Coma Scale scores of 13 to 15, and had ICI on neuroimaging. The data set was split into training and testing cohorts. The generalized linear model (GLM) and recursive partitioning (RP) models showed similar specificity across all risk cutoffs, but the GLM model had higher sensitivity. By comparison, the KIIDS-TBI model had slightly higher sensitivity but lower specificity.
Citation: Greenberg JK, Olsen MA, Johnson GW . Measures of intracranial injury size do not improve clinical decision making for children with mild traumatic brain injuries and intracranial injuries. Neurosurgery 2022 Jun;90(6):691-99. doi: 10.1227/neu.0000000000001895..
Keywords: Children/Adolescents, Brain Injury, Decision Making
Humble SS, Wilson LD, McKenna JW
Tracheostomy risk factors and outcomes after severe traumatic brain injury.
The researchers sought to determine risk factors associated with tracheostomy placement after severe traumatic brain injury (TBI) and subsequent outcomes among those who did and did not receive a tracheostomy. They concluded that age and insurance status are independently associated with tracheostomy placement, but not with mortality after severe TBI. Tracheostomy placement is associated with increased survival after severe TBI.
Citation: Humble SS, Wilson LD, McKenna JW . Tracheostomy risk factors and outcomes after severe traumatic brain injury. Brain Inj 2016;30(13-14):1642-47. doi: 10.1080/02699052.2016.1199915.
Keywords: Adverse Events, Brain Injury, Outcomes, Risk, Trauma
Henry MK, Zonfrillo MR, French B
Hospital variation in cervical spine imaging of young children with traumatic brain injury.
The authors sought to identify child-level and hospital-level factors associated with performance of cervical imaging of children with traumatic brain injury from falls and abusive head trauma. They found no association between annual hospital volume of injured children and cervical imaging performance.
Citation: Henry MK, Zonfrillo MR, French B . Hospital variation in cervical spine imaging of young children with traumatic brain injury. Acad Pediatr 2016 Sep-Oct;16(7):684-91. doi: 10.1016/j.acap.2016.01.017.
Keywords: Brain Injury, Children/Adolescents, Imaging, Hospitals, Practice Patterns
Albrecht JS, McCunn M, Stein DM
Sex differences in mortality following isolated traumatic brain injury among older adults.
This retrospective cohort study's objective was to determine the possibility of sex differences in mortality among older adutls following isolated traumatic brain injury (TBI) and to comapre with findings using all TBI. The researchers did not find that women were significantly associated with decreased odds of mortality following isolated TBI.
Citation: Albrecht JS, McCunn M, Stein DM . Sex differences in mortality following isolated traumatic brain injury among older adults. J Trauma Acute Care Surg 2016 Sep;81(3):486-92. doi: 10.1097/ta.0000000000001118.
Keywords: Sex Factors, Trauma, Brain Injury, Mortality, Elderly
Bekelis K, Gottlieb D, Su Y
Surgical clipping versus endovascular coiling for elderly patients presenting with subarachnoid hemorrhage.
The authors studied elderly Medicare patients who underwent treatment for ruptured cerebral aneurysms. They did not demonstrate a difference in mortality, rate of discharge to rehabilitation, and readmissions between surgical clipping and endovascular coiling of ruptured cerebral aneurysms, although clipping was associated with a slightly longer length of stay.
Citation: Bekelis K, Gottlieb D, Su Y . Surgical clipping versus endovascular coiling for elderly patients presenting with subarachnoid hemorrhage. J Neurointerv Surg 2016 Sep;8(9):913-8. doi: 10.1136/neurintsurg-2015-011890.
Keywords: Brain Injury, Surgery, Comparative Effectiveness, Outcomes, Elderly
Humble SS, Wilson LD, Leath TC
ICU sedation with dexmedetomidine after severe traumatic brain injury.
This study describes the dexmedetomidine dosage and infusion times, as well as the physiological parameters, neurological status and daily narcotic requirements before, during and after dexmedetomidine infusion. Its findings demonstrate that initiation of dexmedetomidine infusion is not associated with a decline in neurological functioning in adults with severe TBI.
Citation: Humble SS, Wilson LD, Leath TC . ICU sedation with dexmedetomidine after severe traumatic brain injury. Brain Inj 2016;30(10):1266-70. doi: 10.1080/02699052.2016.1187289.
Keywords: Adverse Drug Events (ADE), Brain Injury, Intensive Care Unit (ICU), Medication, Trauma
Flottemesch TJ, Raetzman S, Heslin KC
AHRQ Author: Heslin KC
Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines.
Reflecting perceived undertriage to trauma centers (TCs) for older adults, the American College of Surgeons' Committee on Trauma and the Center for Disease Control revised field triage guidelines in 2011 with additional emphasis on direct transport to a Level I or II trauma center. Researchers examined whether age-based disparities in TC care for severe head injury decreased. Although patterns of increased TC treatment for all groups with severe head trauma indicate improvements, age-based disparities persisted.
AHRQ-authored; AHRQ-funded; 290201300002C.
Citation: Flottemesch TJ, Raetzman S, Heslin KC . Age-related disparities in trauma center access for severe head injuries following the release of the updated field triage guidelines. Acad Emerg Med 2016 Apr;24(4):447-57. doi: 10.1111/acem.13150.
Keywords: Healthcare Cost and Utilization Project (HCUP), Disparities, Elderly, Brain Injury, Emergency Medical Services (EMS)
Chen W, Wheeler KK, Lin S
Computerized "Learn-As-You-Go" classification of traumatic brain injuries using NEISS narrative data.
This study evaluated a "Learn-As-You-Go" machine-learning program. When using this program, the user trains classification models and interactively checks on accuracy until a desired threshold is reached. It found that the time frame to classify tens of thousands of narratives was reduced from a few days to minutes after approximately sixty minutes of training.
Citation: Chen W, Wheeler KK, Lin S . Computerized "Learn-As-You-Go" classification of traumatic brain injuries using NEISS narrative data. Accid Anal Prev 2016 Apr;89:111-7. doi: 10.1016/j.aap.2016.01.012.
Keywords: Brain Injury, Health Information Technology (HIT)