Traumatic Brain Injuries in Internal Medicine Wards: An Emerging Challenge Needing for a Call to Action
American Journal of Internal Medicine
Volume 3, Issue 2, March 2015, Pages: 50-54
Received: Jan. 27, 2015;
Accepted: Feb. 9, 2015;
Published: Mar. 2, 2015
Views 2598 Downloads 135
Luca Masotti, Medicina Interna, Ospedale Santa Maria Nuova, Florence, Italy
Gianni Lorenzini, Medicina Interna, Ospedale di Borgo San Lorenzo, Florence, Italy
Irene Chiti, Medicina Interna, Ospedale di Pescia, Pistoia, Italy
Laura Policardo, Agenzia Regionale di Sanità della Toscana Osservatorio di Epidemiologia, Florence, Italy
Paolo Francesconi, Agenzia Regionale di Sanità della Toscana Osservatorio di Epidemiologia, Florence, Italy
Grazia Panigada, Medicina Interna, Ospedale di Pescia, Pistoia, Italy
Giancarlo Landini, Medicina Interna, Ospedale Santa Maria Nuova, Florence, Italy
Follow on us
Background: Traumatic brain injuries (TBIs) represent fearing occurrences in clinical practice, due to high mortality and morbidity. Whether the burden of TBIs is increased in Internal Medicine wards remains unclear, therefore the aim of our study was to provide information about it. Materials and Methods: International Classification of Diseases, 9th revision, Clinical Modification (ICD-9th CM) database referred to patients discharged from Tuscan Hospitals in the 2003, 2008 and 2012 years was analyzed. We searched for codes from 850 to 853.19 and from 854.00 to 854.19 as traumatic intracranial bleedings (TIBs) and codes from 800.00 to 804.99 as traumatic brain injuries without bleedings (TBIWBs) in the first six diagnoses of hospital discharge schedules referred to Internal Medicine wards. Results: Overall, hospital discharges for TBIs reduced over the years. However, hospital discharges for TBIs were 47,2% increased in Internal Medicine wards from 2003 to 2012. TBIs increased in 3,4% of patients under 75 years and 93,7% in patients over 75 years. Internal Medicine ward was the hospital setting in 11,20% and 16,70%of TIBs and TIBWBs in 2003 and 24,10% and 37.50%in 2012, respectively. In-hospital mortality in TBIs patients was unchanged over the years and was seven-tenfold greater in patients over 75 years compared to patients under 75 years. Conclusion: Admissions for TBIs are dramatically increased over the last 10 years in Internal Medicine wards, especially in patients over 75 years, making these conditions as a real emerging challenge for the Internists.
Traumatic Brain Injury, Intracranial Bleedings, Epidemiology, Internal Medicine
To cite this article
Traumatic Brain Injuries in Internal Medicine Wards: An Emerging Challenge Needing for a Call to Action, American Journal of Internal Medicine.
Vol. 3, No. 2,
2015, pp. 50-54.
Tagliaferri F, Compagnone C, Korsic M, Servadei F, Kraus J. A systematic review of brain injury epidemiology in Europe. ActaNeurochir (Wien) 2006; 148: 255-68
Pérez K, Novoa AM, Santamariña-Rubio E et al.; Working Group for Study of Injuriesof Spanish Society of Epidemiology. Incidence trends of traumatic spinal cord injury and traumatic brain injury in Spain, 2000-2009. Accid Anal Prev 2012; 46: 37-44.
Selassie AW, Zaloshnja E, Langlois JA, Miller T, Jones P, Steiner C. Incidence of long-term disability following traumatic brain injury hospitalization, UnitedStates, 2003. J Head Trauma Rehabil. 2008 Mar-Apr; 23(2):123-31.
Rusticali B, Villani R; Working Group. Treatment of minor and severe traumatic brain injury. National reference guidelines. Minerva Anestesiol 2008; 74):583-616.
Brain Trauma Foundation; American Association of Neurological Surgeons; Congress of Neurological Surgeons. Guidelines for the management of severe traumatic brain injury. J Neurotrauma. 2007; 24Suppl 1:S1-106.
Andelic N, Anke A, Skandsen T, Sigurdardottir S, Sandhaug M, Ader T, Roe C. Incidence of hospital-admitted severe traumatic brain injury and in-hospital fatality in Norway: a national cohort study. Neuroepidemiology 2012; 38:259-67.
Colantonio A, Croxford R, Farooq S, Laporte A, Coyte PC. Trends in hospitalization associated with traumatic brain injury in a publicly insured population, 1992-2002. J Trauma 2009; 66:179-83.
Feigin VL, Theadom A, Barker-Collo S et al.; BIONIC Study Group. Incidence of traumatic brain injury in New Zealand: a population-based study. Lancet Neurol 2013; 12:53-64.
Harvey LA, Close JC. Traumatic brain injury in older adults: characteristics, causes and consequences. Injury 2012; 43:1821-6.
Thompson HJ, McCormick WC, Kagan SH. Traumatic brain injury in older adults: epidemiology, outcomes, and future implications. J Am Geriatr Soc. 2006; 54:1590-5.
Corrigan JD, Selassie AW, Orman JA. The epidemiology of traumatic brain injury. J Head Trauma Rehabil 2010; 25:72-80.
Fletcher AE, Khalid S, Mallonee S. The epidemiology of severe traumatic braininjury among persons 65 years of age and older in Oklahoma, 1992-2003. Brain Inj 2007; 21:691-9.