BACKGROUND: Extremely few objective estimates of traumatic brain injury incidence include all ages, both sexes, all injury mechanisms, and the full spectrum from very mild to fatal events. METHODS: We used unique Rochester Epidemiology Project medical records-linkage resources, including highly sensitive and specific diagnostic coding, to identify all Olmsted County, MN, residents with diagnoses suggestive of traumatic brain injury regardless of age, setting, insurance, or injury mechanism. Provider-linked medical records for a 16% random sample were reviewed for confirmation as definite, probable, possible (symptomatic), or no traumatic brain injury. We estimated incidence per 100,000 person-years for 1987-2000 and compared these record-review rates with rates obtained using Centers for Disease Control and Prevention (CDC) data-systems approach. For the latter, we identified all Olmsted County residents with any CDC-specified diagnosis codes recorded on hospital/emergency department administrative claims or death certificates during 1987-2000. RESULTS: Of sampled individuals, 1257 met record-review criteria for incident traumatic brain injury; 56% were ages 16-64 years, 56% were male, and 53% were symptomatic. Mechanism, sex, and diagnostic certainty differed by age. The incidence rate per 100,000 person-years was 558 (95% confidence interval = 528-590) versus 341 (331-350) using the CDC data-system approach. The CDC approach captured only 40% of record-review cases. Seventy-four percent of missing cases presented to the hospital/emergency department; none had CDC-specified codes assigned on hospital/emergency department administrative claims or death certificates; and 66% were symptomatic. CONCLUSIONS: Capture of symptomatic traumatic brain injuries requires a wider range of diagnosis codes, plus sampling strategies to avoid high rates of false-positive events.
BACKGROUND: Extremely few objective estimates of traumatic brain injury incidence include all ages, both sexes, all injury mechanisms, and the full spectrum from very mild to fatal events. METHODS: We used unique Rochester Epidemiology Project medical records-linkage resources, including highly sensitive and specific diagnostic coding, to identify all Olmsted County, MN, residents with diagnoses suggestive of traumatic brain injury regardless of age, setting, insurance, or injury mechanism. Provider-linked medical records for a 16% random sample were reviewed for confirmation as definite, probable, possible (symptomatic), or no traumatic brain injury. We estimated incidence per 100,000 person-years for 1987-2000 and compared these record-review rates with rates obtained using Centers for Disease Control and Prevention (CDC) data-systems approach. For the latter, we identified all Olmsted County residents with any CDC-specified diagnosis codes recorded on hospital/emergency department administrative claims or death certificates during 1987-2000. RESULTS: Of sampled individuals, 1257 met record-review criteria for incident traumatic brain injury; 56% were ages 16-64 years, 56% were male, and 53% were symptomatic. Mechanism, sex, and diagnostic certainty differed by age. The incidence rate per 100,000 person-years was 558 (95% confidence interval = 528-590) versus 341 (331-350) using the CDC data-system approach. The CDC approach captured only 40% of record-review cases. Seventy-four percent of missing cases presented to the hospital/emergency department; none had CDC-specified codes assigned on hospital/emergency department administrative claims or death certificates; and 66% were symptomatic. CONCLUSIONS: Capture of symptomatic traumatic brain injuries requires a wider range of diagnosis codes, plus sampling strategies to avoid high rates of false-positive events.
Authors: Julie Testa Flaada; Cynthia L Leibson; Jayawant N Mandrekar; Nancy Diehl; Patricia K Perkins; Allen W Brown; James F Malec Journal: J Neurotrauma Date: 2007-03 Impact factor: 5.269
Authors: M Smits; M G M Hunink; P J Nederkoorn; H M Dekker; P E Vos; D R Kool; P A M Hofman; A Twijnstra; G G de Haan; H L J Tanghe; D W J Dippel Journal: J Neurol Neurosurg Psychiatry Date: 2007-04-30 Impact factor: 10.154
Authors: James F Malec; Allen W Brown; Cynthia L Leibson; Julie Testa Flaada; Jayawant N Mandrekar; Nancy N Diehl; Patricia K Perkins Journal: J Neurotrauma Date: 2007-09 Impact factor: 5.269
Authors: Cynthia L Leibson; Jack Needleman; Peter Buerhaus; John A Heit; L Joseph Melton; James M Naessens; Kent R Bailey; Tanya M Petterson; Jeanine E Ransom; Marcelline R Harris Journal: Med Care Date: 2008-02 Impact factor: 2.983
Authors: Janet M Powell; Joseph V Ferraro; Sureyya S Dikmen; Nancy R Temkin; Kathleen R Bell Journal: Arch Phys Med Rehabil Date: 2008-07-02 Impact factor: 3.966
Authors: Cynthia L Leibson; Allen W Brown; Kirsten Hall Long; Jeanine E Ransom; Jay Mandrekar; Turner M Osler; James F Malec Journal: J Neurotrauma Date: 2012-04-26 Impact factor: 5.269
Authors: Jennifer L St Sauver; David O Warner; Barbara P Yawn; Debra J Jacobson; Michaela E McGree; Joshua J Pankratz; L Joseph Melton; Véronique L Roger; Jon O Ebbert; Walter A Rocca Journal: Mayo Clin Proc Date: 2013-01 Impact factor: 7.616
Authors: Jennifer S Albrecht; Jon Mark Hirshon; Maureen McCunn; Kathleen T Bechtold; Vani Rao; Linda Simoni-Wastila; Gordon S Smith Journal: J Head Trauma Rehabil Date: 2016 Sep-Oct Impact factor: 2.710
Authors: Allen W Brown; Cynthia L Leibson; Jay Mandrekar; Jeanine E Ransom; James F Malec Journal: J Head Trauma Rehabil Date: 2014 Jan-Feb Impact factor: 2.710
Authors: Anbesaw W Selassie; Dulaney A Wilson; E Elisabeth Pickelsimer; Delia C Voronca; Nolan R Williams; Jonathan C Edwards Journal: Ann Epidemiol Date: 2013-09-20 Impact factor: 3.797