Incidence of traumatic brain injury across the full disease spectrum

A population-based medical record review study

Cynthia L. Leibson, Allen W. Brown, Jeanine E. Ransom, Nancy N. Diehl, Patricia K. Perkins, Jay Mandrekar, James F. Malec

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)836-844
Number of pages9
JournalEpidemiology
Volume22
Issue number6
DOIs
StatePublished - Nov 2011

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Centers for Disease Control and Prevention (U.S.)
Medical Records
Hospital Departments
Incidence
Hospital Emergency Service
Death Certificates
Population
Medical Record Linkage
Wounds and Injuries
Systems Analysis
Insurance
Information Systems
Epidemiology
Traumatic Brain Injury
Confidence Intervals

ASJC Scopus subject areas

  • Epidemiology

Cite this

Leibson, C. L., Brown, A. W., Ransom, J. E., Diehl, N. N., Perkins, P. K., Mandrekar, J., & Malec, J. F. (2011). Incidence of traumatic brain injury across the full disease spectrum: A population-based medical record review study. Epidemiology, 22(6), 836-844. https://doi.org/10.1097/EDE.0b013e318231d535

Incidence of traumatic brain injury across the full disease spectrum : A population-based medical record review study. / Leibson, Cynthia L.; Brown, Allen W.; Ransom, Jeanine E.; Diehl, Nancy N.; Perkins, Patricia K.; Mandrekar, Jay; Malec, James F.

In: Epidemiology, Vol. 22, No. 6, 11.2011, p. 836-844.

Research output: Contribution to journalArticle

Leibson, CL, Brown, AW, Ransom, JE, Diehl, NN, Perkins, PK, Mandrekar, J & Malec, JF 2011, 'Incidence of traumatic brain injury across the full disease spectrum: A population-based medical record review study', Epidemiology, vol. 22, no. 6, pp. 836-844. https://doi.org/10.1097/EDE.0b013e318231d535
Leibson, Cynthia L. ; Brown, Allen W. ; Ransom, Jeanine E. ; Diehl, Nancy N. ; Perkins, Patricia K. ; Mandrekar, Jay ; Malec, James F. / Incidence of traumatic brain injury across the full disease spectrum : A population-based medical record review study. In: Epidemiology. 2011 ; Vol. 22, No. 6. pp. 836-844.
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