Citation

Souayah N, Khosro F, Khan HM, Ji AB, Yacoub HA, Qureshi AI. J. Neurotrauma 2013; 30(2): 84-90.

Affiliation

New Jersey Medical School, Neurology, 90 Bergen street DOC 8100, Newark , New Jersey, United States, 07101; souayani@umdnj.edu.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2011.2283

PMID

22978433

Abstract

Introduction: Several new therapeutic strategies have been introduced for the management of adult traumatic brain injury (TBI) over the last decade such as the development of management pathways and specialized TBI units and improved treatment of cerebral perfusion. The purpose of this study is to compare TBI-related hospitalization outcomes in the United States between two time periods, 1993-1994 and 2006-2007. Materials and Methods: We determined the rates of occurrence, in-hospital outcomes, and mean hospital charges for patients hospitalized with adult TBI in 1993-1994 using the nationally representative all payer Nationwide Inpatient Survey (NIS) database and compared these outcomes with homologous data from 2006-2007. Results: The incidence of TBI admissions was reduced by 35% in 2006-2007 compared to 1993-1994; (22/100,000 versus 34/100,000 population; p< 0.0001). The mean length of hospitalization in days (mean ± SD, in days) was significantly lower in 2006-2007 compared to1993-1994 (2.5 ± 2.4 versus 2.7 ± 2.6; p<0.0001). In-hospital mortality increased significantly in 2006-2007 compared with 1993-1994 (0.8% versus 0.4%, p<0.0001). The average hospitalization charges was significantly higher in 2006-2007 compared to 19993-1994 ($21,460 ± $21,212 versus $5,142 ± $4,625; p<0.0001), even after adjusting for inflation. In both time periods, most hospitalized adult TBI patients were graded as mild injury (98.2% in 1993-1994 versus 98.0% in 2006-2007; p=0.20). There was a significant increase of average hospitalization charges and death rates in all TBI severity subgroups in 2006-2007 compared to that of 1993-1994. Conclusion: The decline in the rate of hospitalization between the two time periods was predominantly related to the decline in the number of admissions of patients with mild TBI. Although the number of TBI admissions was reduced, a significant increase in average hospitalization charges and in-hospital mortality rate was observed in 2006-2007 compared with 1993-1994.

Language: en