@article{ref1,
title="Assessment of follow-up care after emergency department presentation for mild traumatic brain injury and concussion: results from the TRACK-TBI Study",
journal="JAMA network open",
year="2018",
author="Seabury, Seth A. and Gaudette, Étienne and Goldman, Dana P. and Markowitz, Amy J. and Brooks, Jordan and McCrea, Michael A. and Okonkwo, David O. and Manley, Geoffrey T. and Adeoye, Opeolu M. and Badjatia, Neeraj and Boase, Kim and Bodien, Yelena and Bullock, M. Ross and Chesnut, Randall and Corrigan, John D. and Crawford, Karen and Diaz-Arrastia, Ramon and Dikmen, Sureyya and Duhaime, Ann-Christine and Ellenbogen, Richard and Feeser, V. Ramana and Ferguson, Adam and Foreman, Brandon and Gardner, Raquel and Giacino, Joseph T. and González, Luis and Gopinath, Shankar and Gullapalli, Rao and Hemphill, J. Claude and Hotz, Gillian and Jain, Sonia and Korley, Frederick and Kramer, Joel and Kreitzer, Natalie and Levin, Harvey and Lindsell, Chris and Machamer, Joan and Madden, Christopher and Martin, Alastair and McAllister, Thomas and Merchant, Randall and Mukherjee, Pratik and Nelson, Lindsay and Noel, Florence and Palacios, Eva and Perl, Daniel and Puccio, Ava and Rabinowitz, Miri and Robertson, Claudia and Rosand, Jonathan and Sander, Angelle and Satris, Gabriella and Schnyer, David and Sherer, Mark and Stein, Murray and Taylor, Sabrina and Temkin, Nancy and Toga, Arthur and Valadka, Alex and Vassar, Mary and Vespa, Paul and Wang, Kevin and Yue, John and Yuh, Esther and Zafonte, Ross",
volume="1",
number="1",
pages="e180210-e180210",
abstract="IMPORTANCE: Mild traumatic brain injury (mTBI) affects millions of Americans each year. Lack of consistent clinical practice raises concern that many patients with mTBI may not receive adequate follow-up care. <br><br>OBJECTIVE: To characterize the provision of follow-up care to patients with mTBI during the first 3 months after injury. <br><br>DESIGN, SETTING, AND PARTICIPANTS: This cohort study used data on patients with mTBI enrolled in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study between February 26, 2014, and August 25, 2016. We examined site-specific variations in follow-up care, the types of clinicians seen by patients receiving follow-up care, and patient and injury characteristics associated with a higher likelihood of receiving follow-up care. The TRACK-TBI study is a prospective, multicenter, longitudinal observational study of patients with TBI presenting to the emergency department of 1 of 11 level I US trauma centers. Study data included patients with head trauma who underwent a computed tomography (CT) scan within 24 hours of injury, had a Glasgow Coma Scale score of 13 to 15, were aged 17 years or older, and completed follow-up care surveys at 2 weeks and 3 months after injury (N = 831). <br><br>MAIN OUTCOMES AND MEASURES: Follow-up care was defined as hospitals providing TBI educational material at discharge, hospitals calling patients to follow up, and patients seeing a physician or other medical practitioner within 3 months after the injury. Unfavorable outcomes were assessed with the Rivermead Post Concussion Symptoms Questionnaire. <br><br>RESULTS: Of 831 patients (289 [35%] female; 483 [58%] non-Hispanic white; mean [SD] age, 40.3 [16.9] years), less than half self-reported receiving TBI educational material at discharge (353 patients [42%]) or seeing a physician or other health care practitioner within 3 months after injury (367 patients [44%]). Follow-up care varied by study site; adjusting for patient characteristics, the provision of educational material varied from 19% to 72% across sites. Of 236 patients with a positive finding on a CT scan, 92 (39%) had not seen a medical practitioner 3 months after the injury. Adjusting for injury severity and demographics, patient admission to the hospital ward or intensive care unit, patient income, and insurance status were not associated with the probability of seeing a medical practitioner. Among the patients with 3 or more moderate to severe postconcussive symptoms, only 145 of 279 (52%) reported having seen a medical practitioner by 3 months. <br><br>CONCLUSIONS AND RELEVANCE: There are gaps in follow-up care for patients with mTBI after hospital discharge, even those with a positive finding on CT or who continue to experience postconcussive symptoms.<p /> <p>Language: en</p>",
language="en",
issn="2574-3805",
doi="10.1001/jamanetworkopen.2018.0210",
url="http://dx.doi.org/10.1001/jamanetworkopen.2018.0210"
}