Investigating the Variability in Mild Traumatic Brain Injury Definitions: A Prospective Cohort Study

Crowe, Louise M.; Hearps, Stephen; Anderson, Vicki; Borland, Meredith; Phillips, Natalie; Kochar, Amit; Dalton, Sarah; Cheek, John A.; Gilhotra, Yuri; Furyk, Jeremy; Neutze, Jocelyn; Lyttle, Mark; Bressan, Silvia; Donath, Susan; Molesworth, Charlotte; Oakley, Ed; Dalziel, Stuart R.; Babl, Franz E.

Abstract

© 2018 American Congress of Rehabilitation Medicine Objective: To prospectively compare the proportion of traumatic brain injuries (TBIs) that would be classified as mild by applying different published definitions of mild TBI to a large prospectively collected dataset, and to examine the variability in the proportions included by various definitions. Design: Prospective observational study. Setting: Hospital emergency departments. Participants: Children (N=11,907) aged 3 to 16 years (mean age, 8.2±3.9y). Of the participants, 3868 (32.5%) were girls, and 7374 (61.9%) of the TBIs were the result of a fall. Median Glasgow Coma Scale score was 15. Main Outcome Measures: We applied 17 different definitions of mild TBI, identified through a published systematic review, to children aged 3 to 16 years. Adjustments and clarifications were made to some definitions. The number and percentage identified for each definition is presented. Results: Adjustments had to be made to the 17 definitions to apply to the dataset: none in 7, minor to substantial in 10. The percentage classified as mild TBI across definitions varied from 7.1% (n=841) to 98.7% (n=11,756) and varied by age group. Conclusions: When applying the 17 definitions of mild TBI to a large prospective multicenter dataset of TBI, there was wide variability in the number of cases classified. Clinicians and researchers need to be aware of this variability when examining literature concerning children with mild TBI.

• Journal Article Type: Article
• Acceptance Date: Dec 14, 2017
• Online Publication Date: Feb 4, 2018
• Publication Date: Jul 1, 2018
• Deposit Date: Feb 13, 2018
• Publicly Available Date: Feb 4, 2019
• Journal: Archives of Physical Medicine and Rehabilitation
• Print ISSN: 0003-9993
• Electronic ISSN: 1532-821X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 99
• Issue: 7
• Pages: 1360-1369
• DOI: https://doi.org/10.1016/j.apmr.2017.12.026
• Keywords: traumatic brain injury, head injuries, child
• Public URL: https://uwe-repository.worktribe.com/output/863673
• Publisher URL: https://doi.org/10.1016/j.apmr.2017.12.026
• Additional Information: Additional Information : This is the author's accepted manuscript. The final published version is available here: https://doi.org/10.1016/j.apmr.2017.12.026.
• Contract Date: Feb 13, 2018