Children and youth with ′unspecified injury to the head′: implications for traumatic brain injury research and surveillance
Children and youth with ′unspecified injury to the head′: implications for traumatic brain injury research and surveillance
复制标题
DOI：
10.1186/s12982-015-0031-x
复制
发表时间：
2015-06-25
影响因子：
2.3
通讯作者：
Colantonio, Angela
中科院分区：
文献类型：
--
作者：
Chan, Vincy;Mann, Robert;Colantonio, Angela
背景：创伤性脑损伤（TBI）的病例定义通常包括“未指明的头部损伤”诊断代码。然而，研究表明，包含这些代码会导致误报。因此，重要的是确定纳入这些代码对TBI人群的总体数量和特征的影响程度。本文的目的是描述和比较19岁及以下住院儿童和青少年的人口统计学和临床特征、损伤的目的和机制以及出院处置：（1）包括“未指明的头部损伤”诊断代码的包容性TBI病例定义，（2）排除“未指明的头部损伤”诊断代码的限制性TBI病例定义，方法：采用加拿大安大略的全国门诊报告系统和出院摘要数据库，对2003/04 ~ 2009/10年度的病例进行统计分析。使用TBI的包容性病例定义（2，667.2/100，000）的TBI护理事件发生率是限制性病例定义（1，613.3/100，000）的1.65倍。“未指明的头部损伤”诊断代码占所有病例的39.5%，包括病例定义。在TBI病例定义中排除“未指明的头部损伤”诊断代码导致重症监护室患者比例显著升高（p
Background: The case definition for traumatic brain injury (TBI) often includes 'unspecified injury to the head' diagnostic codes. However, research has shown that the inclusion of these codes leads to false positives. As such, it is important to determine the degree to which inclusion of these codes affect the overall numbers and profiles of the TBI population. The objective of this paper was to profile and compare the demographic and clinical characteristics, intention and mechanism of injury, and discharge disposition of hospitalized children and youth aged 19 years and under using (1) an inclusive TBI case definition that included 'unspecified injury to the head' diagnostic codes, (2) a restricted TBI case definition that excluded 'unspecified injury to the head 'diagnostic codes, and (3) the 'unspecified injury to the head' only case definition.Methods: The National Ambulatory Care Reporting System and the Discharge Abstract Database from Ontario, Canada, were used to identify cases between fiscal years 2003/04 and 2009/10.Results: The rate of TBI episodes of care using the inclusive case definition for TBI (2,667.2 per 100,000) was 1.65 times higher than that of the restricted case definition (1,613.3 per 100,000). 'Unspecified injury to the head' diagnostic codes made up of 39.5 % of all cases identified with the inclusive case definition. Exclusion of 'unspecified injury to the head' diagnostic code in the TBI case definition resulted in a significantly higher proportion of patients in the intensive care units (p