Abstract
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.
Keywords
List of abbreviations:
ACRM (American Congress of Rehabilitation Medicine), APHIRST (Australian Paediatric Head Injury Rules Study), GCS (Glasgow Coma Scale), LOC (loss of consciousness), PTA (posttraumatic amnesia), TBI (traumatic brain injury), WHO (World Health Organization)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: February 04, 2018
Footnotes
Supported by the National Health and Medical Research Council of Australia (grant no. 1046727), the Emergency Medicine Foundation, Perpetual Philanthropic Services, WA Health Targeted Research Funds, Townsville Hospital Private Practice Fund, the Auckland Medical Research Foundation, A + Trust, Victorian Government's Operational Infrastructure Support Program, and a National Health and Medical Research Council Early Career Fellowship (award no. GNT1071544).
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
