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The Epidemiology of Outpatient Visits for Minor Head Injury: 2005 to 2009

Mannix, Rebekah MD, MPH*,‡; O’Brien, Michael J. MD§,¶; Meehan, William P. III MD*,‡,§,¶

Neurosurgery:
doi: 10.1227/01.neu.0000429846.14579.41
Research-Human-Clinical Studies
Abstract

BACKGROUND: The Centers for Disease Control and Prevention have called for studies detailing the prevalence and burden of mild traumatic brain injury (mTBI) in the outpatient clinical setting.

OBJECTIVE: The aim of this study was to describe the prevalence of outpatient visits for minor head injury and compare the number of outpatient visits for minor head injury with the number of emergency department (ED) visits.

METHODS: This was a cross-sectional study of outpatient visits for minor head injuries from the National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS). We examined outpatient visits for minor head injury between 2005 and 2009 and compared them with visits in the ED for the same diagnoses using simple survey-weighted descriptive statistics.

RESULTS: In the 5-year study period, there were 4 146 777 outpatient visits for minor head injury and 6 077 147 ED visits for minor head injury. In the outpatient setting, 14% of office-based visits and 21% of hospital-based visits referred patients for advanced imaging, whereas 63% of minor head injury patients in the ED underwent imaging. A return visit was arranged for 54% of minor head injury patients in office-based practices and 29% of patients in hospital-based clinics, while 67% of minor head injury patients were given instructions to follow-up after an ED visit.

CONCLUSION: More than 800 000 outpatient visits for minor head injury occur each year. The diagnostics and management associated with these visits differ from those seen in the ED setting.

ABBREVIATIONS: CDC, Centers for Disease Control and Prevention

ED, emergency department

mTBI, mTBI, traumatic brain injury

NAMCS, National Ambulatory Medical Care Survey

NHAMCS, National Hospital Ambulatory Medical Care Survey

PSI, primary sampling unit

Author Information

*Division of Emergency Medicine,

Brain Injury Center,

§Sports Concussion Clinic, Division of Sports Medicine, Children's Hospital Boston, Boston, Massachusetts;

The Micheli Center for Sports Injury Prevention, Waltham, Massachusetts

Correspondence: Rebekah Mannix, MD, MPH, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115. E-mail: Rebekah.Mannix@childrens.harvard.edu

Received October 24, 2012

Accepted March 08, 2013

Copyright © by the Congress of Neurological Surgeons