Although patients who have had a mild traumatic brain injury (mTBI) will more than likely receive immediate, necessary treatment doesn't mean they will have fully recovered or are receive follow-up care for long-lasting physical and cognitive symptoms.
Less than half of patients receive follow-up care after having a mTBI, according to a study published May 25 in the Journal of the American Medical Association Network Open.
Lead author Seth Seabury, PhD, from the Keck School of Medicine at the University of Southern California, and colleagues determined that there are "significant gaps in follow-up for patients with mTBI after hospital discharge, even those with a positive finding on CT or who continue to experience post concussive symptoms."
"While patients with moderate to severe TBI are almost always admitted to a hospital or ICU for close monitoring and intervention, there is considerably less consensus as to best practices for patients with mTBI," Seabury et al. wrote. "The lack of consistent clinical practice raises concerns that many patients with mTBI may not receive adequate follow-up care."
Seabury and colleagues used data on a total of 831 patients aged 17 years or older with mTBI enrolled in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI), a prospective and multicenter observation study of patients with TBI presenting to the emergency department at 1 of 11 level one U.S. trauma centers.
All 831 patients with head trauma underwent a computed tomography (CT) scan within 24 hours of injury, had a Glasgow coma Scale score of 13 to 15, completed follow-up care surveys at two weeks and three months after injury. Site-specific variations in follow-up care, clinicians who see patients for follow-up care and patient/injury characteristics associated with a high rate of receiving follow-up care for a mTBI were examined, the researchers wrote.
Overall, less than half of patients reported receiving follow-up care with a physician or medical practitioner within three months after injury or getting additional information at discharge, the researchers wrote.
Of these patients, just 15 percent visited a clinic specializing in head injury. Additionally, half of them saw a general practitioner and almost a third reported seeing more than one type of physician.
A positive finding on the initial head CT scan resulted in a higher chance of receiving follow-up care was determined. However, the researchers noted that patients admitted to the hospital or ICU were no more likely to have gotten follow-up care than those discharged directly from the ED.
"Our findings reveal the consequences that may result from the absence of systems of follow-up care for patients with mTBI and concussion. They also highlight an apparent lack of appreciation by many clinicians of the substantial symptom and life burdens experienced by a significant proportion of patients with injuries labeled mild," Seabury et al. wrote. "For that reason, patients with mTBI are often quickly triaged. Increased efforts are warranted to raise ED clinician awareness of the importance of follow-up care to prevent morbidity and disability."
This study was funded by the National Institutes of Health.
A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.