Page 16 - Delaware Medical Journal - October 2016
P. 16
TABLE 1: Severity of TBI by Age Groups
AGE GROUP
MILD TBI
MODERATE/ SEVERE TBI
TOTAL
Infant
901 (89.4%)
107 (10.6%)
1,008
Preschool
563 (84.8%)
101 (15.2%)
664
School-age
1,132 (88.9%)
142 (11.2%)
1,274
Adolescent
2,038 (87.6%)
288 (12.4%)
2,326
Total
4,634
638
5,272
TABLE 2: Substantive and Non-substantive Admissions by Age Group
AGE GROUP
SUBSTANTIVE
NON-SUBSTANTIVE
TOTAL
Infant
479 (47.5%)
529 (52.5%)
1,008
Preschool
342 (51.5%)
322 (48.5%)
664
School-age
658 (51.7%)
616 (48.4%)
1,274
Adolescent
1,414 (60.8%)
912 (39.2%)
2,326
Total
2,893
2,379
5,272
0.0042) and non-substantive (Pearson R = 0.83, p = 0.0001) registrations trended upward over time. Non-substantive registrations increased over time in comparison to as a fraction of all registrations from 42 percent before the incorporation of NAIDHC into the DTS to 47 percent in later years (odds ratio 1.25, 95 percent confidence interval 1.12 – of substantive and non-substantive registrations between the period of NAIDHC’s Level 3 and 2 status and its subsequent confidence interval 0.90 – 1.37).
Rates of non-substantive admissions decreased with increasing
age (Table 2). After controlling for the year of registration, this
There was no association of sex with rates of non-substantive admissions. Rates of non-substantive admissions were slightly lower among African American children than among white children, 43.5 percent and 46.4 percent, respectively, but this
In Table 3 rates of mild TBI and non-substantive admissions are compared with the patient’s mode of transportation to the emergency department. Even among helicopter transports 76 percent of patients had mild TBI, and 29 percent of admissions were non-substantive. Seventy-seven of 503 helicopter transports (15.3 percent) were sent home from the emergency associations of mild TBI and non-substantive subsequent admissions with helicopter transport (data not shown).
In Table 4 rates of mild TBI and non-substantive admissions are compared by the location of the injury. Patients registered after injuries that occurred in other states were even more
likely to have had mild TBI than patients injured in Delaware. associations of mild TBI and non-substantive subsequent admissions with out-of-state injury (data not shown).
Transfers within the System
There were 476 transfers within the Delaware Trauma System
hospital dispositions. Admissions at the receiving facility were studied. There was a suggestion of a step-increase in transfers of patients with mild TBI between 2006 and 2007, coinciding with the entry of NAIDHC into the Trauma System. The proportion of transfers with mild head injuries increased from 77.0 percent before entry to 84.3 percent afterwards, but this difference did substantive admissions at the receiving facility increased from 33.5 percent before entry to 44.4 percent afterwards (odds ratio
304
Del Med J | October 2016 | Vol. 88 | No. 10
