Implications of case definition selection on traumatic brain injury trends: A controlled interrupted time-series analysis of North Carolina emergency department data.

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-09-23 DOI:10.1016/j.annepidem.2025.09.017

Lucas M Neuroth, Yuni Tang, Anna E Waller, Katherine J Harmon

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引用次数: 0

Abstract

Background: In 2015, the CDC removed unspecified head injuries from its TBI surveillance case definition, complicating the investigation of long-term morbidity trends. We examined the long-term impact of this change on quantifying statewide TBI incidence.

Methods: North Carolina emergency department (ED) visit records were obtained from 2012 to 2024 and classified based on the presence (S09.90+) or absence (S09.90-) of the ICD-10-CM code for "head injury, unspecified". Segmented Poisson regression was used to compare slope- and level-changes in monthly TBI visit counts.

Results: From January 2012 through September 2015, TBI visits increased at a rate of 14.9 visits per month. TBI visits dropped at the onset of COVID-19, and then rebounded after the relaxation of the state's stay-at-home-order; however, this trend was diminished under the S09.90- definition, with a difference of 75.9 (57.2-94.6) visits per month between the two definitions.

Conclusions: The presence of unspecified head injuries in the TBI surveillance case definition substantially altered statewide trends and their inclusion may better reflect injury burden.

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创伤性脑损伤趋势的病例定义选择的含义：北卡罗来纳州急诊科数据的受控中断时间序列分析。

背景：2015年，美国疾病控制与预防中心从其TBI监测病例定义中删除了未指明的头部损伤，使长期发病率趋势的调查复杂化。我们研究了这一变化对量化全州TBI发病率的长期影响。方法：获取2012-2024年北卡罗莱纳州急诊科（ED）就诊记录，根据ICD-10-CM“头部损伤，未指明”编码是否存在（S09.90+）或是否存在（S09.90-）进行分类。使用分段泊松回归比较每月TBI就诊计数的斜率和水平变化。结果：从2012年1月到2015年9月，TBI就诊人数以每月14.9次的速度增长。新冠肺炎爆发时，颅脑损伤就诊人数下降，但在国家放松居家令后出现反弹；然而，这一趋势在S09.90-定义下有所减弱，两种定义之间每月访问次数相差75.9次（57.2次对94.6次）。结论：在TBI监测病例定义中，未明确的头部损伤的存在极大地改变了全州的趋势，它们的纳入可能更好地反映了损伤负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.