Incidence rate of mild traumatic brain injury among patients who have suffered from an isolated limb fracture: Upper limb fracture patients are more at risk

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• 作者：Marianne Jodoin^a ; ^b ; Dominique M. Rouleau^b ; ^d ; ^{dominique.rouleau@umontreal.ca" class="auth_mail" title="E-mail the corresponding author} ; Camille Charlebois-Plante^d ; Benoit Benoit^b ; ^d ; Sté ; phane Leduc^b ; ^d ; G-Yves Laflamme^b ; ^d ; Nadia Gosselin^a ; ^b ; Camille Larson-Dupuis^a ; ^b ; Louis De Beaumont^b ; ^c
• 关键词：Mild traumatic brain injury ; Orthopaedic monotrauma ; Incidence rate
• 刊名：Injury
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：47
• 期：8
• 页码：1835-1840
• 全文大小：628 K

文摘

This study compares the incidence rate of mild traumatic brain injury (mild TBI) detected at follow-up visits (retrospective diagnosis) in patients suffering from an isolated limb trauma, with the incidence rate held by the hospital records (prospective diagnosis) of the sampled cohort. This study also seeks to determine which types of fractures present with the highest incidence of mild TBI.

Patients and methods

Retrospective assessment of mild TBI among orthopaedic monotrauma patients, randomly selected for participation in an Orthopaedic clinic of a Level I Trauma Hospital. Patients in the remission phase of a limb fracture were recruited between August 2014 and May 2015. No intervention was done (observational study). Main outcome measurements: Standardized semi-structured interviews were conducted with all patients to retrospectively assess for mild TBI at the time of the fracture. Emergency room related medical records of all patients were carefully analyzed to determine whether a prospective mild TBI diagnosis was made following the accident.

Results

A total of 251 patients were recruited (54% females, Mean age = 49). Study interview revealed a 23.5% incidence rate of mild TBI compared to an incidence rate of 8.8% for prospective diagnosis (χ² = 78.47; p < 0.0001). Patients suffering from an upper limb monotrauma (29.6%; n = 42/142) are significantly more at risk of sustaining a mild TBI compared to lower limb fractures (15.6%; n = 17/109) (χ² = 6.70; p = 0.010). More specifically, patients with a proximal upper limb injury were significantly more at risk of sustaining concomitant mild TBI (40.6%; 26/64) compared to distal upper limb fractures (20.25%; 16/79) (χ² = 7.07; p = 0.008).

Conclusions

Results suggest an important concomitance of mild TBI among orthopaedic trauma patients, the majority of which go undetected during acute care. Patients treated for an upper limb fracture are particularly at risk of sustaining concomitant mild TBI.