Difficulties capturing co-occurring traumatic brain injury among people with traumatic spinal cord injury: a population-based study

Spinal Cord, 2023 · DOI: https://doi.org/10.1038/s41393-022-00851-5 · Published: September 16, 2022

Spinal Cord Injury Rehabilitation Brain Injury

Simple Explanation

This study investigates the challenges of identifying traumatic brain injury (TBI) in individuals who have also experienced a traumatic spinal cord injury (TSCI). It highlights that TBI is often missed in TSCI patients, which can negatively impact their rehabilitation outcomes. The research aimed to evaluate the feasibility of using a specific diagnostic algorithm to identify co-occurring TBI in TSCI patients. The findings revealed difficulties in consistently applying the algorithm due to inconsistent documentation of TBI indicators. The study suggests a need for alternative screening approaches for TBI in TSCI patients and emphasizes the importance of consistent documentation of TBI indicators across the continuum of care to improve treatment planning.

Study Duration

8 Months

Participants

51 adults (age 16+) with TSCI

Evidence Level

Population-based prospective cohort study

Key Findings

1
Co-occurring TBI was identified in 39% of TSCI cases, with an additional proportion of suspected cases, potentially raising the total to 55%.
2
The study found difficulties in consistently applying a published TBI diagnostic algorithm due to variable documentation of TBI indicators.
3
References to post-traumatic amnesia (PTA) were evident in only a third of cases, and estimating PTA duration was often difficult or impossible.

Research Summary

This study investigated the feasibility of using a published algorithm to identify co-occurring TBI in patients with TSCI. The study found that the algorithm was difficult to apply consistently due to inconsistent documentation of TBI indicators. The study identified co-occurring TBI in 39% of TSCI cases, with a potential for up to 55% when including suspected cases. This highlights the prevalence of TBI in TSCI patients. The researchers suggest that alternative approaches to screening for TBI in TSCI patients are needed, along with improved consistency in documenting TBI indicators across the continuum of care.

Practical Implications

Improved TBI Screening

Implement alternative screening methods for TBI in TSCI patients to ensure accurate identification of co-occurring injuries.

Standardized Documentation

Enhance the consistency of documenting TBI indicators, such as PTA and GCS scores, across all stages of care, from acute to rehabilitation settings.

Enhanced Treatment Planning

Incorporate TBI diagnoses into treatment plans to address the specific needs of patients with co-occurring TSCI and TBI, leading to improved rehabilitation outcomes.

Study Limitations

1
Small sample size from a single center.
2
Potential for inflated TBI estimates due to the inclusion of suspected cases.
3
Inability to access paramedic records for out-of-region injuries, resulting in missing information.

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