Secondary Overtriage in Patients with Complicated Mild Traumatic Brain Injury: An Observational Study and Socioeconomic Analysis of 1447 Hospitalizations

Bradley A. Dengler, Sonia Plaza-Wüthrich, Robert C. Chick, Mark T. Muir, Viktor Bartanusz

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Secondary overtriage is a problematic phenomenon because it creates unnecessary expense and potentially results in the mismanagement of healthcare resources. The rates of secondary overtriage among patients with complicated mild traumatic brain injury (cmTBI) are unknown. OBJECTIVE: To determine the rate of secondary overtriage among patients with cmTBI using the institutional trauma registry. METHODS: An observational study using retrospective analysis of 1447 hospitalizations including all consecutive patients with cmTBI between 2004 and 2013. Data on age, sex, race/ethnicity, insurance status, GCS, Injury Severity Score (ISS), Trauma Injury Severity Score, transfer mode, overall length of stay (LOS), LOS within intensive care unit, and total charges were collected and analyzed. RESULTS: Overall, the rate of secondary overtriage among patients with cmTBI was 17.2%. These patients tended to be younger (median: 41 vs 60.5 yr; P <. 001), have a lower ISS (9 vs 16; P <. 001), and were more likely to be discharged home or leave against medical advice. CONCLUSION: Our findings provide evidence to the growing body of literature suggesting that not all patients with cmTBI need to be transferred to a tertiary care center. In our study, these transfers ultimately incurred a total cost of $13 294 ($1337 transfer cost) per patient.

Original languageEnglish (US)
Pages (from-to)374-382
Number of pages9
JournalClinical Neurosurgery
Volume86
Issue number3
DOIs
StatePublished - Mar 1 2020

Keywords

  • Complicated mild traumatic brain injury
  • Hospitalization costs
  • Injury severity score
  • Secondary overtriage
  • Trauma injury severity score

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Fingerprint Dive into the research topics of 'Secondary Overtriage in Patients with Complicated Mild Traumatic Brain Injury: An Observational Study and Socioeconomic Analysis of 1447 Hospitalizations'. Together they form a unique fingerprint.

Cite this