Abstract
Objectives
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.
Keywords
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Article info
Publication history
Published online: May 27, 2016
Accepted:
May 26,
2016
Footnotes
☆This study was conducted at an orthopaedic clinic of a Level 1 Trauma Hospital located in the city of Montreal, Quebec, Canada (Montreal Sacred Heart Hospital Research Centre).
Identification
Copyright
© 2016 Elsevier Ltd. All rights reserved.
