Physician begins national head-trauma registry to track why, how injuries happen

January 24, 2002

Each year, emergency room physicians treat more than 1 million patients for head injuries, many due to outdoor recreational activities. Doctors will report anecdotally that sledding and snow boarding seem to be the biggest wintertime culprits, yet physicians really do not have the data to make accurate predictions about this major public health issue.

But a new surveillance program at the University of Rochester Medical Center could lead to better prevention and become a nationwide model. Jeffrey Bazarian, M.D., assistant professor in Emergency Medicine, has received a $560,000 National Institutes of Health grant to start the nation's first Emergency Department-based traumatic brain injury registry.

The 18-month project involves collecting details about every head-injury patient who comes to the E.D. at the university's Strong Memorial Hospital. Trained interviewers will ask patients or their families questions such as: Exactly where did the injury happen? How? Was a sport involved? Was the patient intoxicated? Wearing a helmet or seatbelt? Bazarian will also scrutinize the medical data to evaluate what type of imaging tests were performed or what medications were prescribed. He will track patients during recovery to find out which ones were more likely to have lingering problems such as dizziness, or an inability to concentrate.

This level of information is currently missing from hospital charts across the United States, Bazarian says, because most institutions do not have the time, personnel or technology to collect it. Therefore, when the Centers for Disease Control or other public health agency wants to review data on head injuries, the records are too vague to make useful conclusions.

"If we really want to design a prevention program, we need to know everything that happened during each injury, in great detail," Bazarian says. "Only then would we be able to look for things like geographic clusters or other environmental conditions that contribute to head injuries."

The UR Medical Center is well positioned for this project. Its Emergency Department already employs people who are specially trained to interview patients for possible enrollment in research studies. Strong Hospital is also plugged into a statewide electronically coded pre-hospital data system. This allows emergency medical technicians across New York to enter patient information into a computer system that ultimately becomes part of the patient's hospital chart.

Once Bazarian begins collecting head injury details, he can begin scientifically testing hypotheses. For example, although men are most likely to suffer head injuries, women have worse outcomes, according to a preliminary study of emergency patients done by Bazarian. Ultimately, the research could help physicians decide if hormonal differences play a role in recovery, and if so, how diagnosis and treatment should change.

Personal experiences prompted Bazarian to investigate brain injuries. His father died in 1993 of a head injury after falling down a flight of stairs. And as an emergency room physician, he sees plenty of seasonal head traumas in summer due to bicycles and scooters, in autumn from football and soccer, and on outdoor playgrounds year round.

One goal of Bazarian's research is to reduce the disabilities from head injuries. Although many head injuries are relatively minor concussions, about 50 percent of these patients still suffer from headaches and other symptoms for as long as three months, Bazarian says. A full 25 percent of patients with concussions will have significant disabilities for six months afterward.

"Some people think there is such a thing as a mild concussion," adds Sandra M. Schneider, M.D., professor and chair, Department of Emergency Medicine. "But what we are learning from Dr. Bazarian and others in this field is that even a mild head injury can have significant consequences at least for a while."

"Prevention is the key," Bazarian says. "In addition, having a surveillance system in place will allow us to eventually test new medications or other treatments for head injuries."
-end-


University of Rochester Medical Center

Related Head Injury Articles from Brightsurf:

Soccer players' head injury risk could be reduced with simple adjustments to the ball
To reduce risk of soccer player head injury, a new study recommends preventing how hard a ball hits the head by inflating balls to lower pressures and subbing them out when they get wet.

Head to head comparison of five assays used to detect SARS-CoV-2 antibodies shows Siemens and Oxford assays met regulatory targets
New research being presented at the ESCMID Conference on Coronavirus Disease (ECCVID, online 23-25 September) shows that, in a head-to-head comparison of five tests used to detect SARS-CoV-2 antibodies (known as 'immunoassays'), an assay manufactured by Siemens and one developed by an academic partnership led by the University of Oxford had the most accurate results.

One in two homeless people may have experienced a head injury in their lifetime
People who are homeless experience a disproportionately high lifetime prevalence of traumatic brain injury (TBI), according to a new UBC-led study published today in The Lancet Public Health.

Global trial is first clear evidence that widely available drug reduces head injury deaths
A low cost and widely available drug could reduce deaths in traumatic brain injury patients by as much as 20%, depending on the severity of injury, according to a major study led by the London School of Hygiene & Tropical Medicine and published in The Lancet.

Microbleeds may worsen outcome after head injury
Using advanced imaging, researchers have uncovered new information regarding traumatic microbleeds, which appear as small, dark lesions on MRI scans after head injury but are typically too small to be detected on CT scans.

Protein tangles linked with dementia seen in patients after single head injury
Scientists have visualized for the first time protein 'tangles' associated with dementia in the brains of patients who have suffered a single head injury.

Head injury effects halted by xenon gas, finds first ever life-long study in mice
Following traumatic brain injury (TBI), xenon prevented early death, improved long-term cognition, and protected brain tissue in mice in a new study.

Mental health disorders common following mild head injury
A new study reveals that approximately 1 in 5 individuals may experience mental health symptoms up to six months after mild traumatic brain injury (mTBI), suggesting the importance of follow-up care for these patients.

One type of brain cell might hold key to inflammation after head injury
By eliminating one type of immune cell in the brain, researchers were able to erase any evidence of inflammation following traumatic brain injury, according to a new study from The Ohio State University.

Youth TBI laws promote head injury evaluation in emergency department
A new study from researchers in the Center for Injury Research and Policy at Nationwide Children's Hospital examined the effectiveness of state youth TBI laws by looking at sports and recreation mild TBI (mTBI)-related emergency department (ED) visits for children ages 5 to 18 years before and after TBI legislation was enacted in each state.

Read More: Head Injury News and Head Injury Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.