Citation

Bowman K, Matney C, Berwick DM. J. Am. Med. Assoc. JAMA 2022; 327(5): 419-420.

Copyright

(Copyright © 2022, American Medical Association)

DOI

10.1001/jama.2022.0089

PMID

35103760

Abstract

raumatic brain injury (TBI) takes a substantial toll on health and health care costs in the US. Yet TBI is often unrecognized, misclassified, undertreated (especially in its longer-term manifestations), and, in proportion to its public health consequences, underresearched. Despite the dedication of an increasing number of professionals, disciplines, and organizations devoted to TBI care and research, including innovative programs for military service members and veterans, care often fails to meet the needs of affected individuals, families, and communities. The US lacks consolidated leadership for achieving improvements in TBI care and outcomes, and, partly as a result, it lacks a strategic plan for fostering change and overseeing progress. With stronger leadership and proper redesign, the health care system could reduce the morbidity and disability associated with TBI, while enhancing the effectiveness of TBI care.

These are among the conclusions of a National Academies of Sciences, Engineering, and Medicine report, Traumatic Brain Injury: A Roadmap for Accelerating Progress,1 written by an 18-member committee, which met over 15 months from 2020 to 2022, gathered testimony from more than 50 researchers, practitioners, patients, and families who experienced TBI and its sequelae, and analyzed evidence from peer-reviewed publications. While the report acknowledges the importance of prevention, its focus is on postinjury care.

TBI encompasses injuries of vastly different severity and causation ranging from concussions during sports participation, to head trauma from falls in older adults, to skull fractures from automobile crashes, to penetrating wounds from projectiles and military combat, and to many other causes of neurotrauma. A consolidated registry is lacking, but data from 2009 and 2010 suggested that an estimated 4.8 million people were evaluated for TBI in US emergency departments each year, and data from 2013 suggested that TBI was diagnosed in approximately 2% of total emergency visits, hospitalizations, and deaths in the US.2,3 In 2017, TBI contributed to an estimated 224 000 hospitalizations and 61 000 deaths, and 2.5 million high school students reported having experienced at least 1 concussion.4,5 Worldwide, more than 55 million people are estimated to experience a "mild" TBI and 5.5 million are estimated to experience a "severe" TBI each year...

Language: en