title: Patterns and predictors of follow-up in patients with mild traumatic brain injury.
abstract: BACKGROUND
  This study was undertaken to identify factors that influence follow-up for patients with mild traumatic brain injury (MTBI).
  
  
  METHODS
  One hundred and ninety-nine consecutive inpatients diagnosed with MTBI at a Trauma Centre (or TC) were monitored for establishment of care with a brain injury specialist after discharge. Bivariate statistics were calculated to determine subject characteristics impacting the decision to pursue TBI-related specialty care.
  
  
  RESULTS
  One hundred and nineteen patients (59.8%) followed up with the TC for routine post-injury care. Patients who followed up were older (age >40: OR = 2.48, p = 0.01, 95% CI = 1.03-8.96) and had longer hospital lengths of stay (LOS > 3 days: OR = 2.99, p < 0.001, 95% CI = 1.33-7.67). Upon follow-up, providers identified 20 patients (16.8%) with persistent neurologic symptoms, seven (3.5%) of whom saw a brain injury specialist. Lack of insurance significantly decreased the likelihood of follow-up with the TC and/or establishment of care with a TBI specialist. (OR = 0.76, p = 0.01, 95% CI = 0.62-0.95).
  
  
  CONCLUSIONS
  Being insured was strongly predictive for follow-up at the TC and for establishing with a brain injury specialist post-MTBI. The TC post-injury visit identified MTBI patients with persistent symptoms, suggesting post-acute TC follow-up is an important venue for MTBI sequelae screening and referral.
authors.affiliation: Northwestern University Feinberg School of Medicine , Surgery, Chicago, IL , USA .
authors.forename: Marie
authors.initials: M
authors.lastname: Crandall
authors.forename: Richard A
authors.initials: RA
authors.lastname: Rink
authors.forename: Aisha Waris
authors.initials: AW
authors.lastname: Shaheen
authors.forename: Bennett
authors.initials: B
authors.lastname: Butler
authors.forename: Erin
authors.initials: E
authors.lastname: Unger
authors.forename: Felise S
authors.initials: FS
authors.lastname: Zollman
mesh_terms: D000328:Adult; D017677:Age Distribution; D001930:Brain Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data*; D038223:Post-Concussion Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012307:Risk Factors; D017678:Sex Distribution; D014193:Trauma Centers / Q000706:statistics & numerical data*
keywords: Concussion; costs; demographics; insurance; mild traumatic brain injury; traumatic brain injury