Concussion: Are We Missing Patients in Follow-up?

Arefa Cassoobhoy, MD, MPH


July 06, 2018

Hello. I'm Dr Arefa Cassoobhoy, a practicing internist, Medscape advisor, and senior medical director for WebMD. Welcome to Morning Report, our 1-minute news story for primary care.

In 2013 there were 2.5 million visits for trauma-related injuries to the brain. Most patients were diagnosed as having "mild traumatic brain injury (TBI)." Although this group isn’t typically admitted to the hospital, follow-up care is recommended.

But a recent study found that among 1000 patients with mild TBI in the ER, only 42% were sent home with TBI educational materials. And by 3 months, only about 44% had seen a practitioner for follow-up, even among those with significant post-concussive symptoms or positive head CTs.

Wide disparities in follow-up rates were seen across different settings, including academic centers of excellence. And patient income and insurance status did not influence follow-up care.

If the low rates of follow-up were due to patients making a full recovery, this might be okay, but this doesn't seem to be the case. There may be a lack of appreciation of the breadth of symptoms and problems faced by those with a mild TBI.

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