Iowa Brain Injury Survival Rates Improve

Iowa City Press-Citizen

Iowans who suffer a traumatic brain injury (TBI) have a better chance of survival thanks to a statewide trauma system that was implemented in 2001, according to a study conducted by researchers from the University of Iowa Injury Prevention Research Center.

Receiving timely and specialized care is critical for patients with brain injuries, since secondary damage can occur during the hours following an injury. However, patients injured in rural areas often must travel farther and longer to reach specialized care facilities.

With the goals of reducing injury deaths, improving patient outcomes, and reducing medical care costs, the Iowa trauma system was established in 1995 through state legislation titled the Iowa Trauma System Care Development Act. The system was fully implemented statewide in January 2001. Features of the system include categorization and verification of each hospital, training in advanced trauma life support, definition of triage protocol, and uniform data definition and collection. Two Level I and seven Level II hospitals in the statewide system were required to have specialty coverage, including neurosurgery for traumatic injuries.

To examine how the implementation of Iowa’s trauma system affected the triage and in-hospital death rates of brain-injured patients, the investigators analyzed data from the State Trauma Registry maintained by the Bureau of Emergency Medical Services in the Iowa Department of Public Health (IDPH). The researchers assessed TBI patient survival two years before the implementation of the trauma system (1997-1998) compared to two years after full implementation (2002-2003). The data included 710 pre-system patients and 886 post-system patients with moderate or severe head injury.

The study found that implementation of the trauma system was associated with a significant decreased risk of death overall — and a nearly 50 percent decreased risk of death in the 72 hours following a TBI — for both patients directly admitted to Level I and II hospitals and those transferred from local hospitals. The study appeared in the July 7 issue of the Journal of Neurotrauma and is available online at http://www.liebertonline.com/neu.