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Subsequent Emergency Department Visits in Geriatric Mild Traumatic Brain Injury: Relationship with Fall, Payor, and
Carrie A Barrett1, Mark G Goetting2, Rob Lyerla3
1Doctor of Physical Therapy Program, Western Michigan University, Kalamazoo, MI 49008, USA.
Healthcare (Basel, Switzerland)
|June 13, 2025
Summary
Older adults (≥65) with mild traumatic brain injury (mTBI) who fall or have Medicare insurance are more likely to need healthcare services after returning to the emergency department (ED). This highlights the need for better post-mTBI monitoring in geriatric populations.
Area of Science:
- Geriatric Medicine
- Emergency Medicine
- Neuroscience
- Public Health
Background:
- Older adults (≥65) face prolonged recovery, reduced self-care independence, and diminished quality of life after mild traumatic brain injury (mTBI).
- mTBI sequelae contribute to increased healthcare costs in older adults, yet research on emergency department (ED) revisit associations is limited.
- This study investigates factors associated with subsequent ED visits for mTBI in older adults.
Purpose of the Study:
- To explore relationships between subsequent mild traumatic brain injury (mTBI-S) ED visits and older adult populations.
- To identify associations with fall injuries, payor types (Medicare, Medicaid, Private, Other), and discharge outcomes.
- To ascertain the relationship between mTBI-S ED visits and healthcare service referrals.
Main Methods:
- Population-based cross-sectional study utilizing the 2018 Nationwide Emergency Department Sample (NEDS) with 4932 participants.
- Descriptive and correlation analyses characterized individuals with subsequent mTBI visits.
- Logistic regressions and odds ratios assessed relationships between mTBI-S visits and predictors (age, fall injury, payor) and healthcare service referrals.
Main Results:
- Falls were significantly associated with referrals to healthcare services (p < 0.001).
- Medicare was significantly associated with healthcare service referrals (p < 0.001).
- Individuals aged ≥65 (OR 4.172), those with fall injuries (OR 3.847), and Medicare beneficiaries (OR 4.492) showed increased odds of referral to healthcare services.
Conclusions:
- Geriatric populations, fall-related injuries, and Medicare enrollment increase the likelihood of healthcare service referral upon ED readmission for persistent mTBI symptoms.
- Findings underscore the need for targeted medical monitoring strategies for older adults post-mTBI.
- This research can inform the development of improved ED discharge models for geriatric mTBI patients.
