Comparison of US TBI-related emergency department visits from two data sources: NEISS-AIP and HCUP-NEDS

Traumatic brain injury (TBI) surveillance in the USA has historically used hospital administrative datasets and vital records to determine the number and rate of people who are hospitalised or die from a TBI. However, gaps exist in obtaining timely and accurate estimates of emergency department (ED)-treated TBIs. The purpose of this paper is to compare the number of TBI-related ED visits derived from two national datasets.

We used 2016-2021 data from the National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) and the Healthcare Cost and Utilization Project - Nationwide ED Sample (HCUP-NEDS). Estimates over time were compared.

Applying a broad TBI case definition to NEISS-AIP that included concussions, skull fractures and internal injuries of the head, an average of 3.0 million TBI-related ED visits occurred on an annual basis, with the number of visits ranging from 2.8 million to 3.2 million. When using the broadest definition of TBI in HCUP-NEDS, which includes the unspecified injury of the head code, there were an average of 2.7 million TBI-related visits per year (estimates ranged from 2.4 million to 2.9 million). However, the narrower definition of TBI, which did not include unspecified injury of the head, found an average of 1.1 million visits per year, ranging from 1.0 million to 1.1 million.

When using the broadest definitions of TBI for both datasets, the number of annual TBI-related ED visits is similar. Deciding which dataset to use for TBI surveillance will depend on the project's goals.