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Traumatic Brain Injury l: Introduction

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Incarceration Status is Associated With Rates of Operative Neurosurgical Intervention and Inpatient Mortality After

Vikas N Vattipally¹, Kathleen R Ran¹, Anant P Rajan¹

¹Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore , Maryland , USA.

|September 18, 2025

Summary

Incarcerated individuals with traumatic brain injury (TBI) face higher inpatient mortality and reduced neurosurgical intervention. These findings reveal critical disparities in TBI care for this population.

Keywords:

Health disparities Incarceration Inpatient mortality Neurosurgical care Traumatic brain injury

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Area of Science:

Neuroscience
Trauma Surgery
Public Health

Background:

Incarcerated populations experience significant healthcare disparities.
Limited research exists on traumatic brain injury (TBI) outcomes in incarcerated individuals.
Understanding TBI outcomes in this demographic is crucial for addressing health inequities.

Purpose of the Study:

To determine if incarceration status is independently linked to inpatient mortality following TBI.
To investigate potential disparities in neurosurgical interventions for incarcerated TBI patients.

Main Methods:

Retrospective cohort study using the American College of Surgeons Trauma Quality Programs data set (2017-2022).
Analysis of adult patients with blunt traumatic brain injury (TBI).
Multivariable logistic regression and propensity score matching to assess mortality and intervention associations.

Main Results:

Incarcerated patients (0.7%) were younger and more likely to have struck-by injury mechanism.
Incarceration was independently associated with higher inpatient mortality (OR, 1.49; P < .01).
Incarcerated patients had lower odds of cranial surgery (OR, 0.76; P = .03) but similar odds for ICP monitor placement.

Conclusions:

Incarceration status is an independent risk factor for increased inpatient mortality post-TBI.
Incarcerated individuals with TBI are less likely to receive operative neurosurgical intervention.
Urgent policy and institutional reforms are needed to ensure equitable neurosurgical care for incarcerated TBI patients.