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Related Concept Videos

Traumatic Brain Injury l: Introduction01:28

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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Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...

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An Investigation of the Effects of Sports-related Concussion in Youth Using Functional Magnetic Resonance Imaging and the Head Impact Telemetry System
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Lost in Transition: Long-term Follow-up in Traumatic Brain Injury Patients.

Marco J Henriquez1, Danyi Wang1, Fabiana C Sanchez1

  • 1Section of Acute & Critical Care Surgery, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.

The Journal of Surgical Research
|December 17, 2025
PubMed
Summary

Nearly half of traumatic brain injury (TBI) patients miss outpatient follow-up, hindering recovery. Ancillary service referrals are critically low, indicating significant gaps in post-acute care for TBI survivors.

Keywords:
Continuity of careHealth disparitiesOutpatient follow-upPost acute careTraumatic brain injury

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Area of Science:

  • Neuroscience
  • Public Health
  • Trauma Surgery

Background:

  • Traumatic brain injury (TBI) is a major cause of long-term disability.
  • Effective outpatient follow-up is crucial for managing TBI deficits and improving outcomes.
  • Current TBI care pathways may not adequately support post-discharge recovery.

Purpose of the Study:

  • To evaluate the rate of outpatient follow-up among TBI patients post-hospital discharge.
  • To assess the utilization of ancillary services for TBI survivors.
  • To identify factors associated with follow-up adherence and service utilization.

Main Methods:

  • Retrospective analysis of 1142 TBI patients admitted between January 2022 and January 2024.
  • Chart reviews to determine post-discharge appointments and referrals for physical therapy, occupational therapy, speech-language pathology, and neurocognitive testing.
  • Multivariate analysis to identify predictors of follow-up and ancillary service use.

Main Results:

  • 53% of TBI patients attended outpatient follow-up, with most seen in neurosurgery clinics for routine care.
  • Ancillary service referrals were infrequent (<2%), with limited discussion of quality of life or cognitive/behavioral changes.
  • Discharge to non-rehabilitative facilities and uninsured status were linked to lower follow-up rates; higher injury severity and decompressive craniectomy were linked to increased follow-up.

Conclusions:

  • A significant proportion of TBI patients do not receive necessary outpatient follow-up care.
  • Low utilization of ancillary services highlights critical gaps in post-acute TBI management.
  • Targeted interventions are needed to enhance follow-up adherence and comprehensive care for TBI survivors.