Aggressive Care Best for Brain Trauma, Study Shows
FRIDAY, March 9 -- Aggressive treatment of patients with traumatic brain injury improves chances of recovery and reduces long-term care costs, according to a new study.
University of Pennsylvania School of Medicine researchers analyzed data from 1,000 patients with traumatic brain injury and found that aggressive care was much more costly than routine care or comfort care. But it was also much more effective and led to better results, improved quality of life and lower long-term care costs, the researchers said.
Aggressive care includes invasive intracranial pressure monitoring and decompressive hemicraniectomy, a procedure in which part of the skull is removed to allow a swelling brain to expand.
The investigators found that aggressive care was cost-effective in patients of all ages, but especially in younger patients.
The study, published online March 6 in the Journal of Neurosurgery, is the first to show the cost-effectiveness of aggressive care for these patients, the authors said.
"This study clearly shows that aggressive care, for both young and older patients who suffer a severe traumatic brain injury, provides patients the best chance at surviving and recovering, and also reduces lifetime costs associated with TBI [traumatic brain injury] treatment," lead author and neurosurgery resident Dr. Robert Whitmore said in a school of medicine news release.
About 1.5 million traumatic brain injuries occur in the United States each year, resulting in 200,000 hospitalizations and more than 52,000 deaths. The costs of associated medical care and lost productivity total about $60 billion a year.
Despite its benefits, the use of aggressive treatment in cases of traumatic brain injury is inconsistent.
"We've reached epidemic levels of traumatic brain injuries in the United States," said study co-author Dr. M. Sean Grady, chair and professor of neurosurgery, in the news release. Standardizing and optimizing care for the most severe cases can improve survival and recovery, help people get back to work and lower costs associated with long-term nursing care, Grady said. "Aggressively treating severe TBI patients, regardless of age, can lessen the financial impact that severe TBIs have on society as a whole," he added.
The U.S. National Institute of Neurological Disorders and Stroke has more about traumatic brain injury.
Posted: March 2012
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