Posters

Presenting Author

Russell Wiggins

Presentation Type

Poster

Discipline Track

Clinical Science

Abstract Type

Research/Clinical

Abstract

Background: Researchers have previously established evidence of early onset neurodegenerative disease (NDD) in certain patient populations post traumatic brain injury (TBI). The Rio Grande Valley (RGV) is a region in South Texas which has some of the largest health disparities in the United States. This retrospective chart review aims to quantify the difference in onset of NDD in patients with and without history of TBI within the RGV from that of the broader American population in order to determine the extent at which early onset NDD may be mitigated with appropriate intervention.

Methods: A retrospective chart review was conducted using electronic medical records (EMR) obtained from the UTRGV health system databases composed of multidisciplinary clinics and hospitals. A search query revealed 2686 unique patients that met our inclusion criteria for charts containing ICD-10 codes of S06.X or Z87.820 (TBI); and either G20, G23, G30, or G31-G35 (NDD). After review and curation, 594 charts met exclusion criteria for insufficient data, erroneous data entry, and redundant entry resulting in 2092 charts that met final inclusion criteria. Population coverage was determined by mapping clinic location via zip code and using corresponding census population data to reach a population estimate of 1,167,792. Patients with concomitant diagnoses of TBI and NDD were compared with patients with a history inclusive for only one of the pathologies by way of relative risk (RR) calculation.

Results: Data analysis suggests a RR of 3.42 favoring NDD development in TBI positive patients within the RGV (RR = 3.42, 95% CI 1.10 - 10.6 ). This risk ratio nominally exceeds that found in comparable American populations (older American veterans; RR: 1.57, 95% CI 1.35–1.83). Average patient age of initial encounter for NDD within the RGV was 73 ±1.72 compared to 64.3 ±27.35 for dually diagnosed TBI/NDD patients.

Conclusions: Trends exist in our current data which suggest an earlier onset of NDD in patients with a history of TBI compared to patients without TBI in the RGV. There also seems to be a greater relative risk for development of NDD in TBI positive patients within the RGV when compared to their broader American counterparts. Adoption of screening techniques aimed at identifying patients with history of TBI may lead to a timelier diagnosis and earlier initiation of treatment of NDD, reducing severity and burden of disease in the valley. In order to strengthen and establish significance of these observed trends, more patient EMRs must be identified which meet study criteria for review and continued analysis to clarify, discover, and strengthen the aforementioned relationships. Different methods can be adopted in the future to create a more robust and accurate data pool. We suggest employing TBI oriented survey questions and screening tools for appropriate patients.

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Quantifying Incidence of Early Onset Neurodegenerative Disease Post Traumatic Brain Injury in the Rio Grande Valley, a Retrospective Chart Review

Background: Researchers have previously established evidence of early onset neurodegenerative disease (NDD) in certain patient populations post traumatic brain injury (TBI). The Rio Grande Valley (RGV) is a region in South Texas which has some of the largest health disparities in the United States. This retrospective chart review aims to quantify the difference in onset of NDD in patients with and without history of TBI within the RGV from that of the broader American population in order to determine the extent at which early onset NDD may be mitigated with appropriate intervention.

Methods: A retrospective chart review was conducted using electronic medical records (EMR) obtained from the UTRGV health system databases composed of multidisciplinary clinics and hospitals. A search query revealed 2686 unique patients that met our inclusion criteria for charts containing ICD-10 codes of S06.X or Z87.820 (TBI); and either G20, G23, G30, or G31-G35 (NDD). After review and curation, 594 charts met exclusion criteria for insufficient data, erroneous data entry, and redundant entry resulting in 2092 charts that met final inclusion criteria. Population coverage was determined by mapping clinic location via zip code and using corresponding census population data to reach a population estimate of 1,167,792. Patients with concomitant diagnoses of TBI and NDD were compared with patients with a history inclusive for only one of the pathologies by way of relative risk (RR) calculation.

Results: Data analysis suggests a RR of 3.42 favoring NDD development in TBI positive patients within the RGV (RR = 3.42, 95% CI 1.10 - 10.6 ). This risk ratio nominally exceeds that found in comparable American populations (older American veterans; RR: 1.57, 95% CI 1.35–1.83). Average patient age of initial encounter for NDD within the RGV was 73 ±1.72 compared to 64.3 ±27.35 for dually diagnosed TBI/NDD patients.

Conclusions: Trends exist in our current data which suggest an earlier onset of NDD in patients with a history of TBI compared to patients without TBI in the RGV. There also seems to be a greater relative risk for development of NDD in TBI positive patients within the RGV when compared to their broader American counterparts. Adoption of screening techniques aimed at identifying patients with history of TBI may lead to a timelier diagnosis and earlier initiation of treatment of NDD, reducing severity and burden of disease in the valley. In order to strengthen and establish significance of these observed trends, more patient EMRs must be identified which meet study criteria for review and continued analysis to clarify, discover, and strengthen the aforementioned relationships. Different methods can be adopted in the future to create a more robust and accurate data pool. We suggest employing TBI oriented survey questions and screening tools for appropriate patients.

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