Abstract
BackgroundIt is essential to use a definition that is precise and accurate for the surveillance of traumatic brain injuries (TBI) and spinal cord injuries (SCI). This paper reviews the International Classification of Diseases 10th revision (ICD-10) definitions used internationally to inform the definition for neurotrauma surveillance using administrative data in Ontario, Canada.MethodsPubMed, Web of Science, Medline and the grey literature were searched for keywords "spinal cord injuries" or "brain injuries" and "international classification of diseases". All papers and reports that used an ICD-10 definition were included. To determine the ICD-10 codes for inclusion consensus across papers and additional evidence were sought to look at the correlation between the condition and brain or spinal injuries.ResultsTwenty-four articles and reports were identified; 15 unique definitions for TBI and 7 for SCI were found. The definitions recommended for use in Ontario by this paper are F07.2, S02.0, S02.1, S02.3, S02.7, S02.8, S02.9, S06, S07.1, T90.2, and T90.5 for traumatic brain injuries and S14.0, S14.1, S24.0, S24.1, S34.1, S34.0, S34.3, T06.0, T06.1 and T91.3 for spinal cord injuries.ConclusionsInternationally, inconsistent definitions are used to define brain and spinal cord injuries. An abstraction study of data would be an asset in understanding the effects of inclusion and exclusion of codes in the definition. This paper offers a definition of neurotrauma for surveillance in Ontario, but the definition could be applied to other countries that have mandated administrative data collection.
Highlights
It is essential to use a definition that is precise and accurate for the surveillance of traumatic brain injuries (TBI) and spinal cord injuries (SCI)
The International Classification of Diseases 10th revision (ICD-10) codes used to define TBI and head injuries were varied with the broadest definition using all head injury codes S00-S09, covering superficial injury to the head to unspecified injury to the head [13]
Since the international literature is inconsistent in defining brain and spinal cord injuries using ICD-10 codes, the definition used for neurotrauma (TBI and SCI) surveillance in Ontario was chosen based on international consensus between studies/reports, a review of the correlation between codes and brain injuries, a review of the reason for inclusion of codes in definitions used in other countries, and a discussion with the steering committee
Summary
It is essential to use a definition that is precise and accurate for the surveillance of traumatic brain injuries (TBI) and spinal cord injuries (SCI). The World Health Organization (WHO) has recognized the importance of surveillance systems for neurotrauma to inform prevention programs, as well as to inform the population of the significance of brain and spinal cord injuries [1]. The use of administrative medical data is attractive for neurotrauma surveillance because it is collected systematically and it is less expensive than independently collecting data It is attractive in countries with universal health insurance because data collection will be comprehensive. The use surveillance is highly important given the considerable rates of death and disability resulting from TBI and SCI worldwide, and the high costs these injuries place on health care systems and individuals alike.
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