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Each year, Americans make 30 to 40 million emergency department (ED) visits for injuries. While the majority of injured patients are treated and released, many are admitted to inpatient trauma units and later receive rehabilitative services. The most favorable patient outcomes result when acute care and subsequent rehabilitation begin as early as possible and when they focus on returning patients to their baseline or an optimal level of functioning. Trauma systems are designed to match trauma patients with the acute care and rehabilitative facilities they need, but in many parts of the United States, trauma systems are not fully operational or do not exist at all. Where these systems are lacking, as many as 30% to 40% of deaths among trauma patients are due to preventable problems in clinical care, including missed diagnoses and treatment delays. Follow-up studies have shown as much as a 50% reduction in preventable trauma deaths after trauma systems are introduced.
Injuries are a major cause of disability in the U.S. Central nervous system injuries-those to the brain and spinal cord-are most likely to result in serious, long_term disability. Each year, an estimated 80,000 Americans sustain traumatic brain injuries (TBI) that result in disabilities; an estimated 5.3 million Americans live with TBI-related disability. Although physical impairments from the injury may contribute to TBI disability, cognitive deficits are the hallmark, frequently resulting in secondary conditions such as depression and other adverse outcomes such as the inability to work. An estimated 200,000 people in the U.S. live with spinal cord injuries (SCI), and this number increases annually by as many as 11,000 individuals. Secondary conditions such as pressure ulcers are a common cause of lost productivity among people with SCI.
Other important disabling injuries include limb injuries, back injuries, eye injuries, and burns. Injuries to the lower extremities constitute the leading cause of trauma admissions among adolescents and young adults, accounting for 235,000 hospitalizations each year. In addition to their high incidence, lower extremity injuries often result in significant impairment and loss of function.
Injured patients may suffer a variety of psychosocial effects, including post-traumatic stress disorder, depression, misuse of alcohol and other drugs, and difficulties returning to the routines of pre-injury work and social lives. Screening and intervention programs may reduce the frequency and severity of these consequences and may also decrease the number of ED and trauma center visits for future injury. In one study, for example, screening and intervention for alcohol problems among patients hospitalized for trauma reduced hospital admissions for injuries by 48% for the following three years. To prevent adverse outcomes, pre-existing injury risk factors, such as excessive alcohol use, must be addressed in a comprehensive way, including during acute care and rehabilitation.
Source: Centers for Disease Control and Prevention
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