Infrequent emergency department diagnosis and outpatient follow-up of mild traumatic brain injury after…

Cohort studyThe American journal of emergency medicine· Aug 2026

Infrequent emergency department diagnosis and outpatient follow-up of mild traumatic brain injury after closed head injury: age and rurality patterns.

Sarah Suchko, Rami Homsi, Adam N Frisch, David J Barton

Emergency Department FlowCohort studyDiagnosisQ1IF 2.1

Less than half of likely mild traumatic brain injury cases got that emergency department diagnosis

Infrequent emergency department diagnosis and outpatient follow-up of mild traumatic brain injury after closed head injury: age and rurality patterns.

Sarah Suchko … David J Barton

The American journal of emergency medicine · Aug 2026 · Q1 in Emergency Medicine

Background

Mild traumatic brain injury (mTBI) is commonly encountered in the emergency department (emergency department), but there is wide variation in diagnosis, specialist referral, and follow-up.

Purpose

We further sought to assess how these frequencies vary with age and rurality.

Methods

We performed a retrospective cohort study of adults treated and discharged from the emergency department with a diagnosis of closed head injury or mTBI for three months in one health system through electronic medical record data abstraction.

n = 314 patients

Results

most likely mTBI cases were missed at emergency department discharge

41%

ACRM-defined mTBI/susp

21%

Clinician-documented m

More results

We compared clinician diagnosis to 2023 American College of Rehabilitation Medicine (American College of Rehabilitation Medicine) consensus diagnostic criteria for mTBI and suspected mTBI.

Forty patients (13%) had an emergency department diagnosis of mTBI, and 27 (9%) had suspected mTBI.

More results

Eighty-four patients (27%) had a follow-up visit; 23 (8%) received mTBI diagnosis at follow-up.

Young and urban adults were most frequently diagnosed with mTBI while rural and older adults were least frequently diagnosed.

“

Conclusion

In conclusion, less than half of patients likely to have mTBI based on consensus criteria were diagnosed with mTBI at emergency department discharge, suggesting opportunities for improvement in emergency department management.

Infrequent emergency department diagnosis and outpatient follow-up of mild traumatic brain injury after closed head injury: age and rurality patterns.

Infrequent emergency department diagnosis and outpatient follow-up of mild traumatic brain injury after closed head injury: age and rurality patterns.

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