Validity of administrative data for characterizing traumatic brain injury-related hospitalizations

Brain Inj. 2005 Aug 10;19(8):613-21. doi: 10.1080/02699050400013568.


Primary objective: To examine the validity of Maryland Hospital Discharge (MHD) data for identifying and characterizing traumatic brain injury (TBI)-related hospitalizations.

Methods: All TBI-related hospitalizations in 1999 were identified using MHD and Maryland Trauma Registry (MTR) data. In addition, a sample of records were abstracted to compare agreement between MHD and chart data.

Results: The MHD file identified fewer TBI cases (61%) compared to the MTR (95%). Overall, TBI-related hospitalization rates based on MHD were significantly fewer (95; 95% CI 92, 98) vs MHD and MTR (144; 95% CI 140, 147). There was good agreement between the MHD and chart data regarding skull fractures or intracranial lesions (kappa = 0.73 and 0.83, respectively), but poor agreement for neurologic abnormalities or amnesia. The MHD significantly underestimated TBI severity.

Conclusions: TBI cases, especially mild ones, were under-reported by MHD data. MHD data are better at detecting anatomic injuries compared to TBI symptoms and sequella.

Publication types

  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Injuries / epidemiology*
  • Child
  • Child, Preschool
  • Female
  • Hospitalization / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Maryland / epidemiology
  • Middle Aged
  • Patient Discharge / statistics & numerical data*
  • Reproducibility of Results