Main group



INJURY HISTORYMain groupStudy Name:*GUID (GUID):Subject ID number (SubjectIDNum):Age in Years (AgeYrs):What is the vital status of the subject? (VitStatus):O Alive Dead UnknownVisit Date (VisitDate):Site Name (SiteName):Days since Baseline (DaysSinceBaseline): ____________________Case Control Indicator (CaseContrlInd): Case Control UnknownGeneral notes (GeneralNotesTxt)_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Form administrationWhat is the ISO 639 code for the language the form/instrument has been administrated? (LangCRFAdministratISOCode). Select one. If “Other, specify” is selected, please write in response.chiChineseczeCzechdanDanishdutDutchengEnglishfinFinnishfreFrenchgerGermangreGreekhebHebrewhinHindihunHungarianiraIranian languages itaItalianjpnJapanesenorNorwegianOther, specify_____________________ (LangCRFAdministratISOCodeOTH)porPortugueserusRussiansgnSign languagespaSpanishvieVietnameseWhat time frame do the questions in this form refer to? (ContextType)Select one. If “Other, specify” is selected, please write in response.After injury At time of assessment Time of injury Before injury Last 2 weeks Last 6 months Last 24 hours Last month Last week Last year Prior to death Since last interview Other, specify (ContextTypeOTH) ____________________Who filled out this form? (DataSource)Select one. If “Other, specify” is selected, please write in response. Participant/Subject Spouse Father Mother Son Daughter Brother Sister Friend Physician Chart/Medical Record Other, specify (DataSourceOTH) ______________________________________ HYPERLINK "" Injury General Info?Traumatic event numberTraumaticEventNumList the earliest as #1 and the latest as #n. For TBI usually only the 5 events are listed.________________________________________The elapsed time (in minutes) from the time of injuryInjElapsedTime*Indicate the time since injury (in minutes), following the definition provided per protocol.__________________________________________Injury date and timeInjDateTime*Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http: //iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).__________________________________________If estimated, the point in time estimated as injury dateInjDateTimeEstTypChoose one. Time of first trauma activationTime of presentation to emergency departmentTime that the participant/subject became symptomaticType of location where the data were taken/recorded.Type of location where the data were taken/recorded.DataAcquisitionLocationTypChoose one. If “Other, specify” selected, provide the input.Acute Care UnitAmbulatoryAssisted LivingCentral LabClinic/MD OfficeCritical Access HospitalCritical Care UnitCT-AngioDischarge LoungeED arrivalED dischargeED-Non-trauma CenterED post-resuscitationED-Trauma CenterFollow-up visitHigh Care UnitHomeHospiceICUImaging Diagnostic DepartmentInjury sceneInpatient Epilepsy Monitoring UnitInpatient RehabIntermediate Care UnitLong Term Care HospitalNursing HomeObservation UnitOROther HospitalOutpatient ClinicOutpatient EEG labPre-hospitalPre-hospital BestPre-hospital WorstReferring HospitalRehabilitation UnitSite LabStep-Down Unit;Supervised Living;Unknown;Urgent Care;WardOther, specify(DataAcquisitionLocationOTH)_______________________________Cause of injuryInjCauseTyp Choose all that apply. If “Other, specify” selected, provide the input.Accidental falls Accidental poisoning by drugs, medicinal substances, and biologicals Accidental poisoning by other solid and liquid substances, gases, and vapors Accidents caused by fire and flames Accidents caused by submersion, suffocation, and foreign bodies Accidents due to natural and environmental factors (e900-e909) Air and space transport accidents Drugs, medicinal and biological substances causing adverse effects in therapeutic use Homicide and injury purposely inflicted by other persons Injury resulting from operations of war Injury undetermined whether accidentally or purposely inflicted Late effects of accidental injury Legal intervention Misadventures to patients during surgical and medical care Motor vehicle non-traffic accidents Motor vehicle traffic accidents Other accidents Other road vehicle accidents Railway accidents Suicide and self-inflicted injury Surgical and medical procedures as the cause of abnormal reaction of patient or later complication, without mention of misadventure at the time of procedure Terrorism Vehicle accidents not elsewhere classifiable Water transport accidents Other, specify (InjCauseTypOTH)___________________________________Body system categoryBodySysCat Choose all that apply. If “Other, specify” selected, provide the input.Allergic/ImmunologicCardiovascularConstitutional symptoms (e.g., fever, weight loss)DermatologicalEars, Nose, Mouth, ThroatEndocrineEyesGastrointestinalGastrointestinal/AbdominalGenitourinaryGynecologic/Urologic/ RenalHematologic/LymphaticHepatobiliaryIntegumentary (skin and/or breast)MusculoskeletalMusculoskeletal (separate from ALS exam)NeurologicalNeurological (separate from ALS exam)Neurologic/CNSOncologicOther, specifyPsychiatricPulmonaryRespiratoryOther, specify (BodySysOTH)_______________________________SNOMED CT codeMedclHistCondSNOMEDCTCode*Code each of the medical history conditions using SNOMED CT. List multiple codes if needed. Use Appendix 2 “cheat sheet” to find the codes._________________________________________________________________________Medical history condition textMedclHistCondTxt*Record one Medical History term per body system category. See the data dictionary for additional information on coding the condition using SNOMED CT. Use Appendix 2 “cheat sheet” to find the codes and the corresponding verbatim names._______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Number of the International Classification of Diseases (ICD) used to obtain the codeICDRevNumber*Choose one.ICD-9ICD-10ICD-11Code to classify the external cause of the injuryInjICDExtCauseCode*Record as many as needed; please refer to http: //nchs/icd.htm. Response is obtained from report by subject/participant (if possible), witnesses, first responders, family and/or medical records.___________________________________________________________________-Describe a mechanism of TBITBIMechTyp Choose all that apply.Acceleration/DecelerationBlastCrushDirect impact: blow to headDirect impact: head against objectFall from height more than 1 meter (3 ft)Fragment (incl. shell/shrapnel)Ground level fallGunshot woundOther penetrating brain injuryType of TBI. Choose all that apply.TBITyp*BlastClosedPenetratingUnknownCrushInjury place of occurrence type. Choose one. If “Other, specify” is selected, provide the input.InjPlcOccncTyp Home/domesticPublic location (e.g. bar, station, nightclub)Sport/recreationOther, specify (InjPlcOccncOTH)____________________________________________Military deploymentStreet/highwayWork/schoolWas the injury intentional or unintentional? Choose one.InjIntentionIntentionalUnintentionalUndeterminedAbbreviated injury scale (AIS)Please note that below is only a short excerpt from AIS. If you have AIS data, please submit them to AIS form.Specify the version of Abbreviated injury scale (AIS) dictionary. Choose one.AISDictionaryVersionTypAIS Revision 1990AIS Revision 2005 Update 2008AIS Revision 1990 Update 1998AIS Revision 2015AIS Revision 2005Category of body region assessed by Abbreviated Injury Scale (AIS) and the corresponding severity score(s) Choose one. For each AISInjurySeverityScore value, select the corresponding body region chapter/category. Use the information from AIS dictionary () to choose the appropriate value.Body region (AISBodyRegionChapterCat)AIS severity score (AISInjurySeverityScore) 1= minor;2= moderate;3=serious;4=severe;5=critical;6= maximal (currently untreatable);9=unknown severityA clinical description of the subject injury(ies) from the medical documentation (AISInjuryDescriptionTxt)For each combination of values recorded in?AISBodyRegionChapterCat+AISInjurySeverityScore, enter the injury description from the medical documentation. This description is used to code the injury in AIS Code and describes the precise injury.1-Head2-Face3- Neck4-Thorax5-Abdomen6-Spine7-Lower Extremity, Pelvis and Buttocks8-Upper Extremity9-External0-Other TraumaCode to classify the external cause of the injuryInjICDExtCauseCode *Record as many as needed; please refer to http: //nchs/icd.htm. Response is obtained from report by subject/participant (if possible), witnesses, first responders, family and/or medical records. _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________LOC, AOC, and PTAThe elapsed time (in minutes) from the time of injuryInjElapsedTime*Indicate the time since injury (in minutes), following definition provided per protocol. ____________________________________________________________________________________________Type of location where the data were taken/recorded.DataAcquisitionLocationTypChoose one. If “Other, specify” selected, please provide an input.Acute Care UnitAmbulatoryAssisted LivingCentral LabClinic/MD OfficeCritical Access HospitalCritical Care UnitCT-AngioDischarge LoungeED arrivalED dischargeED-Non-trauma CenterED post-resuscitationED-Trauma CenterFollow-up visitHigh Care UnitHomeHospiceICUImaging Diagnostic DepartmentInjury sceneInpatient Epilepsy Monitoring UnitInpatient RehabIntermediate Care UnitLong Term Care HospitalNursing HomeObservation UnitOROther HospitalOutpatient ClinicOutpatient EEG labPre-hospitalPre-hospital BestPre-hospital WorstReferring HospitalRehabilitation UnitSite LabStep-Down UnitSupervised LivingUnknownUrgent CareWard Other, specify (DataAcquisitionLocationOTH)______________________Date form completedDataCollDateTimeWhen date/time data are prepared for aggregation or sharing they should be converted to the format specified by ISO 8601, YYYY-MM-DDThh:mm:ss _________________Did participant/subject experience loss of consciousness?LOCInd*Choose one.Yes NoSuspectedUnknownRange of duration of loss of consciousness (LOC)LOCDurRang*Choose one. Response is obtained from report by subject/participant or clinician. If clinically monitored, GCS or other assessment tool recommended.1-29 minutes30-59 minutes1-24 hours1-7 days<1 minute>7 daysNoneNo return of consciousness prior to death or dischargeUnknownLoss of consciousness duration of time valueLOCDurationValRecord the duration of LOC in seconds. ______________________________________How the loss of consciousness was verifiedLOCVerifyTypChoose one. Response may be obtained from report by subject/participant, but verification establishes higher level of evidence.Self-reportClinical interviewMedical chartWitnessNot availableDid the participant/subject experience alteration of consciousness?AOCIndChoose one. Response may be obtained from report by subject/participant (CDC Report to Congress), but verification establishes higher level of evidence.Yes NoSuspectedUnknownDuration of alteration of consciousnessAOCDurRangChoose one. Response is obtained from report by subject/participant or clinician. If clinically monitored, GCS or other assessment tool recommended.1-29 minutes30-59 minutes1-24 hours1-7 days<1 minute>7 daysNoneNo return of consciousness prior to death or dischargeUnknownAlteration of consciousness duration of time valueAOCDurationValRecord the duration of AOC in minutes. _______________________How the alteration of consciousness was verifiedAOCVerifTypChoose one. Response may be obtained from report by subject/participant, but verification establishes higher level of evidence.Self-reportClinical interviewMedical chartWitnessNot availableIndicator of lucid interval LucidIntrvlIndChoose one. If clinically monitored, GCS or other assessment tool recommended.Yes NoSuspectedUnknownRange of duration of lucid intervalLucidIntrvlDurRangChoose one. Response is obtained from report by subject/participant or clinician. If clinically monitored, GCS or other assessment tool recommended.1s-10 minutes11 min- 30 min31 min – 1 hour61 min – 12 hoursMore than 24 hoursN/AUnknownDuration of lucid interval in minutesLucidIntrvlDurationValRecord the duration of lucid interval in minutes. _____________________________How long after initial LOC did lucidity occur?LOCLucidIntrvlDurRangChoose one. Response is obtained from report by subject/participant or clinician. If clinically monitored, GCS or other assessment tool recommended.1s-10 minutes11 min- 30 min31 min – 1 hour61 min – 12 hoursMore than 24 hoursN/AUnknownHow the lucid interval was verifiedLucidIntrvlVerifyTypChoose one. Response may be obtained from report by subject/participant, but verification establishes higher level of evidence.Self-reportClinical interviewMedical chartWitnessNot availableDid participant/subject experience post-traumatic amnesia?PstTraumtcAmnsInd*Choose one.Yes NoSuspectedUnknownRange of duration of post-traumatic amnesiaPstTraumAmnsDurRang*Choose one1-29 minutes30-59 minutes1-24 hours1-7 days<1 minute>7 daysNoneN/AUnknownDuration of post-traumatic amnesia (PTA) the participant/subject experienced.PstTraumAmnsDurationValEnter duration of post-traumatic amnesia in minutes _______________________________________________________________________How the post traumatic amnesia interval was verifiedPstTraumtcAmnsVerifyTypChoose one. Response may be obtained from report by subject/participant, but verification establishes higher level of evidence.Self-reportClinical interviewMedical chartWitnessNot availableType Place Cause Mechanism of Injury - CivilianType of injury violent causeInjVlntCauseTypChoose one. Response is obtained from participant/ subject (if possible), witnesses, first responders, family member or medical record.Child abuseDomestic assaultGang violenceInterpersonal violence (fight)Military deploymentRobbery/assault OtherLikelihood that participant/subject was under the influence of alcohol?InfAlcLkhdTypChoose oneNoneConfrimedSuspectedUnknownLikelihood that injury was due to abusive head trauma?AbsvHdTrmaLkhdTypChoose oneDefinite abuseNo concernPossible abuseProbable abuseHow the determination of abusive head trauma likelihood was madeAbsvHdTrmaRprtrTypChoose one. If “Other, specify” is selected, provide an input.Child Protection Team (CPT)Children, Youth and Families (CYF)CoronerEmergency Department (ED) physicianOther, specifyPediatric Intensive Care Unit (PICU) physicianPoliceOther, specify (AbsvHdTrmaRprtrOTH)______________________Indicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in large amounts. Choose one.DrgSubstCurrntIllicitUseCatYes NoSuspectedUnknownTraffic accident self-role typeTrffAccdntSelfRoleTypChoose one. Response is obtained from report by participant/subject (if possible), witnesses, first responders, family and/or medical records. Information on the nature of the road traffic incident and the function of the victim is not only important from an epidemiological and prevention perspective, but also provides information on what type of intracranial and extracranial injuries might be expected.CyclistMoped/scooterMotorcycle/MotorbikeMotor vehicle occupantPedestrianOtherTraffic accident self-drug influence likelihoodTrffAccdntSefAlcInfLkhdTypChoose one. Response is obtained from hospital reports.NoneConfrimedSuspectedUnknownTraffic accident self-drug influence likelihood typeTrffAccdntSelfDrgIngLkhdTypChoose one. Response is obtained from hospital reports.NoneConfrimedSuspectedUnknownTraffic accident other party role typeTrffAccdntOthPrtyRoleTypChoose one. Response is obtained from participant/ subject (if possible), witnesses, first responders, family member or medical record.CyclistMoped/scooterMotorcycle/MotorbikeMotor vehicleNo other partyObstaclePedestrianTrain/MetroTram/BusUnknownTraffic accident other party alcohol influence likelihood typeTrffAccdntOthPrtyAlcInfLkhdTypChoose one. Response is obtained from hospital reports.NoneConfrimedSuspectedUnknownTraffic accident self-drug influence likelihoodTrffAccdntOthPrtyDrgInfLkhdTypChoose one. Response is obtained from hospital reports.NoneConfrimedSuspectedUnknownAirbag deployed indicatorAirbagDplyIndResponse is obtained from report by participant/subject (if able to provide reliable information), first responders, emergency department physicians, or medical record.YesNoNot applicableUnknownType of protective devices used by the participant/subjectVehclrPrtctvDevTypChoose all that apply. If “Other, specify” is selected, provide an input. Response is obtained from report by participant/subject (if able to provide reliable information), first responders, emergency department physicians, or medical record. This element is recommended for pediatric studies.AirbagChild safety restraintHelmetSeat beltOther, specify (VehclrPrtctvDevOTH)____________________________________________Likelihood of whether a biological agent was encountered at the time of the injury.BiolgclAgntExpsrLkhdTypChoose one. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records. Element recommended for the military populationNoneConfrimedSuspectedUnknownChemical agent exposure likelihood typeChemAgntExpsrLkhdTypChoose one. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records. Element recommended for the military populationNoneConfrimedSuspectedUnknownVerbatim text description of the injury event (optional).InjDescriptionText_________________________________Type Place Cause Mechanism of Injury - SportWas the subject's traumatic brain injury sports related?TBISportIndChoose one.YesNoUnknownType of the sport or team that the athlete participates inSportTeamParticipationTypChoose one. If “Other, specify” is selected, provide an input.BaseballBasketballBeach VolleyballBowlingBoxingCheerleadingClimbingCross countryCyclingDanceDivingDodgeballEquestrianFencingField BallField eventField hockeyFigure skatingFlag FootballFlicker ballFootballFunctional Fitness/CrossFitGoaltimateGolfGymnasticsIce hockeyIn-line HockeyKickballLacrosseMarathonMartial ArtsMountaineeringOrienteeringPaintballParachutingPass-N-GoRifleRodeoRowingRugbySailingSand HurstSkateboardingSkiingSnowboardingSoccerSoftballSprint FootballSquashStrength team/PowerliftingSubmission GrapplingSwimmingTeam HandballTennisTrackTriathlonUltimate FrisbeeUnknownVolleyballWater poloWrestlingOther, specify (SportTeamParticipationTypOTH)___________Sport league/division in which the subject played.SportLeagueOrDivTypSelect all that apply. If “Other, specify” is selected, provide an input.AFLAHLArena Football LeagueCFLDivision IDivision IAA/Football Championship Subdivision (FCS)Division I/Football Bowl Subdivision (FBS)Division IIDivision IIIECHLNAIANFLNFL EuropeNHLXFLOther, specify (SportLeagueOrDivTypOTH)________________________Verbatim text description of the injury event (optional).__________________________InjDescriptionTextType Place Cause Mechanism of Injury - Combat Indicator of whether the injury occurred during deploymentMilDplyInjIndChoose one. Response is obtained from report by participant/subject (interview, self report) or relatives. This element is intended for use in adult military populations. Severity of psychological problems has been shown to correlate with the 'severity' of combat experiences.YesNoUnknownProtective devices used indicatorPrtctvDevcUseIndChoose one. Response is obtained from report by participant/subject (if able to provide reliable information), first responders, emergency department physicians, or medical record. This element is recommended for pediatric studies.YesNoUnknownBody armor indicator BodyArmIndChoose one. Adult only. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records. Element recommended for the military populationYesNoUnknownType of combat helmet worn at the time of the injury.MilCmbtHelmtTypChoose one. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records. Element recommended for the military populationAdvanced combat helmetNoOther combat helmetUnknownBlast direction typeBlastDirTypChoose one. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records.AboveBehindBelowIn frontLeftRightUnknownIndicator if blast happened into an enclosed spaceBlastEnclSpcIndChoose one. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records.YesNoUnknownBlast injury categoryBlastInjCatChoose all that apply. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records.Primary blastQuaternary blastSecondary blastTertiary blastUnknownBlast injury device typeBlastInjDevTypChoose one. If “Other, specify” is selected, provide an input. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records.BombGrenadeImprovised Explosive Device (IED)Land mineMortarOther, specifyRocket Propelled Grenade (RPG)UnknownOther, specify (BlastInjDevOTH)_________________________________________________Number of prior blast prior exposures ______________________________________BlastPriorExposurNumLikelihood of whether a biological agent was encountered at the time of the injury.BiolgclAgntExpsrLkhdTypChoose one. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records. Element recommended for the military populationNoneConfrimedSuspectedUnknownChemical agent exposure likelihood typeChemAgntExpsrLkhdTypChoose one. Response is obtained from participant/subject (if possible), witnesses, first responders, family or medical records. Element recommended for the military populationNoneConfrimedSuspectedUnknownIndicator of participant's/subject's use of illegal drugs, prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in large amounts. Choose one.DrgSubstCurrntIllicitUseCatYesNoUnknownVerbatim text description of the injury event (optional)._______________________InjDescriptionTextED Presentation Emergency medical care providerEmrMedCrProvTypChoose one.BystanderEmergency departmentParamedic/MedicPhysicianTrainer/coach OtherType of training by Emergency medical care providerEmrgyMedclCarePrvdrTrainTypChoose all that apply.Medical rescue teamMilitary - non medicNoneNurseParamedicPhysicianUntrained personOtherEmergency service providedEmrServTypChoose all that apply. If “Other, specify” is selected, provide an input.Ambulance (Core, EMT-B)Ambulance with specialized personnel (EMT-1)FirefighterHelicopter medical serviceNone PoliceOther, specify (EmrServOTH)____________________________The elapsed time (in minutes) from the time of injuryInjElapsedTime*Indicate the time since injury (in minutes) occurred following definition provided per protocol. __________________________________Level of care provided to participant by health care facilityCareProvisionLevelChoose one.AcuteEmergencyEmergency & AcuteEmergency services response time durationEmrServRespTmDurResponse should be recorded in minutes.________________________________________________________Duration of the emergency services provided at the scene of injuryEmrServTmInjScnDurResponse should be recorded in minutes_________________________________________________Type of procedure or therapy used to assess the therapy intensity level (TIL) for treating the traumatic brain injuryTBITherapIntensLvlProcTypeChoose all that apply.CSF drainage <120 ml/day (<5 ml/hour)CSF drainage greater than or equal to 120 ml (greater than or equal to 5 ml/hour)Decompressive craniectomyFluid loading for maintenance of cerebral perfusionHead elevation for ICP controlHigher dose sedation for ICP control (not aiming for burst suppression)Hyperosmolar therapy with hypertonic saline >0.3 g/kg/24 hoursHyperosmolar therapy with hypertonic saline up to 0.3 g/kg/24 hoursHyperosmolar therapy with mannitol >2 g/kg/24 hoursHyperosmolar therapy with mannitol up to 2 g/kg/24 hoursHypothermia below 35 CIntensive hypocapnia for ICP control [PaCO2 <4 kPa (30 mmHg)]Intracranial operation for progressive mass lesion, not scheduled on admissionMetabolic suppression for ICP control with high dose barbiturates or propofolMild hypocapnia for ICP control [PaCO2 4.6 - 5.3 kPa (35 - 40 mmHg)]Mild hypothermia for ICP control with a lower limit of 35 CModerate hypocapnia for ICP control [PaCO2 greater than or equal to 4 kPa (30 mmHg)]Neuromuscular blockade (paralysis)Nursed flat (180 degrees) for CPP managementSedation (low dose as required for mechanical ventilation)Treatment of fever (temp.>38 C) or spontaneous temp. below 34.5 CVasopressor therapy required for management of cerebral perfusionIndicator of hypothermiaHypothermIndChoose one. Add date stamp for when assessed. Recommend collection at least during initial medical treatment.YesNoSuspectedUnknownDid participant/subject experience hypotensive episode?HypotnsnEpiIndChoose one.YesNoSuspectedUnknownDid participant/subject experience hypoxic episode?HypxEpiIndChoose one.YesNoSuspectedUnknownAirway treatment typeAirwyTrtmtTypChoose all that applyAdjunctive airwayIntubationMechanical ventilationNo specific treatmentSupplemental oxygenTemporary support with bag, valve, maskUnknownGlasgow Outcome Scale Extended (GOS-E) ScoreGlasgowOutcomeScalExtScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Glasgow Outcome Scale -Extended, Pediatric Revision ScorePGOSEScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Has brain MRI been performed for the participant/subject?ImgMRIPerfIndChoose one.YesNoUnknownBrain imaging assessment resultImgBrainAssessmtReslt*Choose one.AbnormalNormalNot assessedUnknownPresence of subarachnoid hemorrhage.SAHStatus*Choose one.AbsentIntermediatePremorbidPresentHeight or length measurementHgtMeasrRecord the height (or length for the very young) of the participant/ subject. To be collected at the visit, not self-reported. Also, indicate whether height was measured in inches (in) or centimeters (cm).______________________________________________________Unit of measure for height/lengthHgtUOMChoose either Inches (in) or Centimeters (cm).CentimetersMetersFeetInchesWeight measurementWgtMeasrRecord the weight of the participant/subject in kilograms. If other unit of measure is used, record it.___________________________________________________Weight measurement unit of measureWgtUoMChoose one.KilogramsPoundsED DischargeThe elapsed time (in minutes) from the time of injuryInjElapsedTime*Indicate the time since injury (minutes) occurred following definition provided per protocol.____________________________________________Discharge StatusDischargeStatusChoose oneAliveDeadUnknownReason for ER dischargeEmrgyRmDischrgDestRsnChoose one. If “Other, specify” is selected, provide an input.Medical necessityNo ICU beds availableNormal CTRequiring specialized facilitiesSocial circumstancesUnknown Other, specify (EmrgyRmDischrgDestRsnOTH)_________________Where was the participant subject discharged from the ER?EmrgyRmDischrgDestTypChoose one. If “Other, specify” is selected, provide an input.Admission to hospital - ICUAdmission to hospital - intermediate/high care unitAdmission to hospital - other (e.g., observation unit)Admission to hospital - wardDischarge to homeDischarge to nursing homeDischarge to other hospitalN/A - patient diedUnknownOther, specify (EmrgyRmDischrgDestOTH)_______________Glasgow Outcome Scale Extended (GOS-E) ScoreGlasgowOutcomeScalExtScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Glasgow Outcome Scale -Extended, Pediatric Revision ScorePGOSEScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Additional informationGeneralNotesTxtUse this field to capture additional information.____________________________________________________________________Hospital Early PresentationThe elapsed time from the time of injuryInjElapsedTime*Indicate the time since injury (in minutes) occurred following definition provided per protocol. Note: Accurate determination of time since injury is critical for gauging patient progress and for assessing eligibility for acute phase studies. The need for TBI patients to be transferred from an initial receiving hospital to another hospital may delay definitive care and consequently impact outcome adversely, and longer transport times delay definitive treatment.Hospital admission date and timeHospitlAdmissDateTimeRecord the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http: //iso/home.html). The date/time should be recorded to the level of granularity known__________________________________________________________Hospital presentationHospPresTypChoose one.PrimarySecondaryHospital location where the subject first received careHospLocPatFirstReceiveCarTypChoose one.Direct Admit, not through EDEmergency Department/ Urgent CareImaging SuiteUnknownWas patient evaluated in the Emergency Department (ED) for acute Stroke or TIA and subsequently transferred to another acute care hospital rather than being admitted to your hospitalHospNotAdmTrnsfAnthAcCrHospIndChoose one.YesNoUnknownType of transportation to the hospitalHospTrnsprtTypChoose one. If “Other, specify” is selected, provide an inout.By footGround ambulance no physicianGround ambulance with physicianHelicopterOther, specifyPrivate transportation/taxi/other from home/sceneOther, specify (HospTrnsprtOTH)___________________Previous unitPrevUnitChoose one.CT-AngioDirect Transfer from Other HospitalEDICUORWardHospital UnitHospitalUnitChoose one.CT-AngioEDICUORWardIndicator of hypothermiaHypothermIndChoose one. YesNoSuspectedUnknownDid participant/subject experience hypotensive episode?HypotnsnEpiIndChoose one.YesNoSuspectedUnknownDid participant/subject experience hypoxic episode?HypxEpiIndChoose one.YesNoSuspectedUnknownAirway treatment typeAirwyTrtmtTypChoose all that apply.Adjunctive airwayIntubationMechanical ventilationNo specific treatmentSupplemental oxygenTemporary support with bag, valve, maskUnknownGlasgow Outcome Scale Extended (GOS-E) ScoreGlasgowOutcomeScalExtScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Glasgow Outcome Scale -Extended, Pediatric Revision ScorePGOSEScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Has brain MRI been performed for the participant/subject?ImgMRIPerfIndChoose one.YesNoUnknownBrain imaging assessment resultImgBrainAssessmtReslt*Choose one.AbnormalNormalNot assessedUnknownPresence of subarachnoid hemorrhage.SAHStatus*Choose one.AbsentIntermediatePremorbidPresentHeight or length measurementHgtMeasrRecord the height (or length for the very young) of the participant/ subject. To be collected at the visit, not self-reported. Also, indicate whether height was measured in inches (in) or centimeters (cm).______________________________________________________Unit of measure for height/lengthHgtUOMChoose either Inches (in) or Centimeters (cm).CentimetersMetersFeetInchesWeight measurementWgtMeasrRecord the weight of the participant/subject in kilograms. If other unit of measure is used, record it.___________________________________________________Weight measurement unit of measureWgtUoMChoose one.KilogramsPoundsHospital Late PresentationThe elapsed time (in minutes) from the time of injuryInjElapsedTime*Indicate the time since injury (in minutes) occurred following definition provided per protocol. Hospital admission date and timeHospitlAdmissDateTimeRecord the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http: //iso/home.html). The date/time should be recorded to the level of granularity known__________________________________________________________Injury presentation reasonInjPresentRsnChoose one.On advice significant otherProfessional referralRepatriationRoutine screeningSelf-referral with complaintsWhether the patient was hospitalized directly after late presentation of injuryInjPresLateInitMedCarChoose one.YesNoUnknownOutpatient treatment type provided (if any) if there was no initial hospitalization after late presentation of injuryInjPresLateInitMedTypChoose one.Doctor's OfficeEmergency RoomInfirmary (if incarcerated)Sick Bay (military)Other health care providerNoneCategory of professional that referred the participant/subject to seek medical careInjPrsnttnProfssnlRfrrlCatChoose oneGeneral practitionerHospital staffOther caretakerGlasgow Outcome Scale Extended (GOS-E) ScoreGlasgowOutcomeScalExtScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Glasgow Outcome Scale -Extended, Pediatric Revision ScorePGOSEScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Has brain MRI been performed for the participant/subject?ImgMRIPerfIndChoose one.YesNoUnknownBrain imaging assessment resultImgBrainAssessmtReslt*Choose one.AbnormalNormalNot assessedUnknownPresence of subarachnoid hemorrhage.SAHStatus*Choose one.AbsentIntermediatePremorbidPresentHeight or length measurementHgtMeasrRecord the height (or length for the very young) of the participant/ subject. To be collected at the visit, not self-reported. Also, indicate whether height was measured in inches (in) or centimeters (cm).______________________________________________________Unit of measure for height/lengthHgtUOMChoose either Inches (in) or Centimeters (cm).CentimetersMetersFeetInchesWeight measurementWgtMeasrRecord the weight of the participant/subject in kilograms. If other unit of measure is used, record it.___________________________________________________Weight measurement unit of measureWgtUoMChoose one.KilogramsPoundsHospital Discharge The elapsed time (in minutes) from the time of injuryInjElapsedTime*Indicate the time since injury (in minutes) occurred following definition provided per protocol.__________________________________________________________Hospital discharge date and timeHospitDischgDateTimeRecord the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http: //iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).________________________________________________________________Subject discharge statusDischargeStatusChoose oneAliveDeadUnknownDestination upon discharge from hospitalHospDischrgDestTypChoose one. If “other, specify” is selected, please provide an inout.Discharge to home/private residenceDischarge to nursing homeDischarge to other hospitalDischarge to rehabilitation unitNot applicable - patient diedUnknownOther, specify (HospDischrgDestOTH)________________Glasgow Outcome Scale Extended (GOS-E) ScoreGlasgowOutcomeScalExtScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Glasgow Outcome Scale -Extended, Pediatric Revision ScorePGOSEScore*Choose one. The patient's overall rating is based on the lowest outcome category indicated on the scale.12345678Additional information (if any)GeneralNotesTxtUse this field to capture additional information._________________________________________________________________Was the participant/subject made DNR/DNI during the hospitalization?DNRDNIIndChoose oneYesNoUnknownInjury elapsed time Do Not Resuscitate (DNR)DNRWrittenInjElapsedTime______________________________Earliest documentation of DNR/DNIDNRDNIEarliestDocTimpntTypChoose oneDay 1 or 2Day 3 or afterNot documentedTiming unclearUnknownInjury elapsed time (Support Withdrawn)SupportWithdrawnInjElapsedTime________________________Neurological Assessment Symptoms and SignsThe elapsed time (in minutes) from the time of injuryInjElapsedTime*Indicate the time since injury (in minutes) occurred following definition provided per protocol.__________________________________________________________Type of location where the data were taken/recorded.DataAcquisitionLocationTypChoose one. If “Other, specify” selected, provide the input.Acute Care UnitAmbulatoryAssisted LivingCentral LabClinic/MD OfficeCritical Access HospitalCritical Care UnitCT-AngioDischarge LoungeED arrivalED dischargeED-Non-trauma CenterED post-resuscitationED-Trauma CenterFollow-up visitHigh Care UnitHomeHospiceICUImaging Diagnostic DepartmentInjury sceneInpatient Epilepsy Monitoring UnitInpatient RehabIntermediate Care UnitLong Term Care HospitalNursing HomeObservation UnitOROther HospitalOutpatient ClinicOutpatient EEG labPre-hospitalPre-hospital BestPre-hospital WorstReferring HospitalRehabilitation UnitSite LabStep-Down Unit;Supervised Living;Unknown;Urgent Care;WardOther, specify(DataAcquisitionLocationOTH)_________________________________________________________Does (did) the participant/subject display any TBI symptoms or signs?TBISympIndChoose one for each symptom or sign. Add date and time stamp for when assessed.YesNoUnknownDoes (did) participant/subject display the following TBI symptoms or signs?TBISympTypChoose all that apply. Balance problemsDifficulty concentratingDifficulty falling asleepDifficulty rememberingDrowsinessFatigueFeeling mentally foggyFeeling slowed downHeadacheIrritabilityMore emotionalNauseaNervousnessNumbness/tinglingSadnessSensitive to lightSensitive to noiseSleeping less than usualSleeping more than usualVomitingOther, specify (TBISympTypOTH)_____________________Orientation to person resultOrientPersonResltChoose one.AbnormalNormalOrientation to place resultOrientPlaceResltChoose one.AbnormalNormalOrientation to time resultOrientTimeResltChoose one.AbnormalNormalCategory of traumatic brain injury symptom/sign displayed by the participant/subjectTBISympCatSelect all that apply. If “other, specify” is selected, provide an input.CognitiveEmotionalPhysicalSleepOther, specify (TBISympOthrTxt)____________________TBI symptom or sign rating codeTBISympRatingCodeChoose one124356Previous TBIsPrior traumatic injury indicatorPriorTraumInjryIndChoose one.YesNoUnknownTraumatic event numberTraumaticEventNumList the earliest as #1 and the latest as #n. For TBI usually only the 5 events are listed._____________________________________________________________Injury date and timeInjDateTime *Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http: //iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).________________________________________________________________If estimated, the point in time estimated as injury dateInjDateTimeEstTypChoose one.Time of first trauma activationTime of presentation to emergency departmentTime that the participant/subject became symptomaticWas the subject's traumatic brain injury sports related?TBISportIndChoose one.YesNoUnknownAny prior history of sport-related concussion?ConcussionHistoryIndChoose one.YesNoUnknownWas the subject ever hospitalized for head/neck injury?TBIHospitalizedIndChoose one.YesNoUnknownPrior traumatic injury typePriorTraumInjryTypeChoose all that apply.Brain InjuryOther Extracranial InjurySpine InjuryHead injury prior numberHeadInjPriorNumResponse is obtained from report by participant/subject or proxy._____________________________________________________________Number of concussions prior to the current injury.ConcussionPriorNumResponse is obtained from report by participant/subject or proxy. _______________________________________Number of prior blast prior exposuresBlastPriorExposurNumThis element should be collected in studies including military populations._________________________________Youngest age of loss of consciousness (LOC)TBILocYoungestAgeEnter age in years.___________________________________________________Youngest age of dazed and confused injuryTBIDazedYoungestAgeEnter age in years.___________________________________________________Longest period of unconsciousnessTBILocLongestKOEnter age in years. _____________________________________Did the subject ever dazed or had a gap in memory from injuries?TBILocMemoryGapIndChoose one.YesNoUnknownNumber of times loss of consciousness (LOC) episodes over 30 minutesTBILocOver30MinCntFor the granularity known, enter the number of LOC episodes longer than 30 minutes.________________________________________________________________Number of times the subject lost consciousness from drug overdoseTBIOverdoseCntFor the granularity known, enter the number of LOC episodes from overdose._______________________________________________________________________Longest period of being dazed and confusedTBIDazedLongestKOFor the granularity known, enter the duration of the longest episode.___________________________________________________________Number of times dazed and confused for more than 30 minsTBIDazedOver30MinCntFor the granularity known, enter the number of episodes.______________________________________________________________Concussion HistoryTraumatic event numberTraumaticEventNumList the earliest as #1 and the latest as #n. For TBI usually only the 5 events are listed._________________________________Was or was not the reported concussion diagnosed by a medical provider?ConcussDxStatusChoose one.DiagnosedUndiagnosedUnknownWas concussion episode related to playing sports, civilian accident, military accident, combat experience, or something else?ConcussionRelatednessTypSelect all that apply. If “Other, specify” is selected, provide an input.Civilian accidentCombat-relatedMilitary-relatedNot availableOther, specifySport-relatedUnknownOther, specify (ConcussionRelatednessTypOTH)______________________________Injury date and timeInjDateTime*Record the date/time according to the ISO 8601, the International Standard for the representation of dates and times (http: //iso/home.html). The date/time should be recorded to the level of granularity known (e.g., year, year and month, complete date plus hours and minutes, etc.).________________________________________________________________If estimated, the point in time estimated as injury dateInjDateTimeEstTypChoose one.Time of first trauma activationTime of presentation to emergency departmentTime that the participant/subject became symptomaticScreening for previous TBIsAge at LOC injury 1 (TBILocAge1)______Unconscious for how long (in minutes) : LOC injury 1 (TBILocDuration1)________Age at Dazed Injury 1 (TBIDazedAge1) ___________________Dazed and confused for how long dazed injury 1 (TBIDazedDuration1)________Age at LOC injury 2 (TBILocAge2)______Unconscious for how long (in minutes): LOC injury 2 (TBILocDuration2)______Age at Dazed Injury 2 (TBIDazedAge2) __________________Dazed and confused for how long dazed injury 2 (TBIDazedDuration2)_________Age at LOC injury 3 (TBILocAge3)______Unconscious for how long (in minutes) : LOC injury 3 (TBILocDuration3)______Age at Dazed Injury 3 (TBIDazedAge3) __________________Dazed and confused for how long dazed injury 3 (TBIDazedDuration3)________Age at LOC injury 4 (TBILocAge4)______Unconscious for how long (in minutes) : LOC injury 4 (TBILocDuration4)______Age at Dazed Injury 4 (TBIDazedAge4) __________________Dazed and confused for how long dazed injury 4 (TBIDazedDuration4)_________Age at LOC injury 5 (TBILocAge5)_____Unconscious for how long (in minutes) : LOC injury 5 (TBILocDuration5)______Age at Dazed Injury 5 (TBIDazedAge5) _________________Dazed and confused for how long dazed injury 5 (TBIDazedDuration5)________Age at LOC injury 6 (TBILocAge6)_____Unconscious for how long (in minutes) : LOC injury 6 (TBILocDuration6)______Age at Dazed Injury 6 (TBIDazedAge6) _________________Dazed and confused for how long dazed injury 6 (TBIDazedDuration6)________Age at LOC injury 7 (TBILocAge7)_____Unconscious for how long (in minutes) : LOC injury 7 (TBILocDuration7)______Age at Dazed Injury 7 (TBIDazedAge7) _________________Dazed and confused for how long dazed injury 7 (TBIDazedDuration7)________Age at LOC injury 8 (TBILocAge8)_____Unconscious for how long (in minutes) : LOC injury 8 (TBILocDuration8)______Age at Dazed Injury 8 (TBIDazedAge8) _________________Dazed and confused for how long dazed injury 8 (TBIDazedDuration8)________Age at LOC injury 9 (TBILocAge9)_____Unconscious for how long (in minutes) : LOC injury 9 (TBILocDuration9)______Age at Dazed Injury 9 (TBIDazedAge9) _________________Dazed and confused for how long dazed injury 9 (TBIDazedDuration9)________Age at LOC injury 10 (TBILocAge10)_____Unconscious for how long (in minutes) : LOC injury 10 (TBILocDuration10)______Age at Dazed Injury 10 (TBIDazedAge10) _________________Dazed and confused for how long dazed injury 10 (TBIDazedDuration10)________How long was the subject recovery from the most recent concussion? ConcussionSymptomDurDaysEnter the number of days____________________Appendix 1: TBI Core Common Data ElementsVariable NamePageCommentsGUID1InjElapsedTime8, 18, 20, 22, 27, 29InjDateTime3, 32, 35(not required for FITBIR)InjICDExtCauseCode6, 8LOCInd9LOCDurRang10PstTraumtcAmnsInd10PstTraumAmnsDurRang10TBITyp7MedclHistCondTxt6MedclHistCondSNOMEDCTCode6GlasgowOutcomeScalExtScore20, 21, 24, 26, 28PGOSEScore20, 21, 24, 26, 28ImgBrainAssessmtReslt20, 25, 28SAHStatus20, 25, 28Appendix 2: Some SNOMED Concept Codes and Verbatim TextSNOMED Concept CodeMedical History SNOMED Concept Verbatim Name ()441806004Abscess of brain702632000Acquired brain injury (disorder)209922004Brain contusion with open intracranial wound, with 1-24 hours loss of consciousness209921006Brain contusion with open intracranial wound, with more than 1 hour loss of consciousness209923009Brain contusion with open intracranial wound, with more than 24 hours loss of consciousness and return to pre-existing conscious level209924003Brain contusion with open intracranial wound, with more than 24 hours loss of consciousness without return to pre-existing conscious level209920007Brain contusion with open intracranial wound, with no loss of consciousness2470005Brain damage275272006Brain damage - traumatic28188001Brain injury with open intracranial wound28156009Brain injury with open intracranial wound AND brief loss of consciousness (less than one hour)5202009Brain injury with open intracranial wound AND concussion13752003Brain injury with open intracranial wound AND loss of consciousness86010003Brain injury with open intracranial wound AND moderate loss of consciousness (1-24 hours)12912004Brain injury with open intracranial wound AND no loss of consciousness27923006Brain injury with open intracranial wound AND prolonged loss of consciousness (more than 24 hours) AND return to pre-existing conscious level86488006Brain injury with open intracranial wound AND prolonged loss of consciousness (more than 24 hours) without return to pre-existing conscious level9015001Brain injury without open intracranial wound22693008Brain injury without open intracranial wound AND with brief loss of consciousness (less than one hour)33332005Brain injury without open intracranial wound AND with concussion53267002Brain injury without open intracranial wound AND with loss of consciousness47450003Brain injury without open intracranial wound AND with moderate loss of consciousness (1-24 hours)79228001Brain injury without open intracranial wound AND with no loss of consciousness55885004Brain injury without open intracranial wound AND with prolonged loss of consciousness (more than 24 hours) with return to pre-existing conscious level47462004Brain injury without open intracranial wound AND with prolonged loss of consciousness (more than 24 hours) without return to pre-existing conscious level39020005Brain injury, without skull fracture25816005Brain stem compression127305005Brain stem contusion78968003Brain stem contusion with open intracranial wound57012007Brain stem contusion with open intracranial wound AND brief loss of consciousness (less than one hour)78028004Brain stem contusion with open intracranial wound AND concussion66393002Brain stem contusion with open intracranial wound AND loss of consciousness23026001Brain stem contusion with open intracranial wound AND moderate loss of consciousness (1-24 hours)52913008Brain stem contusion with open intracranial wound AND no loss of consciousness16837005Brain stem contusion with open intracranial wound AND prolonged loss of consciousness (more than 24 hours) AND return to pre-existing conscious level42670008Brain stem contusion with open intracranial wound AND prolonged loss of consciousness (more than 24 hours) without return to pre-existing conscious level52888005Brain stem contusion without open intracranial wound54637009Brain stem contusion without open intracranial wound AND with brief loss of consciousness (less than one hour)79220008Brain stem contusion without open intracranial wound AND with concussion29807001Brain stem contusion without open intracranial wound AND with loss of consciousness38761006Brain stem contusion without open intracranial wound AND with moderate loss of consciousness (1-24 hours)36716000Brain stem contusion without open intracranial wound AND with no loss of consciousness10061007Brain stem contusion without open intracranial wound AND with prolonged loss of consciousness (more than 24 hours) AND return to pre-existing conscious level63023005Brain stem contusion without open intracranial wound AND with prolonged loss of consciousness (more than 24 hours) without return to pre-existing conscious level95454007Brain stem hemorrhage63986002Brain stem herniation95457000Brain stem infarction95456009Brain stem ischemia127307002Brain stem laceration12589008Brain stem laceration with open intracranial wound6147005Brain stem laceration with open intracranial wound AND brief loss of consciousness (less than one hour)41222005Brain stem laceration with open intracranial wound AND concussion3119002Brain stem laceration with open intracranial wound AND loss of consciousness41025001Brain stem laceration with open intracranial wound AND moderate loss of consciousness (1-24 hours)19210000Brain stem laceration with open intracranial wound AND no loss of consciousness5073009Brain stem laceration with open intracranial wound AND prolonged loss of consciousness (more than 24 hours) AND return to pre-existing conscious level64413001Brain stem laceration with open intracranial wound AND prolonged loss of consciousness (more than 24 hours) without return to pre-existing conscious level20899000Brain stem laceration without open intracranial wound59561005Brain stem laceration without open intracranial wound AND with brief loss of consciousness (less than one hour)17819003Brain stem laceration without open intracranial wound AND with concussion10256000Brain stem laceration without open intracranial wound AND with loss of consciousness18531006Brain stem laceration without open intracranial wound AND with moderate loss of consciousness (1-24 hours)78525006Brain stem laceration without open intracranial wound AND with no loss of consciousness70686002Brain stem laceration without open intracranial wound AND with prolonged loss of consciousness (more than 24 hours) AND return to pre-existing conscious level67378005Brain stem laceration without open intracranial wound AND with prolonged loss of consciousness (more than 24 hours) without return to pre-existing conscious level51568001Brain stem vertigo230807001Brain ventricular shunt displacement444869007Cavernous hemangioma of brain191475009Chronic alcoholic brain syndrome78689005Chronic brain syndrome15139001Chronic brain-hydrocephalus syndrome429271000124103Chronic hypoxic-ischemic brain injury27195007Chronic non-psychotic brain syndrome111033008Circumscribed atrophy of brain209871005Closed hindbrain contusion10481000119108Colloid brain cyst46963008Compression of brain141091000119105Compression of brain co-occurrent and due to nontraumatic subarachnoid hemorrhage (disorder)140881000119109Compression of brain co-occurrent and due to spontaneous cerebral hemorrhage (disorder)135801000119109Compression of brain due to focal lesion110030002Concussion injury of brain34663006Contusion of brain84170006Contusion of brain with open intracranial wound90768003Contusion of brain without open intracranial wound342751000119101Cortical blindness of left side of brain (disorder)342741000119103Cortical blindness of right side of brain (disorder)445166009Cystic degeneration of brain441460004Cysticercosis of brain52522001Degenerative brain disorder133301000119102Degenerative brain disorder caused by alcohol (disorder)276730002Dermoid cyst of brain262693007Diffuse brain injury210038008Focal brain injury429565004Germ cell tumor of the brain301764006Hematoma of brain209885000Hind brain contusion with open intracranial wound, with 1-24 hours loss of consciousness209884001Hind brain contusion with open intracranial wound, with less than 1 hour loss of consciousness209886004Hind brain contusion with open intracranial wound, with more than 24 hours loss of consciousness and return to pre-existing conscious level209887008Hind brain contusion with open intracranial wound, with more than 24 hours loss of consciousness without return to pre-existing conscious level209883007Hind brain contusion with open intracranial wound, with no loss of consciousness209900006Hind brain laceration with open intracranial wound209904002Hind brain laceration with open intracranial wound, with 1-24 hours loss of consciousness209903008Hind brain laceration with open intracranial wound, with less than 1 hour loss of consciousness209905001Hind brain laceration with open intracranial wound, with more than 24 hours loss of consciousness and return to pre-existing conscious level209906000Hind brain laceration with open intracranial wound, with more than 24 hours loss of consciousness without return to pre-existing conscious level209902003Hind brain laceration with open intracranial wound, with no loss of consciousness95659007Hindbrain hernia headache253203003Hypoplasia of brain gyri389088001Hypoxia of brain126944002Hypoxic-ischemic brain injury128614008Infectious disease of brain431266005Intraparenchymal hematoma of brain449020009Intraparenchymal hemorrhage of brain78914008Laceration of brain22819008Laceration of brain with open intracranial wound55702009Laceration of brain without open intracranial wound254941009Mixed glial tumor of brain204074000Multiple brain anomalies192926004Multiple sclerosis of the brainstem126952004Neoplasm of brain126961004Neoplasm of brain stem94767002Neoplasm of uncertain behavior of brain94766006Neoplasm of uncertain behavior of brain stem189488006Neoplasm of uncertain or unknown behavior of brain, Infratentorial189487001Neoplasm of uncertain or unknown behavior of brain, supratentorial281560004Neuroblastoma of brain254944001Neuronal and mixed neuronal - glial tumor of brain76011009Non-specific brain syndrome209881009Open hindbrain contusion126945001Perinatal anoxic-ischemic brain injury187080002Pheohyphomycotic brain abscess698837003Posttraumatic porencephalic cyst of brain (disorder)204032005Reduction deformities of brain127294003Traumatic AND/OR non-traumatic brain injury127295002Traumatic brain injury708728007Traumatic brain injury of unknown intent (disorder)127299008Traumatic brain injury with brief loss of consciousness127298000Traumatic brain injury with loss of consciousness450569000Traumatic brain injury with loss of consciousness one hour or more127300000Traumatic brain injury with moderate loss of consciousness127302008Traumatic brain injury with no loss of consciousness127301001Traumatic brain injury with prolonged loss of consciousness450551009Traumatic brain injury with prolonged loss of consciousness (more than 24 hours) and return to pre-existing conscious level450552002Traumatic brain injury with prolonged loss of consciousness (more than 24 hours) without return to pre-existing conscious level428089008Venous hemangioma of brainAPPENDIX 3: ReferencesNational Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Significant Medical History form (F0302_ Significant Medical History.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Injury Presentation Early/Late form (F0307_ Injury Presentation Early/Late .docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Type, Place, Cause and Mechanism of Injury(F0308_ Type, Place, Cause and Mechanism of Injury.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2) , Baseline Risk Assessment, (F0310_ Baseline Risk Assessment.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2) , Injuries and Injury Severity, (F0309_ Injuries and Injury Severity.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Second Insults and Other Complications, (F0311_ Second Insults and Other Complications.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Discharge Status, (F0312_ Discharge Status.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), ED Destination, (F0312_ ED Destination.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Neurological_Assessment_Glasgow_Coma_Scale_(GCS)_and_Pupils, (F0314_Neurological_Assessment_Glasgow_Coma_Scale_(GCS)_and_Pupils.docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Neurological_Assessment_LOC, PTA and AOC, (F0315_Neurological_Assessment_LOC,_PTA_and_AOC (1).docx) Institute of Neurological Disorders and Stroke (NINDS) CDE project, Traumatic Brain Injury (TBI) CDEs (v2), Neurological_Assessment_TBI_Symptoms_and_Signs, (F0316_Neurological_Assessment_TBI_Symptoms_and_Signs (2).docx) State University Traumatic Brain Injury Identification Method (OSU TBI-ID), K. Yue, Mary J. Vassar, Hester F. Lingsma, Shelly R. Cooper, David O. Okonkwo, Alex B. Valadka, Wayne A. Gordon, Andrew I. R. Maas, Pratik Mukherjee, Esther L. Yuh, Ava M. Puccio, David M. Schnyer, Geoffrey T. Manley and TRACK-TBI Investigators including:, Scott S. Casey, Maxwell Cheong, Kristen Dams-O'Connor, Allison J. Hricik, Emily E. Knight, Edwin S. Kulubya, David K. Menon, Diane J. Morabito, Jennifer L. Pacheco, and Tuhin K. Sinha. Journal of Neurotrauma. October 2013, 30(22): 1831-1844. doi:10.1089/neu.2013.2970.Kathryn E. Saatman, Ann-Christine Duhaime, Ross Bullock, Andrew I.R. Maas, Alex Valadka, and Geoffrey T. Manley. Journal of Neurotrauma. November 2010, 25(7): 719-738. doi:10.1089/neu.2008.0586.Maas, Stocchetti, Bullock , Moderate and severe traumatic brain injury in adults, A review, The LANCET Neurology, Volume 7, Issue 8, August 2008, Pages 728–741, (08)70164-9Cantor J, Ashman T, Dams-O’Connor K, et al. Evaluation of the short-term executive plus intervention for executive dysfunction after traumatic brain injury: a randomized controlled trial with minimization. Arch Phys Med Rehabil. 2014;95(1):1-9.e3.Maas et al, Standardizing Data Collection in Traumatic Brain Injury, J Neurotrauma. 2011 Feb; 28(2): 177–187. doi: 10.1089/neu.2010.1617Hawryluk GW, Manley GT. Classification of traumatic brain injury: past, present, and future. Handb Clin Neurol. 2015;127:15-21. Lingsma HF, Yue JK, Maas AI, Steyerberg EW, Manley GT; TRACK-TBI Investigators, Cooper SR, Dams-O'Connor K, Gordon WA, Menon DK, Mukherjee P, Okonkwo DO, Puccio AM, Schnyer DM, Valadka AB, Vassar MJ, Yuh EL. Outcome prediction after mild and complicated mild traumatic brain injury: external validation of existing models and identification of new predictors using the TRACK-TBI pilot study. JNeurotrauma. 2015 Jan 15;32(2):83-94. Sherer M et al, Early cognitive status and productivity outcome after traumatic brain injury: Findings from the TBI Model Systems, Archives of Physical Medicine and Rehabilitation, Volume 83, Issue 2, February 2002, Pages 183–192Pellman, Elliot J. M.D.; Powell, John W. Ph.D.; Viano, David C. Dr. med., Ph.D.; Casson, Ira R. M.D.; Tucker, Andrew M. M.D.; Feuer, Henry M.D.; Lovell, Mark Ph.D.; Waeckerle, Joseph F. M.D.; Robertson, Douglas W. M.D. Concussion in Professional Football: Epidemiological Features of Game Injuries and Review of the LiteraturePart 3. Neurosurgery: January 2004 - Volume 54 - Issue 1 - pp 81-96, doi: 10.1227/01.NEU.0000097267.54786.54IMPACT: International Mission for Prognosis and Analysis of Clinical Trials in TBI, Medical History Traumatic Brain Injury Therapeutic Area Data Standard User Guide v1 (Provisional) TO CONGRESS, Traumatic Brain Injury in the United States: Epidemiology and Rehabilitation, Submitted by the Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention - . Harabangui et. Al. Experiments with Open-Domain Textual Question Answering, in proceedings of COLING-2000, Saarburkrn, Germany, pp 292-298, August 2000 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download