A Nationwide Study of Incidence and Mortality Due to Traumatic Brain Injury in Ecuador (2004–2016)

Abstract

<b><i>Objective:</i></b> Traumatic brain injury (TBI) is a public health problem worldwide. Information regarding TBI from low- and middle-income countries is scarce. The objectives of this study are to determine the incidence, mortality and geodemographic distribution of TBI in Ecuador. <b><i>Methods:</i></b> A population-based analytical study from 2004 to 2016 was conducted in Ecuador. Men and women with a diagnosis of TBI from all ages (0–110 years) were included. Data was obtained from official hospital-discharges records and retrieved from the National Institute of Statistics and Census (INEC) Database. We analyzed data by region, province and canton with a monthly resolution. The incidence, mortality, case fatality rates and the risk of developing TBI within the population were calculated based on the last 13 years of available data. <b><i>Results:</i></b> A total of 124,576 hospital admissions and 5,264 deaths due to TBI were registered in Ecuador from 2004 to 2016. The overall TBI-related hospital admission rate was 70.68 per 100,000. The sex- and age-specific rate was 90.1 per 100,000 for men and 64.1 per 100,000 for women. Mestizos’ population has the highest adjusted incidence rate of 195.6 per 100,000, followed by the indigenous with 61.4 per 100,000 and Afro-Americans with 14.2 per 100,000. The overall annual mortality rate during the study ranged from 2.11 to 3.35 per 100,000. Case fatality rates were significantly higher in older populations, becoming fatal in up to 27% of men >90 years/old and in 15% of women older than 90 years/old. <b><i>Conclusion:</i></b> This is the first recorded epidemiological study of the socio-demographic distribution of TBI in Ecuador to date. The study found that young men were almost 4 times more likely to be hospitalized due to TBI than women of this age. Fatalities due to TBI were less likely to occur among younger age groups, increasing significantly among the elderly population. The national incidence rate of TBI has been decreasing since 2011, which coincides with the introduction of stricter alcohol regulation, suggesting that this measure might have played a role in this reduction.

Changes in Mortality Related to Traumatic Brain Injuries in the Seychelles from 1989 to 2018

“…TBI-related mortality rates differ widely between populations. Studies conducted in LMICs have found higher rates of TBIrelated mortality in rural vs. urban populations, with evidence of a significant gendered gradient (1,13,23,24). Systemic issues within the healthcare systems of resource-limited settings often pose challenges, including delay in accessing health providers, ill-functioning equipment, lack of diagnostic equipment, and inadequate case management, which can adversely impact on outcomes after TBIs (14).…”

Operation Brain Trauma Therapy: An Exploratory Study of Levetiracetam Treatment Following Mild Traumatic Brain Injury in the Micro Pig

“…Traumatic brain injury (TBI) is a critical public health and socio-economic problem and, according to the World Health Organization, will soon become the third leading cause of death and disability worldwide (1)(2)(3)(4)(5)(6)(7)(8)(9). Despite many potential therapeutics that showed great promise in pre-clinical models, the list of negative or inconclusive clinical trials keeps growing, and the quest for effective therapeutic interventions for TBI continues.…”

Buprenorphine Alters Microglia and Astrocytes Acutely Following Diffuse Traumatic Brain Injury.

“…Sections were collected serially in 12-well plates and stored in MIllonig's buffer at 4 o C. All quantitative analyses were performed at least 1 mm posterior to the needle track used for ICP monitoring. The well from which sections would be taken for analysis was selected via a random number generator (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12) and the rst 4 sections with visible hippocampus were taken representing serial sections throughout the rostral-caudal extent (1.8 mm±0.2 mm to 3.8 mm±0.2 mm posterior to bregma, each 480μm apart). Histologic analyses were performed on the left lateral somatosensory cortex restricted to layers V and VI extending from the area lateral to CA1 to the area lateral to CA3 of the hippocampus and entire left hemi-thalamus extending from the midline and dorsal surface of the thalamus to the reticular nucleus and zona inserta of the thalamus laterally and ventrally.…”

“…The parameters used to determine myelin debris were circularity=0.3-1.0 and particle size=0.5-10 µm 2 . To assess myelin bers the analysis settings were as follows, circularity= 0.0-0.1 and particle size= 25-in nity µm 2 . The average total area covered by intact myelin bers or myelin debris was quanti ed for each image and averaged for each animal.…”

“…Traumatic brain injury (TBI) is an increasingly common phenomenon, with almost 2 million reported cases occurring annually in the US alone [1][2][3] . Overall, TBIs contribute to nearly 30% of all injury-related deaths, and account for signi cant healthcare cost and adverse health effects.…”