Changing Epidemiological Patterns in Traumatic Brain Injury: A Longitudinal Hospital-Based Study in Belgium

Abstract

Background: Various reports have suggested that epidemiological patterns of Traumatic Brain Injury (TBI) are changing in high-income countries, but the evidence to support this is often indirect and only a few longitudinal studies exist. We aimed to explore epidemiological patterns of TBI in Belgium over a 10-year period. Methods: A retrospective analysis of Minimum Hospital Data provided by Statistics Belgium was performed for the period 2003-2012. ICD-9 classification was used to identify TBI and to differentiate subtypes. The annual incidence of hospital admissions and in-hospital mortality rates were calculated and further differentiated for age, gender and cause of injury. Results: The age-adjusted incidence of hospital admissions decreased by 3.6% per year. An increase in the number of elderly patients with TBI and a decrease in the younger age groups were found. Falls now represent the main cause of TBI. A mortality rate of 6.5 per 100,000 population per year was found and did not change significantly over time. Conclusions: This longitudinal study confirms that epidemiological patterns in TBI are changing: overall incidence is steadily decreasing, but in elderly patients, the incidence is increasing. Falls are the leading cause, occurring most frequently in elderly patients. These changes are relevant for prevention.

Clinical outcome and prognostic factors in elderly traumatic brain injury patients receiving neurointensive care

“…The main cause of trauma in all elderly age groups was fall (Table 1 ), which is in accordance with our earlier findings [ 22 , 28 ] as well as with the results of many other studies [ 8 , 15 , 17 , 19 , 23 , 34 , 36 , 40 ]. Although there was a predominant injury mechanism, there was a notable significant difference between the age groups regarding several other characteristics (Table 1 ).…”

Complementary Traditional Chinese Medicine Therapy for Traumatic Brain Injury

“…The high incidence of TBI-associated disability and death incurs many costs and social challenges [5]. In the United States, the cost of TBI has been estimated to be greater than USD 75 billion per year, and the cost for one patient in their whole lifetime is estimated at USD 396,000 [6]. Indeed, even after emergency treatment and hospitalization, deficits persist, even in cases of mild TBI.…”

Evidence of Decreasing Hospital Admissions for Traumatic Brain Injury in Europe

“…In the current issue of Neuroepidemiology , Peeters et al [2] present the findings of a longitudinal study of hospital admissions for TBI over a 10-year period in Belgium. The study identified that contrary to findings in the United States, TBI hospital admissions in young to middle aged adults have decreased over time.…”

“…As discharges from the emergency department did not appear to be included in the analysis by Peeters et al [2], it remains unclear if the trends observed in the United States are also occurring in Europe. Indeed, while the authors state that there was no change in hospital policy during the study period, there may be an increasing trend in clinical practice to discharge rather than admit people to hospital following a TBI, particularly if the reason for admission was solely for the purpose of monitoring the person's condition.…”

“…Older age has been linked to poorer outcome [3] and the higher mortality rate observed is likely to be reflective of this link, but such variation in mortality rate within the same age group over time is intriguing. Given the advances in the treatment of TBI, it would have been encouraging to see a decline in mortality rates across all ages, yet the stability of the mortality rate from TBI over the 10-year period reported by Peeters et al [2] suggests that more substantive developments in the screening and management of TBI are needed.…”