Geographic Variation in Outcomes from Severe Traumatic Brain Injury

Georgoff, Patrick E.; Meghan, Sudha; Mirza, Kasim L.; Stein, Sherman C.

doi:10.1016/j.wneu.2010.03.025

Cited by 28 publications

(18 citation statements)

References 209 publications

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“…Reynolds et al Process (3,5,6,9,12,13,14,15,20,21,46,50,53,54,57,64,67,68,69,71,86,93,103) 23 (32) Clinical or population health outcome (3,4,12,14,15,16,17,18,19,22,23,24,28,29,35,36,41,42,43,45,48,49,53,54,57,59,60,61,64,…”

mentioning

confidence: 99%

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

Reynolds

Stewart

Drewett

et al. 2017

Annu. Rev. Public Health

140

120

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Injury is a leading cause of death globally, and organized trauma care systems have been shown to save lives. However, even though most injuries occur in low-and middle-income countries (LMICs), most trauma care research comes from high-income countries where systems have been implemented with few resource constraints. Little context-relevant guidance exists to help policy makers set priorities in LMICs, where resources are limited and where trauma care may be implemented in distinct ways. We have aimed to review the evidence on the impact of trauma care systems in LMICs through a systematic search of 11 databases. Reports were categorized by intervention and outcome type and summarized. Of 4,284 records retrieved, 71 reports from 32 countries met inclusion criteria. Training, prehospital systems, and overall system organization were the most commonly reported interventions. Quality-improvement, costing, rehabilitation, and legislation and governance were relatively neglected areas. Included reports may inform trauma care system planning in LMICs, and noted gaps may guide research and funding agendas.

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confidence: 99%

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

Reynolds

Stewart

Drewett

et al. 2017

Annu. Rev. Public Health

140

120

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“…Additionally, these countries started with the highest mortality rate, resulting in a statistically significant increase in mortality between developing countries and the US in 2009 [3]. There was no significant difference between the US and other developed countries [3].…”

Section: Introductionmentioning

confidence: 98%

“…TBI disproportionately affects LMIC [3]. A meta-analysis comparing the US, other developed countries, and developing countries found that mortality rates declined between 1975 and 2009 in all groups, but that the rate of decline was lowest in developing countries [3].…”

Section: Introductionmentioning

confidence: 99%

“…A meta-analysis comparing the US, other developed countries, and developing countries found that mortality rates declined between 1975 and 2009 in all groups, but that the rate of decline was lowest in developing countries [3]. Additionally, these countries started with the highest mortality rate, resulting in a statistically significant increase in mortality between developing countries and the US in 2009 [3].…”

Section: Introductionmentioning

confidence: 99%

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Challenges and Solutions for Traumatic Brain Injury Management in a Resource-Limited Environment: Example of a Public Referral Hospital in Rwanda

Ramesh¹,

Fezeu²,

Fidele³

et al. 2014

Cureus

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“…Although the epidemiological aspects of TBI have been studied in different populations, it is difficult to validly describe and quantify their global patterns owing mainly to the lack of standardized data collection, variability in definitions (7), and geographical and time-related variability in TBI patterns (3,8). Defining risk factors, protective factors and populations at increased risk is essential for effective public health action (9).…”

Section: Introductionmentioning

confidence: 99%

Severity, Causes and Outcomes of Traumatic Brain Injuries Occurring at Different Locations: Implications for Prevention and Public Health

Majdán¹,

Rusňák²,

Bražinová³

et al. 2015

Cent Eur J Public Health

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SUMMARYAim: Traumatic brain injuries (TBI) are a major public health problem. Although they are well studied, information on some aspects, such as the place of occurrence, is limited. The aim of this study was to describe the patterns of severity, causes and outcomes of TBI occurring at different locations and to identify the primary populations at risk of suffering TBI at each of the analysed locations.Methods: 1,818 patients with TBI admitted to hospitals in Austria, Slovakia, Croatia, Bosnia, and Macedonia were analysed. Primary populations at risk, injury severity and extent along with short/long-term outcomes were analysed for TBI at each location.Results: The highest mean age (57.9 years, p < 0.001) was observed in injuries at home. The distribution of injury causes across the group was significantly different (p < 0.001), with falls (39%) and traffic accidents (30%) being predominant. TBI occurring on roads or highways were the most severe (mean ISS = 32.5, p < 0.001; mean GCS = 7.8, p < 0.001). Injuries at home had the worst outcome (50% mortality, p < 0.001 and 70% unfavourable outcome, p < 0.001) whereas TBI at sport facilities or outdoors had the best outcome (24% mortality, 44% unfavourable outcome). When adjusted for age and severity, TBI occurring at home had the highest odds of mortality (OR = 3.12, 95% CI = 1.86-5.25) and unfavourable outcome (OR = 2.51, 95% CI = 1.54-4.08), compared to sports facility and outdoors as a reference.Conclusions: TBI at different locations display distinctive patterns as to causes, severity, outcome and populations at risk. Location is therefore a relevant epidemiological aspect of TBI and we advocate its inclusion in future studies. Definitions of primary populations at risk at different locations could help in targeted public health actions.

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Geographic Variation in Outcomes from Severe Traumatic Brain Injury

Cited by 28 publications

References 209 publications

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

The Impact of Trauma Care Systems in Low- and Middle-Income Countries

Challenges and Solutions for Traumatic Brain Injury Management in a Resource-Limited Environment: Example of a Public Referral Hospital in Rwanda

Severity, Causes and Outcomes of Traumatic Brain Injuries Occurring at Different Locations: Implications for Prevention and Public Health

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