Incidence and Outcome of Traumatic Brain Injury in an Urban Area in Western Europe over 10 Years

Abstract

Introduction: Valid epidemiological data on incidence and outcome of traumatic brain injury (TBI) show great variability. A study on incidence, severity and outcome of TBI was conducted in an urban area of one million inhabitants. Materials and Methods: 130,000 prehospital emergencies were screened for TBI. Inclusion criteria: Glasgow Coma Scale (GCS) score ≤8 and/or Abbreviated Injury Scale for head injuries (AIS_head) score ≧2 with confirmed TBI via appropriate diagnostics. Results: Annual incidence was 7.3/100,000. Overall mortality rate was 45.8%: 182 (28%) were prehospital deaths, 116 (17.8%) patients died in hospital. Two hundred and fourteen of 352 (60.8%) surviving patients were sufficiently rehabilitated at discharge [Glasgow Outcome Scale (GOS) score = 1], but 138 patients (39.2%) survived with persisting deficits. GOS was associated with initial GCS and AIS_head. Conclusion: The incidence of TBI was lower compared to the literature. The overall mortality was high, especially prehospital and early in-hospital mortality rates.

Incidence of Hospital-Admitted Severe Traumatic Brain Injury and In-Hospital Fatality in Norway: A National Cohort Study

“…Roughly half of the patients had accompanying injuries, and these results are in accordance with other studies [21]. As expected, these injuries were more often observed in high-energy events such as transport accidents [10].…”

“…Severe-TBI fatality rates after admission to hospital are 25–40% [21,22]. In the present study, a fatal outcome was found in 29% of the patients.…”

“…A study by Masson et al [15] examined patients admitted to the hospital with prolonged coma (GCS ≤ 8 before sedation) in 1996 and found an incidence rate of 8.5/100,000. A German study assessed severe TBI in an urban area of 1,000,000 inhabitants over 10 years (from 1990 to 1999) and found an estimated annual incidence of 7.3/100,000 [21]. …”

Epidemiology of in-hospital trauma deaths

“…About half of all trauma deaths are said to belong to this group; however, the data vary from 30 to 70% based on various factors, such as type of injury, region, or type of emergency medical system (EMS). Evans et al [5] found that 66% of trauma deaths were prehospital deaths in Australia, Maegele et al [6] found that 61% of patients with traumatic brain injury (TBI) died outside the hospital, and Demetriades et al [7] found a 50% rate for immediate deaths in the county of Los Angeles. However, these very early deaths are usually not seen in hospital-based trauma registries, and the present analysis also could not contribute to this aspect.…”

What Do We Know About the Detailed Mechanism on How Stem Cells Generate Their Mode of Action

“…Thus, TBI is a highly relevant medical and socio-economic problem of modern society. During the last two decades, improvements in acute pre-and inhospital care, time management, diagnostic procedures, and rehabilitation strategies have substantially improved the level of care and outcome following TBI (Maegele 2007). But still, to date, no therapeutic approach has been proven effective in reversing the pathologic cellular sequelae underlying the progression of cell loss and in improving neurobehavioral outcome.…”