BACKGROUND: The aim of this prospective study was to estimate annual incidences of hospitalization for severe traumatic brain injury (TBI) (maximum Abbreviated Injury Score in the head region [HAIS] 4 or 5) in a defined population of 2.8 million. METHODS: Severe TBI patients were included in the emergency departments in the 19 hospitals of the region. A prospective data form was completed with initial neurologic state, computed tomographic scan lesions, associated injuries, length of unconsciousness, and length of stay in acute care centers. Outcome at the time the patient left acute hospitalization was retrospectively assessed from medical notes. RESULTS: During the 1-year period (1996), 497 residents fulfilled the inclusion criteria, leading to an annual incidence rate of 17.3 per 100,000 population; 58.1% were HAIS5. Mortality rate was 5.2 per 100,000. Men accounted for 71.4% of cases. Median age was 44 years, with a quarter of patients more than 70 years old. Traffic accidents were the most frequent causes (48.3%), but falls accounted for 41.8% of all patients. Age and severity were different according to the major categories of external causes. In HAIS5 patients, 86.5% were considered as comatose (coma lasting more than 24 hours or leading to immediate death) but only 60.9% had an initial Glasgow Coma Scale score < 9. In the HAIS4 group, 7.2% had an initial Glasgow Coma Scale score < 9. Fatality rates were 30.0% in the whole study group, 7.7% in HAIS4, 12.8% in HAIS5 without coma, and 51.2% in HAIS5 with coma. CONCLUSION: This study shows a decrease in severe TBI incidence when results are compared with another study conducted 10 years earlier in the same region. This is because of a decrease in traffic accidents. However, this results in an increase in the proportion of falls in elderly patients and an increase in the median age in our patients. This increased age influences the mortality rate.
BACKGROUND: The aim of this prospective study was to estimate annual incidences of hospitalization for severe traumatic brain injury (TBI) (maximum Abbreviated Injury Score in the head region [HAIS] 4 or 5) in a defined population of 2.8 million. METHODS: Severe TBIpatients were included in the emergency departments in the 19 hospitals of the region. A prospective data form was completed with initial neurologic state, computed tomographic scan lesions, associated injuries, length of unconsciousness, and length of stay in acute care centers. Outcome at the time the patient left acute hospitalization was retrospectively assessed from medical notes. RESULTS: During the 1-year period (1996), 497 residents fulfilled the inclusion criteria, leading to an annual incidence rate of 17.3 per 100,000 population; 58.1% were HAIS5. Mortality rate was 5.2 per 100,000. Men accounted for 71.4% of cases. Median age was 44 years, with a quarter of patients more than 70 years old. Traffic accidents were the most frequent causes (48.3%), but falls accounted for 41.8% of all patients. Age and severity were different according to the major categories of external causes. In HAIS5 patients, 86.5% were considered as comatose (coma lasting more than 24 hours or leading to immediate death) but only 60.9% had an initial Glasgow Coma Scale score < 9. In the HAIS4 group, 7.2% had an initial Glasgow Coma Scale score < 9. Fatality rates were 30.0% in the whole study group, 7.7% in HAIS4, 12.8% in HAIS5 without coma, and 51.2% in HAIS5 with coma. CONCLUSION: This study shows a decrease in severe TBI incidence when results are compared with another study conducted 10 years earlier in the same region. This is because of a decrease in traffic accidents. However, this results in an increase in the proportion of falls in elderly patients and an increase in the median age in our patients. This increased age influences the mortality rate.
Authors: Y-C Lu; N P Daphalapurkar; A K Knutsen; J Glaister; D L Pham; J A Butman; J L Prince; P V Bayly; K T Ramesh Journal: Ann Biomed Eng Date: 2019-02-14 Impact factor: 3.934
Authors: Nicolas Côte; Alexis F Turgeon; François Lauzier; Lynne Moore; Damon C Scales; Francis Bernard; Ryan Zarychanski; Karen E A Burns; Maureen O Meade; David Zygun; Jean-François Simard; Amélie Boutin; Jacques G Brochu; Dean A Fergusson Journal: Neurocrit Care Date: 2013-02 Impact factor: 3.210
Authors: Christina R Marmarou; Xiuyin Liang; Naqeeb H Abidi; Shanaz Parveen; Keisuke Taya; Scott C Henderson; Harold F Young; Aristotelis S Filippidis; Clive M Baumgarten Journal: Brain Res Date: 2014-06-13 Impact factor: 3.252
Authors: Michael A Flierl; Philip F Stahel; Kathryn M Beauchamp; Steven J Morgan; Wade R Smith; Esther Shohami Journal: Nat Protoc Date: 2009-08-27 Impact factor: 13.491