P053: Characteristics and patterns of major traumatic brain injury in Nova Scotia: a 12-year retrospective analysis

Introduction: Traumatic brain injury (TBI) is a leading cause of death and disability in Nova Scotia. TBI occurs in approximately 50% of major trauma seen annually in the province. The purpose of this study was to describe the characteristics and patterns of major TBI seen in Nova Scotia over a 12-year period. Methods: This was a retrospective case series. Data were obtained from the Nova Scotia Trauma Registry for all patients presenting with major TBI (abbreviated injury score [AIS] head ≥3) between 2002 and 2013. Injury rates were calculated on the basis of 100,000 population (all ages) using population estimates from Statistics Canada. Results: Overall, 4152 major TBI patients were seen in Nova Scotia hospitals during the study period. Mean age of TBI patients was 51±25 years; 73% were male. The majority of injuries were the result of blunt trauma (93%), with relatively few major TBIs resulting from penetrating trauma (7%). The most common mechanisms of injury were falls (44%) and motor vehicle crashes (27%). Analysis of census-based subpopulations of the province showed that injury rates varied significantly among counties (from 25 to 63 per 100,000 population). We observed an increase in the number of major TBI patients over twelve years. Conclusion: Our findings suggest significant regional variation in major TBI rates in Nova Scotia. There are ongoing needs for prevention and intervention efforts that focus on unintentional falls and motor vehicle crashes, especially in older adults. These results also suggest that geographically targeted efforts may be warranted.

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Sertraline to improve arousal and alertness in severe traumatic brain injury secondary to motor vehicle crashes

Brain Injury ◽

10.1080/026990501750111274 ◽

2001 ◽

Vol 15 (4) ◽

pp. 321-331 ◽

Cited By ~ 50

Author(s):

Jay M. Meythaler ◽

Lawrence Depalma ◽

Michael J. Devivo ◽

Sharon Guin-Renfroe ◽

Thomas A. Novack

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Motor Vehicle ◽

Motor Vehicle Crashes ◽

Vehicle Crashes

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Mild traumatic brain injury and motor vehicle crashes: Limitations to our understanding

Injury ◽

10.1016/j.injury.2014.08.044 ◽

2015 ◽

Vol 46 (10) ◽

pp. 1871-1874 ◽

Cited By ~ 1

Author(s):

Jagnoor Jagnoor ◽

Ian Cameron

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Motor Vehicle ◽

Motor Vehicle Crashes ◽

Vehicle Crashes

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A Predictive Model to Analyze the Factors Affecting the Presence of Traumatic Brain Injury in the Elderly Occupants of Motor Vehicle Crashes Based on Korean In-Depth Accident Study (KIDAS) Database

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083975 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3975

Author(s):

Hee Young Lee ◽

Hyun Youk ◽

Oh Hyun Kim ◽

Chan Young Kang ◽

Joon Seok Kong ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Logistic Regression ◽

Regression Analysis ◽

Brain Injury ◽

Predictive Model ◽

Motor Vehicle ◽

The Elderly ◽

Motor Vehicle Crashes ◽

Vehicle Crashes ◽

Factors Affecting

Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force injures the brain. This study aimed to analyze the factors affecting the presence of TBI in the elderly occupants of motor vehicle crashes. We defined elderly occupants as those more than 55 years old. Damage to the vehicle was presented using the Collision Deformation Classification (CDC) code by evaluation of photos of the damaged vehicle, and a trauma score was used for evaluation of the severity of the patient’s injury. A logistic regression model was used to identify factors affecting TBI in elderly occupants and a predictive model was constructed. We performed this study retrospectively and gathered all the data under the Korean In-Depth Accident Study (KIDAS) investigation system. Among 3697 patients who visited the emergency room in the regional emergency medical center due to motor vehicle crashes from 2011 to 2018, we analyzed the data of 822 elderly occupants, which were divided into two groups: the TBI patients (N = 357) and the non-TBI patients (N = 465). According to multiple logistic regression analysis, the probabilities of TBI in the elderly caused by rear-end (OR = 1.833) and multiple collisions (OR = 1.897) were higher than in frontal collision. Furthermore, the probability of TBI in the elderly was 1.677 times higher in those with unfastened seatbelts compared to those with fastened seatbelts (OR = 1.677). This study was meaningful in that it incorporated several indicators that affected the occurrence of the TBI in the elderly occupants. In addition, it was performed to determine the probability of TBI according to sex, vehicle type, seating position, seatbelt status, collision type, and crush extent using logistic regression analysis. In order to derive more precise predictive models, it would be needed to analyze more factors for vehicle damage, environment, and occupant injury in future studies.

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Sertraline to improve arousal and alertness in severe traumatic brain injury secondary to motor vehicle crashes

Brain Injury ◽

10.1080/02699050120506 ◽

2001 ◽

Vol 15 (4) ◽

pp. 321-331 ◽

Cited By ~ 1

Author(s):

Jay M. Meythaler, Lawrence Depalma,

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Motor Vehicle ◽

Motor Vehicle Crashes ◽

Vehicle Crashes

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Quantification of Alcohol Dehydrogenase Concentration for Traumatic Brain Injury in Alcohol-intoxicated Patients as a Predictor of Severity and Prognosis

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.5845 ◽

2021 ◽

Vol 9 (B) ◽

pp. 212-216

Author(s):

Muhammad Z. Arifin ◽

David Atmaja ◽

Ahmad Faried

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Alcohol Dehydrogenase ◽

Motor Vehicle ◽

Alcohol Intoxication ◽

Public Health Problem ◽

Motor Vehicle Crashes ◽

Vehicle Crashes ◽

Middle Income ◽

A Prospective Study

BACKGROUND: Traumatic brain injury (TBI) stills the leading cause of public health problem and disabilities in many countries, especially in lower-middle-income countries. Motor vehicle crashes, especially motorized two-wheeler riders, are the major cause of TBI, followed by fall and assault. During 2013–2014, a total of 2108 TBI cases (65.4% of them being caused by motor vehicle crashes) were documented in the Emergency Unit of Dr. Hasan Sadikin Hospital (RSHS) Bandung. Among these, 30.7% of cases were categorized as moderate and severe TBI, with a mortality rate of 29.2%. Half of the cases arrived at RSHS within 6 h and 14.0% of these cases were alcohol-intoxicated. Individuals with low activity of alcohol-metabolizing enzymes have low tolerance to alcohol and are therefore rapidly intoxicated, making them more susceptible to more serious injuries from motor vehicle crashes. METHODS: A prospective study was designed by consecutive sampling from January to August 2017 to review 30 intoxicated patients with TBI on hospital admission by measuring their serum alcohol dehydrogenase (ADH) concentration using an ELISA and then correlated it with the severity, type of TBI lesions, and the outcome. RESULTS: Demonstrated an ADH level of l d0.24 ng/ml in patients with TBI with a history of alcohol intoxication, which statistically correlated with lower initial Glasgow coma scale (GCS) scores on admission by approximately 6.53 times (p < 0.001), thus increasing the risk of developing multiple lesions by 3.98 times (p = 0.029) and worse outcomes by 5.27 times (p = 0.003), but it did not correlate with length of stay (p = 0.392). CONCLUSIONS: ADH concentrations in intoxicated TBI patients can be taken into consideration to decide about the therapeutic action and further informed consent to the family.

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A Retrospective Evaluation of Pediatric Major Trauma Related to Sport and Recreational Activities in Nova Scotia

CJEM ◽

10.1017/cem.2015.69 ◽

2015 ◽

Vol 18 (2) ◽

pp. 106-111 ◽

Cited By ~ 3

Author(s):

Robert S. Green ◽

Michael B. Butler ◽

Nelofar Kureshi ◽

Mete Erdogan

Keyword(s):

Traumatic Brain Injury ◽

Nova Scotia ◽

Brain Injury ◽

Severe Traumatic Brain Injury ◽

Major Trauma ◽

Pediatric Trauma ◽

Case Series ◽

Hospital Length Of Stay ◽

Series Data ◽

Recreational Activities

AbstractObjectivesA small proportion of pediatric sport- and recreation-related injuries are serious enough to be considered “major trauma.” However, the immediate and long-term consequences in cases of pediatric major trauma are significant and potentially life-threatening. The objective of this study was to describe the incidence and outcomes of pediatric major traumas related to sport and recreational activities in Nova Scotia.MethodsThis study was a retrospective case series. Data on major pediatric traumas related to sport and recreational activities on a provincial scope were extracted from the Nova Scotia Trauma Program Registry between 2000 and 2013. We evaluated frequency, type, severity, and outcomes of major traumas. Outcomes assessed included length of hospital stay, admission to a special care unit (SCU), and mortality.ResultsOverall, 107 children aged three to 18 years sustained a major trauma (mean age 12.5 [SD 3.8]; 84% male). Most injuries were blunt traumas (97%). The greatest proportion were from cycling (59, 53%), followed by hockey (8, 7%), skateboarding (7, 7%) and skiing (7, 7%). The Nova Scotia Pediatric Trauma Team was activated in 27% of cases. Mean in-hospital length of stay was five days (SD 5.6), and nearly half (49%) of patients required SCU admission. Severe traumatic brain injury occurred in 52% of cases, and mortality in five cases.ConclusionsOver a 13-year period, the highest incidence of pediatric major trauma related to sport and recreational activities was from cycling, followed by hockey. Severe traumatic brain injury occurred in over half of pediatric major trauma patients.

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