Incidence, causes and consequences of moderate and severe traumatic brain injury as determined by Abbreviated Injury Score in the Netherlands

AbstractTraumatic brain injury (TBI) is a leading cause of death and disability. Epidemiology seems to be changing. TBIs are increasingly caused by falls amongst elderly, whilst we see less polytrauma due to road traffic accidents (RTA). Data on epidemiology is essential to target prevention strategies. A nationwide retrospective cohort study was conducted. The Dutch National Trauma Database was used to identify all patients over 17 years old who were admitted to a hospital with moderate and severe TBI (AIS ≥ 3) in the Netherlands from January 2015 until December 2017. Subgroup analyses were done for the elderly and polytrauma patients. 12,295 patients were included in this study. The incidence of moderate and severe TBI was 30/100.000 person-years, 13% of whom died. Median age was 65 years and falls were the most common trauma mechanism, followed by RTAs. Amongst elderly, RTAs consisted mostly of bicycle accidents. Mortality rates were higher for elderly (18%) and polytrauma patients (24%). In this national database more elderly patients who most often sustained the injury due to a fall or an RTA were seen. Bicycle accidents were very frequent, suggesting prevention could be an important aspect in order to decrease morbidity and mortality.

Download Full-text

Traumatic brain injury in adults

InnovAiT Education and inspiration for general practice ◽

10.1177/1755738017710043 ◽

2017 ◽

Vol 10 (10) ◽

pp. 608-613 ◽

Cited By ~ 2

Author(s):

Jayran Mistry ◽

Nicola Murray

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Traffic Accidents ◽

Road Traffic ◽

The Elderly ◽

Road Traffic Accidents ◽

Common Causes ◽

The Common ◽

The Uk

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Falls, assaults and road traffic accidents are the most common causes, with alcohol precipitating 65% of adult cases. The incidence of TBI is highest in men. As the UK population ages, however, the incidence of TBI in the elderly is rising. Approximately 1 million people affected in the UK have long-term sequelae, and GPs should be aware of the common causes and consequences of TBI. This article will focus primarily on mild TBI in adults.

Download Full-text

Hypopituitarism in childhood and adolescence following traumatic brain injury: the case for prospective endocrine investigation

Acta Endocrinologica ◽

10.1530/eje.1.02284 ◽

2006 ◽

Vol 155 (5) ◽

pp. 663-669 ◽

Cited By ~ 45

Author(s):

Carlo L Acerini ◽

Robert C Tasker ◽

Simonetta Bellone ◽

Gianni Bona ◽

Christopher J Thompson ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Hormone Replacement ◽

Published Data ◽

Childhood And Adolescence ◽

Pituitary Dysfunction ◽

Severe Tbi ◽

Few Data

Pituitary dysfunction is now well recognised after traumatic brain injury (TBI) in adults; however, little except anecdotal evidence is known about this potential complication in childhood and adolescence. Histopathological evidence exists for both hypothalamic and pituitary damage, but few data specific to children have been published. We review the available paediatric data, which shows that after both mild and severe TBI, hypopituitarism may occur, with GH and gonadotrophin deficiencies appearing to be most common. Precocious puberty has also been documented. Road-traffic accidents, falls, sport and child abuse are the most common aetiological factors for paediatric TBI. There are no published data on the incidence or prevalence, neither within a population of children with TBI, of hypopituitarism, nor on its natural history or response to hormone replacement. We urge paediatric endocrinologists, in collaboration with adult endocrinologists, to perform formal prospective research studies in patients suffering from TBI to clarify these questions.

Download Full-text

Traumatic brain injury in Denmark 2008–2012

Scandinavian Journal of Public Health ◽

10.1177/1403494819852826 ◽

2019 ◽

Vol 48 (3) ◽

pp. 331-337 ◽

Cited By ~ 1

Author(s):

Nuri Cayuelas Mateu

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Relative Frequency ◽

Traffic Accidents ◽

Road Traffic ◽

Older Men ◽

Road Traffic Accidents ◽

Sex Risk ◽

Severe Tbi ◽

External Causes

Aims: To examine the epidemiology of traumatic brain injury (TBI) in Denmark, including the relative frequency, distribution of injuries and the external causes across the days of the week, sex and age. Methods: I carried out a nationwide register-based study of the full population aged 16–65 years with a diagnosis of TBI between 2008 and 2012, a total of 27,030 hospital contacts. I calculated the average annual relative frequency and the sex risk ratio for four TBI diagnoses across age. I report the distribution of five external causes and the odds ratio of acquiring a TBI during the weekend. Results: The relative frequency of TBI peaked among 16- to 35-year-olds for all diagnosis except for haemorrhages, which increase with age. During weekends, the relative frequency of concussions increases for men, whereas the relative frequency of severe TBI increases for young men and decreases for older men. The relative frequency of TBI is stable throughout the week for women aged 16–35 years, but decreases for women aged 36–65 years. For 16- to 35-year-olds, the main external causes of TBI are falls and road traffic accidents. During the weekend, the risk of violence-, sport- and fall-related TBI increases for 16- to 35-year-olds, whereas the risk of TBI related to road traffic accidents decreases for women and older men. The risk of sports-related TBI increases during weekends for older men. Conclusions: Injury patterns and external causes across TBI diagnoses differ substantially across sex, age and the day of week, indicating differences in the behavioural patterns that result in a TBI.

Download Full-text

OUTCOME OF CEREBRAL CONTUSIONS DUE TO TRAUMATIC BRAIN INJURY

Journal of University Medical & Dental College ◽

10.37723/jumdc.v11i1.263 ◽

2020 ◽

Vol 11 (1) ◽

pp. 39-43

Author(s):

Zubair Ahmed Khan ◽

Habib sultan ◽

Amir Aziz ◽

Shahrukh Rizvi ◽

Tauqeer Ahmed ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Hospital Stay ◽

Traffic Accidents ◽

Road Traffic ◽

Road Traffic Accidents ◽

Male And Female ◽

Duration Of Hospital Stay ◽

History Of ◽

Age Range

ABSTRACT:BACKGROUND & OBJECTIVE: To compare the results of surgically operated vs conservatively treated patients of cerebral contusions due to traumatic brain injury. METHODOLOGY: This comparative study was conducted from January 2012 to December 2014 at the department of Neurosurgery, PGMI Lahore General Hospital, Lahore. A total of 50 patients were included in this study of both gender (male and female) and in the age range of 15-65 years. In our study 20 patients were managed conservatively while other 30 patients were operated for cerebral contusions. The mode of injury in our study was road traﬃc accidents and history of falls. RESULTS: Out of 50 patients, there were 41 (82%) males and 09 (18%) female patients. Their age ranged from 15 - 65 years. In this study the overall mean age is 38.36 years. The maximum numbers of patients were in their third and fourth decades of life. In our study the duration of hospital stay in conservatively managed patients was longer as compared to surgically treated patients who were discharged earlier. Mortality rate in surgically managed patients having a GCS ranged between 09 to 12 was very low contrary to the conservatively managed group, similarly the rate of delayed contusion formation and edema was also low in surgically managed patients as compared to those who were managed conservatively. CONCLUSION: Surgically managed patients of cerebral contusions in traumatic brain injury has better outcome and decreased hospital stay as compared to conservatively managed patients.

Download Full-text

Traumatic Brain Injury Patterns on Ct Scan: A Comparison of Motorcyclist Versus Passenger Vehicle Patients Involved in Road Traffic Accidents

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i1.1189 ◽

2017 ◽

Vol 16 (1) ◽

Author(s):

Radhiana Hassan ◽

Muniruddin Mohamad ◽

Muhamad Zaim Azami ◽

Husin Ali ◽

Hafizah Pasi

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Skull Fracture ◽

Common Finding ◽

Subdural Hemorrhage ◽

Road Traffic Accidents ◽

Passenger Vehicle ◽

Injury Patterns

Introduction: Traumatic brain injury following road traffic accidents is a common cause of morbidity and mortality in Malaysia. We aim to determine the differences of traumatic brain injury patterns based on CT findings among motorcyclist versus passenger vehicle patients involved in road traffic accidents. Materials and method: This retrospective study was conducted in Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang. A total of 100 CT scan brains of patients who were involved in road traffic accidents were retrieved and reviewed, 50 of them were motorcyclists and the other 50 were passenger vehicles. Results: Fifty percent of the motorcyclists had an abnormal CT brain finding while only 24% of the passenger vehicle showed abnormal finding. Among motorcyclist, skull fracture was the most common finding (30%) followed by subdural hemorrhage (28%). Among passenger vehicle, the most common finding was subdural hemorrhage (10%) followed by subarachnoid hemorrhage, intraparenchymal haemorrhage and skull fracture (8% each). The motorcyclist had significantly higher rate of subdural haemorrhage, extradural haemorrhage, intraparenchymal contusion and skull fracture compared to passenger vehicle patients with p value of 0.02, 0.03, 0.007 and 0.005 respectively. Conclusion: The occurrence of traumatic brain injury was significantly higher among the motorcyclist compared to passenger vehicle patients involved in road traffic accidents. The findings of this study highlighted the need for taking further measures to increase safety among the motorcyclists.

Download Full-text

Remarks on patients with traumatic brain injury due to traffic accident related to alcohol comsumption treated in Vietduc hospital after implementing the decree 100

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1327 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Nguyen Duc Chinh ◽

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Road Traffic Accident ◽

Traffic Accident ◽

Traffic Accidents ◽

Road Traffic ◽

Blood Alcohol Concentration ◽

Alcohol Concentration ◽

Hospital Death ◽

Risk Of Death

Purpose: Traumatic Brain Injury (TBI) is still considered as a leading cause of morbidity and mortality of victims by traffic accident. Despite a fact that many measurements and preventions have been applied, the rate of TBI is remained high. Aim of this study was to investigate treatment process of TBI caused by road traffic accident at Viet Duc Hospital after the Decree 100 which has been issued in Vietnam in early 2020. Materials and method: A retrospective and prospective study has been conducted in Viet Duc Hospital from Dec, 2020 to March, 2021. All the patients with TBI by road traffic accident were enrolled. Severity of TBI was identified by Glasgow Scale (GCS) and BAC (Blood Alcohol Concentration) test taken on arrival. The data was collected from medical record as well as autopsy report and analysed by SPSS.20.0 Results: A total of 150 patients with TBI by road traffic accidents were enrolled, age group from 21 to 60 years old accounted for 64%, male accounted for 86.7%. Associated injuries were maxillofacial lesions 48%, extremities 24.7%, chest accounted for 20%. Severity of TBI with GCS 6 - 8 was the highest rate 52%, from 3 - 5 GCS accounted for 30%. 40% were operated on emergency; BAC was positive 46.7%, of which over from 50 mg/L accounted for 32.6%. The patients with GCS from 6 to 8 were BAC positive accounted for a higher rate than groups with GCS above 9 or below 5. The most common TBI lesions were subarachnoid hemorrhage, subdural hematoma and cerebral edema accounted for 67.3%, 60% and 58% respectively. Overall mortality was 26% including in-hospital death and discharged to die. Conclusions and recommendations: Data from the study has shown that many young men with severe TBI by road traffic accident were BAC positive which can results in the high risk of death and disability. Thus, we highly recommend counterparts should constantly strengthen the propaganda and enforcement measures in order to reduce traffic accidents and TBI patients. Keywords: traffic accidents; injury; brain trauma severity.

Download Full-text

Traumatic brain injury in dogs and cats

Companion Animal ◽

10.12968/coan.2019.0015 ◽

2019 ◽

Vol 24 (9) ◽

pp. 480-487 ◽

Cited By ~ 1

Author(s):

Neus Elias ◽

Ana-Maria Rotariu ◽

Tobias Grave

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Companion Animals ◽

Treatment Strategies ◽

Secondary Injury ◽

Different Types ◽

Veterinary Surgeon ◽

Primary Injury

Traumatic brain injury is common in companion animals and can occur from many different types of trauma such as road traffic accidents or bites. Following the primary injury, which is beyond control of the clinician, secondary injury occurs minutes to days following the trauma. The secondary injury will lead to neuronal death, and is the focus of treatment strategies for the emergency veterinary surgeon. Treatment of traumatic brain injury includes nursing strategies, intravenous fluid therapy, hyperosmolar therapy and diuretics, pain management, maintenance of oxygenation and ventilation, temperature regulation, anticonvulsant therapy and glycaemic control. All of these are discussed in this clinical review.

Download Full-text

Outcome at two weeks in patients with Traumatic brain injury following road traffic accidents in an urban tertiary hospital in Uganda

Cogent Medicine ◽

10.1080/2331205x.2017.1326205 ◽

2017 ◽

Vol 4 (1) ◽

pp. 1326205 ◽

Cited By ~ 2

Author(s):

Geoffrey Erem ◽

Samuel Bugeza ◽

Elsie Kiguli Malwadde ◽

Udo Schumacher

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Traffic Accidents ◽

Road Traffic ◽

Tertiary Hospital ◽

Road Traffic Accidents

Download Full-text

Predictors of In-Hospital Mortality for Road Traffic Accident-Related Severe Traumatic Brain Injury

Journal of Personalized Medicine ◽

10.3390/jpm11121339 ◽

2021 ◽

Vol 11 (12) ◽

pp. 1339

Author(s):

Chien-Hung Chen ◽

Yu-Wei Hsieh ◽

Jen-Fu Huang ◽

Chih-Po Hsu ◽

Chia-Ying Chung ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mortality Rate ◽

Hospital Mortality ◽

Prothrombin Time ◽

High Mortality ◽

Clinical Characteristics ◽

Road Traffic ◽

Road User ◽

Severe Tbi

(1) Background: Road traffic accidents (RTAs) are the leading cause of pediatric traumatic brain injury (TBI) and are associated with high mortality. Few studies have focused on RTA-related pediatric TBI. We conducted this study to analyze the clinical characteristics of RTA-related TBI in children and to identify early predictors of in-hospital mortality in children with severe TBI. (2) Methods: In this 15-year observational cohort study, a total of 618 children with RTA-related TBI were enrolled. We collected the patients’ clinical characteristics at the initial presentations in the emergency department (ED), including gender, age, types of road user, the motor components of the Glasgow Coma Scale (mGCS) score, body temperature, blood pressure, blood glucose level, initial prothrombin time, and the intracranial computed tomography (CT) Rotterdam score, as potential mortality predictors. (3) Results: Compared with children exhibiting mild/moderate RTA-related TBI, those with severe RTA-related TBI were older and had a higher mortality rate (p < 0.001). The in-hospital mortality rate for severe RTA-related TBI children was 15.6%. Compared to children who survived, those who died in hospital had a higher incidence of presenting with hypothermia (p = 0.011), a lower mGCS score (p < 0.001), a longer initial prothrombin time (p < 0.013), hyperglycemia (p = 0.017), and a higher Rotterdam CT score (p < 0.001). Multivariate analyses showed that the mGCS score (adjusted odds ratio (OR): 2.00, 95% CI: 1.28–3.14, p = 0.002) and the Rotterdam CT score (adjusted OR: 2.58, 95% CI: 1.31–5.06, p = 0.006) were independent predictors of in-hospital mortality. (4) Conclusions: Children with RTA-related severe TBI had a high mortality rate. Patients who initially presented with hypothermia, a lower mGCS score, a prolonged prothrombin time, hyperglycemia, and a higher Rotterdam CT score in brain CT analyses were associated with in-hospital mortality. The mGCS and the Rotterdam CT scores were predictive of in-hospital mortality independently.

Download Full-text