scholarly journals Traumatic Brain Injury in Qatar: Age Matters—Insights from a 4-Year Observational Study

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Moamena El-Matbouly ◽  
Ayman El-Menyar ◽  
Hassan Al-Thani ◽  
Mazin Tuma ◽  
Hany El-Hennawy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Young Adults ◽  
Brain Injury ◽  
Mortality Rate ◽  
Motor Vehicle ◽  
Public Awareness ◽  
Adult Population ◽  
Age Groups ◽  
Common Mechanism ◽  
Mechanism Of Injury

Background. Overall traumatic brain injury (TBI) incidence and related death rates vary across different age groups.Objectives. To evaluate the incidence, causes, and outcome of TBI in adolescents and young adult population in Qatar.Method. This was a retrospective review of all TBIs admitted to the trauma center between January 2008 and December 2011. Demographics, mechanism of injury, morbidity, and mortality were analyzed in different age groups.Results. A total of 1665 patients with TBI were admitted; the majority were males (92%) with a mean age of 28 ± 16 years. The common mechanism of injury was motor vehicle crashes and falls from height (51% and 35%, resp.). TBI was incidentally higher in young adults (34%) and middle age group (21%). The most frequent injuries were contusion (40%), subarachnoid (25%), subdural (24%), and epidural hemorrhage (18%). The mortality rate was 11% among TBI patients. Mortality rates were 8% and 12% among adolescents and young adults, respectively. The highest mortality rate was observed in elderly patients (35%). Head AIS, ISS, and age were independent predictors for mortality.Conclusion. Adolescents and adults sustain significant portions of TBI, whereas mortality is much higher in the older group. Public awareness and injury prevention campaigns should target young population.

scholarly journals Recent trends in hospitalization and in-hospital mortality associated with traumatic brain injury in Canada: a nationwide, population-based study

2015 ◽  
Vol 42 (S1) ◽  
pp. S21-S21
Author(s):  
T Fu ◽  
R Jing ◽  
S McFaull ◽  
M Cusimano
Keyword(s):  
Traumatic Brain Injury ◽  
Young Adults ◽  
Brain Injury ◽  
Hospital Mortality ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Population Based ◽  
Hospital Length Of Stay ◽  
Elderly Adults ◽  
Hospitalization Rates

Background: Traumatic brain injury (TBI) is the leading cause of traumatic death and disability worldwide. We examined nationwide trends in TBI-related hospitalizations and in-hospital mortality between April 2006 and March 2010 using a population-based database that is mandatory for all hospitals in Canada. Methods: Trends in hospitalization rates were analyzed using linear regression. Independent predictors of in-hospital mortality were evaluated using logistic regression. Results: Hospitalization rates remained stable for children and young adults, but increased considerably among elderly adults (ages 65 and older). Falls and motor vehicle collisions (MVCs) were the most common causes of TBI hospitalizations. TBIs caused by falls increased by 24% (p=0.01), while MVC-related hospitalization rates decreased by 18% (p=0.03). Elderly adults were most vulnerable to falls, and experienced the greatest increase (29%) in fall-related hospitalization rates. Young adults (ages 15-24) were most at risk for MVCs, but experienced the greatest decline (28%) in MVC-related admissions. There were significant trends towards increasing age, injury severity, comorbidity, hospital length of stay, and in-hospital mortality. However, multivariate regression showed that the odds of death decreased over time after controlling for relevant factors. Conclusions: Hospitalizations for TBI are increasing in severity and involve older populations with more complex comorbidities.

scholarly journals Traumatic Brain Injury Related Hospitalization and Mortality in California

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Clint Lagbas ◽  
Shahrzad Bazargan-Hejazi ◽  
Magda Shaheen ◽  
Dulcie Kermah ◽  
Deyu Pan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Motor Vehicle Accident ◽  
Age Groups ◽  
Motor Vehicle Accidents ◽  
Elderly Male ◽  
Cross Sectional ◽  
Discharge Data ◽  
Vehicle Accidents

Objective. The aim of this study is to describe the traumatic brain injury (TBI) population and causes and identify factors associated with TBI hospitalizations and mortality in California.Methods. This is a cross-sectional study of 61,188 patients with TBI from the California Hospital Discharge Data 2001 to 2009. We used descriptive, bivariate, and multivariate analyses in SAS version 9.3.Results. TBI-related hospitalizations decreased by 14% and mortality increased by 19% from 2001 to 2009. The highest percentages of TBI hospitalizations were due to other causes (38.4%), falls (31.2%), being of age≥75years old (37.2%), being a males (58.9%), and being of Medicare patients (44%). TBIs due to falls were found in those age≤4years old (53.5%),≥75years old (44.0%), and females (37.2%). TBIs due to assaults were more frequent in Blacks (29.0%). TBIs due to motor vehicle accidents were more frequent in 15–19 and 20–24 age groups (48.7% and 48.6%, resp.) and among Hispanics (27.8%). Higher odds of mortality were found among motor vehicle accident category (adjusted odds ratio (AOR): 1.27, 95% CI: 1.14–1.41); males (AOR: 1.36, 95% CI: 1.27–1.46); and the≥75-year-old group (AOR: 6.4, 95% CI: 4.9–8.4).Conclusions. Our findings suggest a decrease in TBI-related hospitalizations but an increase in TBI-related mortality during the study period. The majority of TBI-related hospitalizations was due to other causes and falls and was more frequent in the older, male, and Medicare populations. The higher likelihood of TBI-related mortalities was found among elderly male≥75years old who had motor vehicle accidents. Our data can inform practitioners, prevention planners, educators, service sectors, and policy makers who aim to reduce the burden of TBI in the community. Implications for interventions are discussed.

scholarly journals Developing an Adjunct to an Electronic Medical Records System in a Developing Country: Establishing the First Electronic Traumatic Brain Injury Database in Yangon, Myanmar

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Aung Thurein Win ◽  
Su Myat Moe ◽  
Nang Saw Myat Hnin Aye ◽  
Aye Mya Phyu ◽  
Thet Maung Maung ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mortality Rate ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Motor Vehicle ◽  
Road Traffic ◽  
Postoperative Mortality ◽  
Transport Systems ◽  
Trauma Centers

Abstract INTRODUCTION Traumatic brain injury (TBI) is a frequent cause of admission and fatality in Myanmar, secondary to a high number of road traffic accidents. In a country of over 50 million, trauma centers serve less than 4% of the population. North Okkalappa General Hospital (NOGH) is 1 of 3 trauma centers in Yangon providing significant care for patients with TBI. In this pilot study, we collected prospective data encompassing patient demographics, nature of injury, intervention, and outcome at a tertiary trauma center (NOGH). METHODS Neurosurgery residents utilized an iPad-driven database management online software (Redcap) to document TBI admissions, treatment, and outcomes prospectively between November 2018 and April 2019. The data was monitored and analyzed weekly by the supervising physicians at the Henry Ford Hospital in Detroit, Michigan. RESULTS There were 242 TBI admissions (mean Glasgow Coma Scale (GCS) 12.97) during the study's timeline. Etiologies consisted of motorcycle accidents (n = 130), falls (n = 45), assaults (n = 39), pedestrian–motor vehicle accidents (n = 21), industrial accidents (n = 7), and other (n = 7). A total of 50 patients presenting with GCS < 8 were admitted directly or transferred to NOGH leading to a mortality rate of 68% during hospitalization. Neurosurgery was performed in 33 patients (14%) with a 24% postoperative mortality rate. CONCLUSION Poor outcomes after severe TBI in Myanmar are multifactorial including a lack of access-to-care, suboptimal patient management (eg, pre-hospital, in-hospital and postoperative) and limited resources (eg, ventilators, arterial lines, etc.). Additionally, critical care expertise is limited. Overall, in this study we were able to establish a robust database in a research and electronic medical records-naïve location, serving to study and characterize TBI patients. Improved TBI care at local and national levels requires public education, efficient transport systems, geographically strategic trauma centers and improved in-hospital patient care. Government funding and international neurosurgery support is essential.

scholarly journals Lifetime costs of traumatic brain injury identified in the emergency department in Ontario

2015 ◽  
Vol 42 (S1) ◽  
pp. S39-S39
Author(s):  
T Fu ◽  
R Jing ◽  
M Cusimano
Keyword(s):  
Traumatic Brain Injury ◽  
Emergency Department ◽  
Brain Injury ◽  
Economic Burden ◽  
Motor Vehicle ◽  
Productivity Loss ◽  
Age Groups ◽  
Population Based ◽  
Lifetime Costs ◽  
Ed Visits

Background: Traumatic brain injury (TBI) is a leading cause of death and disability, yet there is limited research on its economic burden. We estimated the incidence and lifetime costs of TBI identified in the Emergency Department (ED) in Ontario, Canada between April 2009 and March 2010. Methods: ED visits for TBI were identified using a population-based database that is mandatory for ambulatory care facilities in Ontario. The authors calculated unit costs for medical treatment and productivity loss, and multiplied these by incidence estimates to determine the lifetime costs of identified TBI cases. Results: In 2009, there were over 133,000 ED visits for TBI in Ontario, resulting in a conservative estimate of $945 million in total lifetime costs. Costs were greater for males than females across nearly all age groups, with males incurring two-fold higher costs overall. Together, falls ($407 million), struck by/against ($309 million), and motor vehicle injuries ($161 million) represented 93% of lifetime costs associated with TBI. Conclusions: This study revealed a high incidence and economic burden associated with TBI identified in the ED. More research is needed to fully appreciate the burden of TBI across a variety of healthcare settings.

scholarly journals Head Impact Injury Mitigation to Vehicle Occupants: An Investigation of Interior Padding and Head Form Modeling Options against Vehicle Crash

2021 ◽  
Author(s):  
Ermias G. Koricho ◽  
Elizabeth Dimsdale
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Brain Injuries ◽  
Motor Vehicle ◽  
Impact Load ◽  
Age Groups ◽  
Vehicle Crash ◽  
Materials Modeling ◽  
Head Form ◽  
The Brain

Traumatic Brain Injuries (TBI) occur approximately 1.7 million times each year in the U.S., with motor vehicle crashes as the second leading cause of TBI-related hospitalizations, and the first leading cause of TBI-related deaths among specific age groups. Several studies have been conducted to better understand the impact on the brain in vehicle crash scenarios. However, the complexity of the head is challenging to replicate numerically the head response during vehicle crash and the resulting traumatic Brain Injury. Hence, this study aims to investigate the effect of vehicle structural padding and head form modeling representation on the head response and the resulting causation and Traumatic Brain Injury (TBI). In this study, a simplified and complex head forms with various geometries and materials including the skull, cerebrospinal fluid (CSF), neck, and muscle were considered to better understand and predict the behavior of each part and their effect on the response of the brain during an impact scenario. The effect of padding thickness was also considered to further analyze the interaction of vehicle structure and the head response. The numeral results revealed that the responses of the head skull and the brain under impact load were highly influenced by the padding thickness, head skull material modeling and assumptions, and neck compliance. Generally, the current work could be considered an alternative insight to understand the correlation between vehicle structural padding, head forms, and materials modeling techniques, and TBI resulted from a vehicle crash.

scholarly journals Epidemiological study of traumatic brain injury in a tertiary care centre in South India

2020 ◽  
Vol 7 (10) ◽  
pp. 3311
Author(s):  
Prasanth Asher ◽  
Jijo Joseph Joseph ◽  
Varun Singh Pendro ◽  
Anilkumar Peethambaran ◽  
Rajmohan Bhanu Prabhakar
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Seat Belt ◽  
Tertiary Care ◽  
Socioeconomic Background ◽  
Common Mechanism ◽  
Mechanism Of Injury ◽  
Road Traffic Accidents

Background: This study investigated the epidemiological pattern of traumatic brain injury (TBI) in our hospital, so as to juxtapose with available statistics and formulate recommendations for patient betterment.Methods: The Government Medical College, Thiruvananthapuram was the setting of this cross-sectional longitudinal study and included all patients admitted with clinical/radiological evidence of TBI over a period of three months (October 2019 to December 2019). Details regarding mechanism of injury and the socioeconomic background of the subjects were collected during the stay in hospital, by means of a semi structured questionnaire. SPSS software was used to analyze the data collected.Results: Out of 658 patients included in the study, majority of the subjects belonged to the age group 30-60 years. About 80% of subjects were males. 63% were manual laborers. Majority of the patients had about 10-15 days’ stay in the hospital. Road traffic accidents were the most common mechanism of injury and involved two wheelers mainly. Lack of helmet and restraining seat belt was noted in a sizeable percent of the subjects. Loss of consciousness was the most common complaint and GCS in the majority of subjects ranged from 9-13. Subdural hematomas and hemorrhagic contusions were the most common CT findings. 39.7% of the patients had associated spinal injury. About 48% of the subjects were operated. There was 7% mortality.Conclusions: Road traffic accidents accounted for the majority of traumatic brain injury incidents and a sizeable portion of patients required expert neurosurgical care.

scholarly journals LO67: Association between hypotension and mortality in critically ill patients with severe traumatic brain injury: experience at a single Canadian trauma center

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S32
Author(s):  
R. Green ◽  
M. Erdogan ◽  
N. Kureshi ◽  
D. Clarke
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Injury Severity ◽  
Motor Vehicle ◽  
Treatment Guidelines ◽  
Multiple Logistic Regression Analysis ◽  
Trauma Team ◽  
Common Mechanism ◽  
Severe Tbi

Introduction: Hypotension is known to be associated with increased mortality in severe traumatic brain injury (TBI) patients. Systolic blood pressure (SBP) of &lt;90 mmHg is the threshold for hypotension in consensus TBI treatment guidelines; however, evidence suggests hypotension should be defined at higher levels for these patients. Our objective was to determine the influence of hypotension on mortality in TBI patients requiring ICU admission using different thresholds of SBP on arrival at the emergency department (ED). Methods: Retrospective cohort study of patients with severe TBI (Abbreviated Injury Scale Head score ≥3) admitted to ICU at the QEII Health Sciences Centre (Halifax, Canada) between 2002 and 2013. Patients were grouped by SBP on ED arrival ( &lt;90 mmHg, &lt;100 mmHg, &lt;110 mmHg). We performed multiple logistic regression analysis with mortality as the dependent variable. Models were adjusted for confounders including age, gender, Injury Severity Score (ISS), injury mechanism, and trauma team activation (TTA). Results: A total of 1233 patients sustained a severe TBI and were admitted to the ICU during the study period. The mean age was 43.4 ± 23.9 years and most patients were male (919/1233; 74.5%). The most common mechanism of injury was motor vehicle collision (491/1233; 41.2%) followed by falls (427/1233; 35.8%). Mean length of stay in the ICU was 6.1 ± 6.4 days, and the overall mortality rate was 22.7%. SBP on arrival was available for 1182 patients. The &lt;90 mmHg group had 4.6% (54/1182) of these patients; mean ISS was 20.6 ± 7.8 and mortality was 40.7% (22/54). The &lt;100 mmHg had 9.3% (110/1182) of patients; mean ISS was 19.3 ± 7.9 and mortality was 34.5% (38/110). The &lt;110 mmHg group had 16.8% (198/1182) of patients; mean ISS was 17.9 ± 8.0 and mortality was 28.8% (57/198). After adjusting for confounders, the association between hypotension and mortality was 2.22 (95% CI 1.19-4.16) using a &lt;90 mmHg cutoff, 1.79 (95% CI 1.12-2.86) using a &lt;100 mmHg cutoff, and 1.50 (95% CI 1.02-2.21) using a &lt;110 mmHg cutoff. Conclusion: While we found that TBI patients with a SBP &lt;90 mmHg were over 2 times more likely to die, patients with an SBP &lt;110 mmHg on ED arrival were still 1.5 times more likely to die from their injuries compared to patients without hypotension. These results suggest that establishing a higher threshold for clinically meaningful hypotension in TBI patients is warranted.

Update on the epidemiology of work-related traumatic brain injury: a systematic review and meta-analysis

2020 ◽  
pp. oemed-2020-107005
Author(s):  
Danielle Toccalino ◽  
Angela Colantonio ◽  
Vincy Chan
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Motor Vehicle ◽  
Meta Analysis ◽  
Adult Population ◽  
Management Strategies ◽  
Health Concern ◽  
Medical Subject Headings ◽  
Work Related ◽  
Meta Analyses

BackgroundTraumatic brain injury (TBI) is a public health concern that can occur in a range of contexts. Work-related TBI (wrTBI) is particularly concerning. Despite overall work-related injury claims decreasing, the proportion of claims that are wrTBI have increased, suggesting prevention and support of wrTBI requires ongoing attention.ObjectivesThis review aimed to provide updated information on the burden and risk factors of wrTBI among the working adult population.MethodsMedline, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched using a combination of TBI, work, and epidemiology text words and medical subject headings. Two reviewers independently assessed articles for inclusion. Meta-analyses were conducted to estimate prevalence and mortality of wrTBI and a narrative synthesis was conducted to provide additional context.ResultsPooled proportions meta-analyses estimate that 17.9% of TBIs were work-related and 6.3% of work-related injuries resulted in TBI, with 3.6% of wrTBI resulting in death. Populations of wrTBI were predominantly male (76.2%) and were 40.4 years of age, on average. The most commonly reported industries for wrTBI were education and training, healthcare and social assistance, construction, manufacturing, and transportation. Falls, being struck by an object or person, motor vehicle collisions, and assaults were the most commonly reported mechanisms of wrTBI.ConclusionsA better understanding of the epidemiology of wrTBI can inform prevention and management strategies. This review highlights existing gaps, including a notable lack of sex or gender stratified data, to direct future investigation.PROSPERO registration numberCRD42020169642.

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