scholarly journals Morbidity and Mortality of Traumatic Brain Injury in Hospitalized Patients in Brazil Between 2010 and 2020: An Ecological Study

2021 ◽  
Author(s):  
Vitória Bittencourt de Carvalho ◽  
Kauan Alves Sousa Madruga
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mortality Rate ◽  
Ecological Study ◽  
Traumatic Injury ◽  
Mortality Rates ◽  
Hospitalization Rate ◽  
Morbidity And Mortality ◽  
Age Group ◽  
Unified Health System

Background: Traumatic Brain Injury (TBI) is defined as any traumatic injury causing an anatomical lesion or functional impairment of the scalp, skull, meninges, brain or its vessels. Hospitalization of this patient, depending on the severity, can result in irreversible sequelae or death. Objective: To report the morbidity and mortality rates of patients suffering from TBI hospitalized in Brazilian hospitals between 2010 and 2020. Methods: Descriptive ecological study of the data collected at the Informatics Department of the Unified Health System (DATASUS). Results: There were 1,143,187 admissions due to TBI. There was a predominance of males with 871,999 (76.28%) cases and the age group between 20 and 29 years old 199,857 (17.48%). Brown patients were the ones with the highest hospitalization rate: 370,639 (32.42%). The mortality rate in the period was 9.52/100 hospitalizations, with the Southeast region occupying the first place (10.44 per 100 hospitalizations). In total, 108,853 deaths were recorded, of which 50,013 occurred in the Southeast, the region with the highest rate. Although the number of deaths was higher in people between 20 and 29 years old (16,687), the age group with the highest mortality rate was over 80 years old (19.84 per 100 hospitalizations). Conclusion: In the last 10 years, TBI has caused 1,143,187 hospitalizations in Brazil, with a predominance of males and the age group between 20 and 29 years. Brown patients had the highest rate of hospitalization. The region with the highest mortality was the Southeast and the smallest was the South.

scholarly journals Analytical Study of the Evolution of Hospitalizations for Traumatic Brain Injury In Brazil, In Comparison With Region, Race, Gender, Age Range and Death, Between January 2011 and December 2020

2021 ◽  
Author(s):  
Daniel de Christo Esteves ◽  
Antônio Henrique Roberti dos Santos ◽  
Guilherme Neumann de Araújo ◽  
Mylena Sobreira Sena ◽  
Giovanna Amaral Lopes ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mortality Rate ◽  
Early Diagnosis ◽  
Public Health Problem ◽  
Age Group ◽  
Important Public Health Problem ◽  
Risk Of Death ◽  
External Agent ◽  
Methods Analytical

Background: Traumatic brain injury (TBI) consists of an damage to the brain tissue by an external agent, whether due to falls, car accidents or aggressions. It is a situation that often requires emergency care, due to possible sequelae and the imminent risk of death. Thus, TCE is one of the main causes of death worldwide, especially in children and young adults, translating into an important public health problem with a high socioeconomic impact. Objectives: To report the number of hospitalizations for TBI, in order to clarify the relationship between it and the variables studied. Methods: Analytical epidemiological study carried out by research at DATASUS based on data on head trauma in Brazil, with patients aged less than 1 year to 80 years or more, between January 2011 and December 2020, associating the location according to the age group, region, race, gender, mortality rate, year and number of deaths in the country. Results: Observing the cases of intracranial trauma, in the last 10 years (2011- 2020), 1,033,512 cases were noted, 787,480 (76.19%) of which were male. As for the regional proportion, there is a higher incidence in the southeastern region, with 431,785 (43.02%) cases, with São Paulo being 236,653 (54.80%) the state with the largest number, followed by the northeast region, in which it occupies the second position with the highest number of cases, with 274,781 (26.58%) and Ceará the most relevant state with 65,602 (23.87%) cases. Regarding race, browns with 348,581 (33.72%) cases had the highest rate. Evaluating an age group, 17.23% of the cases are between 20 and 29 years old, followed by 14.88% between 30 and 39 years old. In relation to deaths, there is a total of 98,537, with the age group between 20 and 29 years with the highest incidence with 14,814 (15.03%), with a highlight in the male gender with 13,152 (88.78%). With regard to the mortality rate, a higher rate was observed in males aged over 80 years. Conclusion: Traumatic brain injury often requires an early diagnosis for a better prognosis. Judging from the large number of cases, it is worth investing in methods for early diagnosis, seeking to improve the prognosis and reduce the total number of deaths. In addition, it is necessary to look at the causes of TBI and to emphasize the prevention of causes that can be avoided, especially among the youngest who are the most affected group.

scholarly journals Hypertonic saline reduces cumulative and daily intracranial pressure burdens after severe traumatic brain injury

2015 ◽  
Vol 122 (1) ◽  
pp. 202-210 ◽  
Author(s):  
Halinder S. Mangat ◽  
Ya-Lin Chiu ◽  
Linda M. Gerber ◽  
Marjan Alimi ◽  
Jamshid Ghajar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Mortality Rate ◽  
Hypertonic Saline ◽  
New York State ◽  
Mortality Rates ◽  
Icp Monitoring ◽  
Severe Tbi ◽  
The Mean

OBJECT Increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI) is associated with a higher mortality rate and poor outcome. Mannitol and hypertonic saline (HTS) have both been used to treat high ICP, but it is unclear which one is more effective. Here, the authors compare the effect of mannitol versus HTS on lowering the cumulative and daily ICP burdens after severe TBI. METHODS The Brain Trauma Foundation TBI-trac New York State database was used for this retrospective study. Patients with severe TBI and intracranial hypertension who received only 1 type of hyperosmotic agent, mannitol or HTS, were included. Patients in the 2 groups were individually matched for Glasgow Coma Scale score (GCS), pupillary reactivity, craniotomy, occurrence of hypotension on Day 1, and the day of ICP monitor insertion. Patients with missing or erroneous data were excluded. Cumulative and daily ICP burdens were used as primary outcome measures. The cumulative ICP burden was defined as the total number of days with an ICP of > 25 mm Hg, expressed as a percentage of the total number of days of ICP monitoring. The daily ICP burden was calculated as the mean daily duration of an ICP of > 25 mm Hg, expressed as the number of hours per day. The numbers of intensive care unit (ICU) days, numbers of days with ICP monitoring, and 2-week mortality rates were also compared between the groups. A 2-sample t-test or chi-square test was used to compare independent samples. The Wilcoxon signed-rank or Cochran-Mantel-Haenszel test was used for comparing matched samples. RESULTS A total of 35 patients who received only HTS and 477 who received only mannitol after severe TBI were identified. Eight patients in the HTS group were excluded because of erroneous or missing data, and 2 other patients did not have matches in the mannitol group. The remaining 25 patients were matched 1:1. Twenty-four patients received 3% HTS, and 1 received 23.4% HTS as bolus therapy. All 25 patients in the mannitol group received 20% mannitol. The mean cumulative ICP burden (15.52% [HTS] vs 36.5% [mannitol]; p = 0.003) and the mean (± SD) daily ICP burden (0.3 ± 0.6 hours/day [HTS] vs 1.3 ± 1.3 hours/day [mannitol]; p = 0.001) were significantly lower in the HTS group. The mean (± SD) number of ICU days was significantly lower in the HTS group than in the mannitol group (8.5 ± 2.1 vs 9.8 ± 0.6, respectively; p = 0.004), whereas there was no difference in the numbers of days of ICP monitoring (p = 0.09). There were no significant differences between the cumulative median doses of HTS and mannitol (p = 0.19). The 2-week mortality rate was lower in the HTS group, but the difference was not statistically significant (p = 0.56). CONCLUSIONS HTS given as bolus therapy was more effective than mannitol in lowering the cumulative and daily ICP burdens after severe TBI. Patients in the HTS group had significantly lower number of ICU days. The 2-week mortality rates were not statistically different between the 2 groups.

scholarly journals Epidemiological comparison of adults with TBI before and after the mandatory use of frontal airbags in Salvador

2021 ◽  
Author(s):  
Victor de Araújo Coelho ◽  
Gabriela Malaquias Barreto Gomes ◽  
Vicente José Araújo Neto ◽  
Rodrigo Costa Micheli Xavier
Keyword(s):  
Traumatic Brain Injury ◽  
Mortality Rate ◽  
Ecological Study ◽  
Age Group ◽  
Average Amount ◽  
Automobile Accidents ◽  
Before And After ◽  
The Law ◽  
External Trauma ◽  
Mandatory Use

Introduction: Traumatic Brain Injury (TBI) is an external trauma, which results in brain alterations. Law 11.910, which requires the presence of frontal Airbags, was developed as a mechanism to minimize the consequences of automobile accidents, like TBI. Objectives: To epidemiologically compare adults with TBI before and after the mandatory use of Airbags in Salvador. Design and settings: An ecological study in Brazil. Methods: Data was published by the Ministry of Health through DATASUS. The selected timeframe was five years before and after the mandatory use of frontal Airbags (2014). The data collected were hospitalizations, deaths, mortality rate, age, and total value. Results: The average mortality rate due to TBI (2009-2013) was 11.6, while decreasing from 2014- 2018 to 8.9 (reduction of 23,3%). The average amount spent in the period preceding the law was 1.250.675 reais, while afterwards it was 1.535.268 (increase of 22,76%). The age group with the most hospitalizations before the law was 20-29 years old, while after it was 30-39. Conclusions: There was a reduction in the mortality rate after 2014, which may be associated with the mandatory use of Airbags. Prior to the law, the total amount spent was lower, possibly associated with a greater severity of injuries and, consequently, a higher number of deaths.

scholarly journals Management of Traumatic Brain Injury: A review Update

2017 ◽  
Vol 6 (2) ◽  
pp. 87-89
Author(s):  
ATM Ashadullah ◽  
Monirul Islam ◽  
Fazley Elahi Milad ◽  
Abdullah Alamgir ◽  
Md Shafiul Alam
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injuries ◽  
Skull Fracture ◽  
Traumatic Injury ◽  
Loss Of Consciousness ◽  
Extradural Haematoma ◽  
Inner Surface ◽  
Injury Patient ◽  
Extradural Haematomas

Traumatic Brain Injury leads to serious consequences. Approximately half of all deaths is related to traumatic injury and the main cause of head trauma. Extradural haematomas (EDH) develops in all major head injuries. A head injury patient who is only temporary loss of consciousness and is left asleep may sometimes be found dead in the bed next morning due to extradural haematoma. Extradural haematoma which lies in between the inner surface of skull and stripes of dural membrane, are nearly always caused by, and located near a skull fracture. The collection takes several forms in terms of size, location, speed of development and effects they exert on patient. Immediate management is necessary to decrease the bad consequences. In this review the management of traumatic brain injury is highlighted.J Shaheed Suhrawardy Med Coll, 2014; 6(2):87-89

scholarly journals Adult sports-related traumatic brain injury in United States trauma centers

2016 ◽  
Vol 40 (4) ◽  
pp. E4 ◽  
Author(s):  
Ethan A. Winkler ◽  
John K. Yue ◽  
John F. Burke ◽  
Andrew K. Chan ◽  
Sanjay S. Dhall ◽  
...  
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
The United States ◽  
Mortality Rates ◽  
Hospital Length Of Stay ◽  
Health Concern ◽  
Medical Complications ◽  
Equestrian Sports ◽  
Prolonged Hospital

OBJECTIVE Sports-related traumatic brain injury (TBI) is an important public health concern estimated to affect 300,000 to 3.8 million people annually in the United States. Although injuries to professional athletes dominate the media, this group represents only a small proportion of the overall population. Here, the authors characterize the demographics of sports-related TBI in adults from a community-based trauma population and identify predictors of prolonged hospitalization and increased morbidity and mortality rates. METHODS Utilizing the National Sample Program of the National Trauma Data Bank (NTDB), the authors retrospectively analyzed sports-related TBI data from adults (age ≥ 18 years) across 5 sporting categories—fall or interpersonal contact (FIC), roller sports, skiing/snowboarding, equestrian sports, and aquatic sports. Multivariable regression analysis was used to identify predictors of prolonged hospital length of stay (LOS), medical complications, inpatient mortality rates, and hospital discharge disposition. Statistical significance was assessed at α < 0.05, and the Bonferroni correction for multiple comparisons was applied for each outcome analysis. RESULTS From 2003 to 2012, in total, 4788 adult sports-related TBIs were documented in the NTDB, which represented 18,310 incidents nationally. Equestrian sports were the greatest contributors to sports-related TBI (45.2%). Mild TBI represented nearly 86% of injuries overall. Mean (± SEM) LOSs in the hospital or intensive care unit (ICU) were 4.25 ± 0.09 days and 1.60 ± 0.06 days, respectively. The mortality rate was 3.0% across all patients, but was statistically higher in TBI from roller sports (4.1%) and aquatic sports (7.7%). Age, hypotension on admission to the emergency department (ED), and the severity of head and extracranial injuries were statistically significant predictors of prolonged hospital and ICU LOSs, medical complications, failure to discharge to home, and death. Traumatic brain injury during aquatic sports was similarly associated with prolonged ICU and hospital LOSs, medical complications, and failure to be discharged to home. CONCLUSIONS Age, hypotension on ED admission, severity of head and extracranial injuries, and sports mechanism of injury are important prognostic variables in adult sports-related TBI. Increasing TBI awareness and helmet use—particularly in equestrian and roller sports—are critical elements for decreasing sports-related TBI events in adults.

Increased morbidity and mortality of traumatic brain injury in victims of nonaccidental trauma

2013 ◽  
Vol 75 (1) ◽  
pp. 157-160 ◽  
Author(s):  
Katherine J. Deans ◽  
Peter C. Minneci ◽  
Wendi Lowell ◽  
Jonathan I. Groner
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Morbidity And Mortality ◽  
Nonaccidental Trauma

scholarly journals DIAGNOSIS AND MANAGEMENT OF COMPUTED TOMOGRAPHY IN HEAD INJURY

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Dr. Dileep Kumar Jha ◽  
Dr. Rajnikant Narsinhbhai Chauhan
Keyword(s):  
Computed Tomography ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Head Trauma ◽  
Severe Head Injury ◽  
Mild Head Injury ◽  
Age Group ◽  
Ct Findings ◽  
Craniocerebral Injuries

Introduction: In human body there are many causes of the injuries. Among all the injuries head injury is also one of the most important injuries which may cause morbidity and mortality. Craniocerebral injuries or Traumatic brain injury (TBI) is defined as any structural skull traumatic injury with alterations of cerebral physiology as a result of an external force either in the form of chemical energy, mechanical energy, electrical energy or thermal heating. Globally craniocerebral injuries or Traumatic brain injury (TBI)is cause of disability in young patients, especially those  <40 years of age. TBI is classified as mild, with most showing adequate and quick recovery. Nevertheless there are some kinds of TBI which showed persistent disabling symptoms that interrupt with their normal daily routine activities. Brain imaging is very important for the patients who suffer traumatic brain injury. In the emergency services Computed tomography (CT) is recommended as first assessment that provides initial information and diagnosis to identify the need of surgery. It also helps in the following of the patient and the evolution of pathology. Many studies suggest that CT can be used to predict patient outcomes. Computed tomography (CT) is an imaging technique which uses as dynamics of injected contrast material, allows rapid quantitative and qualitative evaluation of cerebral perfusion by generating cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT) maps providing clinically important information with stroke subarachnoid hemorrhage (SAH)and head injury. Aim: The main aim of this study is to evaluate the computed tomography findings sustaining head injury and role of computed tomography scan in head injury. Material and Methods: During the study total 90 patients with head injury were included with different age group from 20 to 70 years old. Glasgow coma score (GCS) range 4–15 (mild head injury: GCS >14; moderate head injury: GCS = 9–13; severe head injury GCS <8) were also included in this study. For all the patients with head injury Computed tomography (CT) image were performed with siemen's somatom spirit dual slice spiral CT machine and a protocol of contiguous axial 5-mm sections through the posterior fossa and a contiguous 10 mm axial sequential scans for the rest of the brain and thinner cuts were also taken whenever required. For visualize any fractures of the skull bone algorithms with wide window settings were studied. After initial resuscitation, severity of the cranio-cerebral trauma was graded with the help of Glasgow Coma Scale (GCS) into mild head injury (GCS13- 15), moderate head injury (GCS 9-12) and severe head injury (GCS 3-8). Result: Among total patients sixty five (72.2%) patients were male and twenty five (27.8 %) were female with age range from 20 to 70 years old. In the age group 31-50 year group showed highest frequency of head trauma. The most common causes of head injury were RTA (65.6%) followed by fall injuries (20%) and physical assaults (14.4%). Among patients with head injuries Loss of consciousness and vomiting were the commonest clinical features brought to emergency. Out of 90 cases 59 (65.5%) cases showed mild head injury followed by 14(15.6%) cases sustained moderate head injury and 17(18.9%) had severe head injury. In all types of severity of head injury RTA was the prime etiological factor. Out of total cases 31(34.4%) had normal CT findings and 59(65.6%) had abnormal CT findings. Abnormal CT findings were seen in 59(65.6%) sustaining mild head injury and in all the patients with moderate and severe head injury. Out of 90 cases 13 cases with severe head injury had mortality. The most common mode of injury to cause the mortality was RTA. Five patients with severe head injury also had cervical spine injury Conclusion: This study concludes that use of CT in head trauma can finds high prevalence of head trauma related to CT. Therefore CT should be done when clinically necessary that helps to reduce cost and avoids unnecessary exposure to radiation. Keywords: Head injury, Traumatic brain injury (TBI), computed tomography (CT), Glasgow coma scale (GCS)

scholarly journals Traumatic Brain Injury and the Importance of Neurosurgical Care: 10-year Retrospective Study on Cadavers

Folia Medica ◽  
2020 ◽  
Vol 62 (1) ◽  
pp. 105-111 ◽  
Author(s):  
Alexandrina Nikova ◽  
Ivaylo Dimitrov ◽  
Theodossios Birbilis ◽  
Lora Zaharieva
Keyword(s):  
Health Care ◽  
Traumatic Brain Injury ◽  
Retrospective Study ◽  
Brain Injury ◽  
Mortality Rate ◽  
Brain Injuries ◽  
Common Type ◽  
Quick Response ◽  
Male Predominance ◽  
Transport Accidents

Objective: Traumatic brain injury (TBI) due to transport accidents is a serious cause of death and disability. In every case, however, quick response and a proper health care are required. &nbsp; Materials and methods: We collected 10-year data retrospectively from the laboratory of forensic science and toxicology in Montana, Bulgaria with the intention to show the importance of neurosurgical care in the traumatology and its connection to mortality rate. &nbsp; Results: 124 cadavers were included with significant male predominance. The data analysis shows that the mortality rate at the hospitals without neurosurgical facilities and the mortality at the scene of the accident is the same for traffic brain injuries. Furthermore, we found that the age has no correlation with the mortality rate. &nbsp; Conclusion: Road injuries are the most common type of brain injury. We believe that the outcome of these TBIs depends on the availability of a neurosurgical unit.

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