Severe Traumatic Brain Injury in a High-Income Country: An Epidemiological Study

Article Article scientifique Article Severe Traumatic Brain Injury in a High-Income Country: An Epidemiological Study eng 2013-12 author Walder Bernhard 124875 author Haller Guy Serge Antoine 28638 author Rebetez Marie My Lien 527773 author Delhumeau-Cartier Cécile 514342 author Bottequin Ezra 678117 author Schoettker Patrick author Ravussin Patrick author Brodmann Maeder Monika author Stover John F. author Zürcher Mathias author Haller Alois author Wäckelin Adrian author Haberthür Christoph author Fandino Javier author Haller Chiara Simone 688474 author Osterwalder Joseph 527069 1934-1942 10.1089/neu.2013.2955 23822874 0897-7151 http://www.liebertpub.com/doi/10.1089/neu.2013.2955 This adult cohort determined the incidence and patients' short-term outcomes of severe traumatic brain injury (sTBI) in Switzerland and age-related differences. A prospective cohort study with a follow-up at 14 days was performed. Patients ≥16 years of age sustaining sTBI and admitted to 1 of 11 trauma centers were included. sTBI was defined by an Abbreviated Injury Scale of the head (HAIS) score >3. The centers participated from 6 months to 3 years. The results are presented as percentages, medians, and interquartile ranges (IQRs). Subgroup analyses were performed for patients ≤65 years (younger) and >65 (elderly). sTBI was observed in 921 patients (median age, 55 years; IQR, 33–71); 683 (74.2%) were male. Females were older (median age, 67 years; IQR, 42–80) than males (52; IQR, 31–67; p<0.00001). The estimated incidence was 10.58 per 100,000 inhabitants per year. Blunt trauma was observed in 879 patients (95.4%) and multiple trauma in 283 (30.7%). Median Glasgow Coma Score (GCS) on the scene was 9 (IQR 4–14; 8 in younger, 12 in elderly) and in emergency departments 5 (IQR, 3–14; 3 in younger, 8 in elderly). Trauma mechanisms included the following: 484 patients with falls (52.6%; younger, 242 patients [50.0%]; elderly, 242 [50.0%]), 291 with road traffic accidents (31.6%; younger, 237 patients [81.4%]; elderly, 54 [18.6%]), and 146 with others (15.8%). Mortality was 30.2% (24.5% in younger, 40.9% in elderly). Median GCS at 14 days was 15 (IQR, 14–15) without differences among subgroups. Estimated incidence of sTBI in Switzerland was low, age was high, and mortality considerable. The elderly had higher initial GCS and a higher death rate, but high GCS at 14 days. Accidents / statistics & numerical data Accidents, Traffic / statistics & numerical data Adult Age Factors Aged Aged, 80 and over Brain Injuries / epidemiology Brain Injuries / mortality Data Interpretation, Statistical Emergency Medical Services Female Hospitalization / statistics & numerical data Humans Incidence Income Male Middle Aged Sample Size Sex Factors Switzerland / epidemiology Treatment Outcome Dewey 613 Dewey 617 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 64 Département de santé et médecine communautaires 22A false 88 Epidémiologie clinique et biostatistique 115 Journal of neurotrauma 30 23 1618d56b-b455-4a3b-a63d-cdff8654fd21 Article (Published version) Restricted Brain injury Haller Walder.pdf 259536 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires

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Severe Traumatic Brain Injury in a High-Income Country: An Epidemiological Study	Journal of neurotrauma			2013	199	0

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Haller, Chiara Simone