Research Reports - Trends in epidemiological and clinical characteristics in severe traumatic brain injury

Neurocirugia (Astur). 2014 Jul 3

Gómez PA(1), Castaño-Leon AM(2), de-la-Cruz J(3), Lora D(3), Lagares A(2)

OBJECTIVE: To describe the demographic and clinical profiles of a cohort of
environmentally representative severe traumatic brain injury (TBI) cases
collected for the past 25 years and to analyse the changes that occurred by
dividing the analysis period into 3 equal time periods.
MATERIAL AND METHODS: This was an observational cohort study of consecutive adult
patients (>14 years of age) with severe closed TBI (Glasgow Coma Scale score
[GCS]≤8) who were admitted during the first 48h after injury to the 12 de Octubre
hospital from 1987 to 2012. The most relevant epidemiological and clinical
variables reported in the literature were defined and compared in 3 equal time
periods (1987-1995, 1996-2004 and 2005-2014).
RESULTS: There was a 13% reduction in the frequency of severe TBI from the first
to the last time period. An increase in the mean age from 35 to 43 years was
observed, whereas the frequency of severe TBI according to sex remained
approximately the same during the last decades of life. A distinct change was
observed in the injury mechanism; traffic accidents decreased from 76% to 55%,
particularly those involving 4-wheeled vehicles. However, falls increased
significantly, especially in older women, and contusion and subdural haematoma
were the most frequent structural injuries. Motor scores could not be reliably
assessed for the last time period because of early intubation and sedative drug
use.
CONCLUSIONS: TBI epidemiology in Western countries has changed. This trend was
also observed in our environment as an increase in mean age, which reflected the
increase in falls among elderly patients.

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