This study documents the epidemiology of head injury over the course of 22 years in the largest Level I adult trauma center in Canada. This information defines the current state, changing pattern, and relative distribution of demographic factors in a defined group of trauma patients. It will aid in hypothesis generation to direct etiological research, administrative resource allocation, and preventative strategies.
Data on all the trauma patients treated at Sunnybrook Health Sciences Centre (SHSC) from 1986 to 2007 were collected in a consecutive, prospective fashion. The authors reviewed these data from the Sunnybrook Trauma Registry Database in a retrospective fashion. The aggregate data on head injury included demographic data, cause of injury, and Injury Severity Score (ISS). The collected data were analyzed using univariate techniques to depict the trend of variables over years. The authors used the length of stay (LOS) and number of deaths per year (case fatality rate) as crude measures of outcome.
A total of 16,678 patients were treated through the Level I trauma center at SHSC from January 1986 to December 2007. Of these, 9315 patients met the inclusion criteria (ISS > 12, head Abbreviated Injury Scale score > 0). The median age of all trauma patients was 36 years, and 69.6% were male. The median ISS of the head-injury patients was 27. The median age of this group of patients increased by 12 years over the study period. Motorized vehicle accidents accounted for the greatest number of head injuries (60.3%) although the relative percentage decreased over the study period. The median transfer time of patients sustaining a head injury was 2.58 hours, and there was an approximately 45 minute improvement over the 22-year study period. The median LOS in our center decreased from 19 to 10 days over the study period. The average case fatality rate was 17.4% over the study period. In multivariate analysis, more severe injuries were associated with increased LOS as was increasing time from injury to hospital presentation. Age and injury severity were independently predictive of mortality.
These data will provide useful information to guide future studies on the changing patterns of head injury, possible mechanisms of injury, and efficient resource allocation for management of this condition.
Please include this information when citing this paper: published online January 28, 2011; DOI: 10.3171/2010.12.JNS10808.
Andersson EH, , Björklund R, , Emanuelson I, & Stålhammar D: Epidemiology of traumatic brain injury: a population based study in western Sweden. Acta Neurol Scand 107:256–259, 2003
Bruns J Jr, & Hauser WA: The epidemiology of traumatic brain injury: a review. Epilepsia 44:Suppl 10 2–10, 2003
Chesnut RM, , Carney N, , Maynard H, , Mann NC, , Patterson P, & Helfand M: Summary report: evidence for the effectiveness of rehabilitation for persons with traumatic brain injury. J Head Trauma Rehabil 14:176–188, 1999
Chua KS, , Ng YS, , Yap SG, & Bok CW: A brief review of traumatic brain injury rehabilitation. Ann Acad Med Singapore 36:31–42, 2007
Diamond IR, , Parkin PC, , Wales PW, , Bohn D, , Kreller MA, & Dykes EH, et al.: Preventable pediatric trauma deaths in Ontario: a comparative population-based study. J Trauma 66:1189–1195, 2009
Dykes EH, , Spence LJ, , Bohn DJ, & Wesson DE: Evaluation of pediatric trauma care in Ontario. J Trauma 29:724–729, 1989
Khan F, , Baguley IJ, & Cameron ID: 4: Rehabilitation after traumatic brain injury. Med J Aust 178:290–295, 2003
Macpherson A, & Spinks A: Bicycle helmet legislation for the uptake of helmet use and prevention of head injuries. Cochrane Database Syst Rev 3:CD005401, 2008
Masson F, , Thicoipe M, , Aye P, , Mokni T, , Senjean P, & Schmitt V, et al.: Epidemiology of severe brain injuries: a prospective population-based study. J Trauma 51:481–489, 2001
Myburgh JA, , Cooper DJ, , Finfer SR, , Venkatesh B, , Jones D, & Higgins A, et al.: Epidemiology and 12-month outcomes from traumatic brain injury in Australia and New Zealand. J Trauma 64:854–862, 2008
Wu X, , Hu J, , Zhuo L, , Fu C, , Hui G, & Wang Y, et al.: Epidemiology of traumatic brain injury in eastern China, 2004: a prospective large case study. J Trauma 64:1313–1319, 2008
All Time | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 979 | 344 | 10 |
Full Text Views | 151 | 8 | 0 |
PDF Downloads | 123 | 3 | 0 |
EPUB Downloads | 0 | 0 | 0 |