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Injury pattern, hospital triage and mortality of 1,250 patients with severe traumatic brain injury caused by road traffic accidents.
MedLine Citation:
PMID:  24093437     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
This epidemiological study analyzed the incidence, risk factors, hospital triage and outcome of patients with severe traumatic brain injuries (sTBI) caused by road traffic accidents (RTA) admitted to hospitals in the Trauma Center West-Netherlands (TCWN) region. Trauma registry data were used to identify TBI in all RTA victims admitted to hospitals in the mid-West region of the Netherlands from 2003 to 2011. Type of head injury and severity were classified using the Abbreviated Injury Scale (AIS). Head injuries with AIS severity scores ≥ 3 were considered sTBI. Ten percent of all 12,503 hospital admitted RTA victims sustained sTBI, ranging from 5.4% in motorcyclists, 7.4% in motorists, 9.6% in cyclists and 12.7% in moped riders to 15.1% in pedestrians (p<0.0001). Amongst RTA victims admitted to hospital, sTBI was most prevalent in pedestrians (OR 2.25; 95% CI 1.78-2.86) and moped riders (OR 1.86; 95% CI 1.51-2.30). Injury patterns differed between road user groups. The incidence of contusion ranged from 46.6% in cyclists to 74.2% in motorcyclists, whereas basilar and open skull fractures were least common in motorcyclists (22.6%) and most common in moped riders (51.5%). Haemorrhage incidence ranged from 44.9% (motorists) to 63.6% (pedestrians). Subdural and subarachnoid bleedings were most frequent. Age, Glasgow Coma Scale, and type of haemorrhage were independent prognostic factors for in-hospital mortality after sTBI. In-hospital mortality ranged from 4.2% in moped riders to 14.1% in motorists. Pedestrians have the highest risk to sustain sTBI and more specifically intracranial haemorrhage. Haemorrhage and contusion both occur in over 50% of the patients with sTBI. Specific brain injury patterns can be distinguished for specific road user groups and independent prognostic risk factors for sTBI were identified. This knowledge may be used to improve the vigilance for particular injuries in specific patient groups and stimulate development of focussed diagnostic strategies.
Authors:
Henry Alexander Leijdesdorff; Jeroen T J M van Dijck; Pieta Krijnen; Carmen L A M Vleggeert; Inger B Schipper
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-6
Journal Detail:
Title:  Journal of neurotrauma     Volume:  -     ISSN:  1557-9042     ISO Abbreviation:  J. Neurotrauma     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8811626     Medline TA:  J Neurotrauma     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Leiden University Medical Center, Department of Trauma Surgery, Leiden, Netherlands ; a.leijdesdorff@gelre.nl.
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