Document Detail


Regional brain injury epidemiology as the basis for planning brain injury treatment. The Romagna (Italy) experience.
MedLine Citation:
PMID:  12690333     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Neurosurgical services for traumatic brain injury (TBI) should be based upon the understanding of the epidemiology of TBI in the region as well as the clinical parameters. Our objective was to measure incidence and epidemiologic factors associated with TBI in the Romagna region of Northeastern Italy and correlate those parameters with neurosurgical imaging and related clinical features. METHODS: Guidelines for brain injury management in our region were derived following meetings of all physicians involved in the treatment of brain injury. An epidemiologic study was undertaken in 1998. The study population was all patients admitted for hospital care in the Region following a TBI with a discharge diagnosis of pertinent International Classification Disease, 9(th) revision, codes. Data on the extent, diagnoses, severity, external causes and hospital course were abstracted from the hospital record and computer entered for analyses. RESULTS: Using data for the population of Romagna of about 1000000 persons we identified, in the full year 1998, 2430 TBI patients or an incidence rate of 250 per 100000 resident population. There were, in addition, 460 nonresident patients who were admitted in the region. External causes of injury were generally similar to reports from other places in Western Europe, with the exception of a very low frequency of cases stemming from violence. Age specific incidence rates were highest among young children, persons aged 15-24, and those aged 65 and older. Computerized tomography scans were given to 1732 patients and intracranial traumatic lesions were identified in 497 (28.6%) patients or a rate of 38 /100000. We performed 128 craniotomies, an incidence rate of 11/100000. The case fatality rate (CFR) was 2.8% among admitted patients with the highest rate among those aged 75 or older. CONCLUSION: Incidence of TBI in Italy is similar to other published European series. The number of minor brain injuries admitted for hospital care remains high and can be significantly reduced with better use of CT scans in adults whenever possible. The workload for a neurosurgical unit servicing a population of 1 million is limited and does not justify the opening of new units for trauma care or the use of craniotomies outside the Neurosurgical Unit.
Authors:
F Servadei; V Antonelli; L Betti; A Chieregato; E Fainardi; E Gardini; G Giuliani; L Salizzato; J F Kraus
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of neurosurgical sciences     Volume:  46     ISSN:  0390-5616     ISO Abbreviation:  J Neurosurg Sci     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2003-04-11     Completed Date:  2003-07-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0432557     Medline TA:  J Neurosurg Sci     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  111-9     Citation Subset:  IM    
Affiliation:
Department of Injury Prevention, WHO Neurotrauma Collaborating Center, Maurizio Bufalini Hospital, Cesena, Italy. fservade@ausl-cesena.emr.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Age Factors
Aged
Brain Injuries / epidemiology*,  mortality,  radiography,  therapy*
Child
Child, Preschool
Cohort Studies
Craniotomy
Female
Hospitalization
Humans
Incidence
Infant
Italy
Male
Middle Aged
Survival Rate
Tomography, X-Ray Computed
Comments/Corrections
Comment In:
J Neurosurg Sci. 2003 Mar;47(1):61   [PMID:  12900735 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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