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Abstract
Objectives Since 2000/2001, no large-scale prospective studies addressing traumatic brain injury (TBI) epidemiology in Germany have been published. Our aim was to look for a possible shift in TBI epidemiology described in other European countries, to look for possible changes in TBI management and to identify predictors of 1-year outcome especially in patients with mild TBI.
Design Observational cohort study.
Setting All patients suffering from a TBI of any degree between 1 October 2014 and 30 September 2015, and who arrived in one of the seven participating BG hospitals within 24 hours after trauma, were included.
Participants In total, 3514 patients were included.
Outcome measures Initial care, acute hospital care and rehabilitation were documented using standardised documentation forms. A standardised telephone interview was conducted 3 and 12 months after TBI in order to obtain information on outcome.
Results Peaks were identified in males in the early 20s and mid-50s, and in both sexes in the late 70s, with 25% of all patients aged 75 or older. A fall was the most frequent cause of TBI, followed by traffic accidents (especially bicyclists). The number of head CT scans increased, and the number of conventional X-rays of the skull decreased compared with 2000/2001. Besides, more patients were offered rehabilitation than before. Though most TBI were classified as mild, one-third of the patients participating in the telephone interview after 12 months still reported troubles attributed to TBI. Negative predictors in mild TBI were female gender, intracranial bleeding and Glasgow Coma Scale (GCS) 13/14.
Conclusion The observed epidemiologic shift in TBI (ie, elderly patients, more falls, more bicyclists) calls for targeted preventive measures. The heterogeneity behind the diagnosis ‘mild TBI’ emphasises the need for defining subgroups not only based on GCS.
- epidemiology
- neurological injury
- neurosurgery
- accident & emergency medicine
Data availability statement
Data are available upon reasonable request. Requests for access to extra data will be considered by the corresponding author (peter.schwenkreis@rub.de).
This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
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Data availability statement
Data are available upon reasonable request. Requests for access to extra data will be considered by the corresponding author (peter.schwenkreis@rub.de).
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Footnotes
Contributors PS, AG, UM, WR, IS, BCK, H-JM, KW, SG, MT, JB, RB, AF, MSc, MSt, AP, HJT and JL participated in the conception and design of the study. PS, FB, WR, BCK, KW, SG, MS-K, JB, RB, MSt, AP and JL recruited participants and collected clinical data. LLJ, HR and HJT performed the statistical analysis. All authors were involved in interpretation and critical review of the data, and drafting of the manuscript.
Funding The study is funded by the German Social Accident Insurance (DGUV; FR-0216).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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