A systematic review of brain injury epidemiology in Europe
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Background. The world’s literature on traumatic brain injury (TBI) grows annually including new reports on epidemiologic findings from many regions. With the wide variety of reports emphasizing various factors it is useful to compile these findings, hence the objective of this report. Thus, we describe epidemiological factors from European studies largely published in the last 20 years.
Method. The Medline was searched for TBI related articles from about 1980 to 2003 including terms such as “epidemiology”, “head injury”, “brain injury” and others. From the research reports identified, we checked references for additional relevant reports and from those reports we abstracted data on TBI incidence, severity, external cause, gender, mortality, prevalence, cost and related factors.
Results. Twenty three European reports met inclusion criteria and included findings from national studies from Denmark, Sweden, Finland, Portugal, Germany, and from regions within Norway, Sweden, Italy, Switzerland, Spain, Denmark, Ireland, the U.K. and France. An aggregate hospitalized plus fatal TBI incidence rate of about 235 per 100,000 was derived. Prevalence rate data were not reported from any European country. An average mortality rate of about 15 per 100,000 and case fatality rate of about 11 per 100 were derived. The TBI severity ratio of hospitalized patients was about 22:1.5:1 for mild vs. moderate vs. severe cases, respectively. The percentages of TBI from external causes varied considerably and several reports reported an association of alcohol use with TBI. Outcome or disability findings were mixed and inconsistent.
Interpretation. It was difficult to reach a consensus on all epidemiological findings across the 23 published European studies because of critical differences in methods employed across the reports. We highly recommend the development of research guidelines to standardize definitional, case finding, and data reporting parameters to help establish a more precise description and hence utility of the epidemiology of TBI in Europe.
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- Annoni, J, Beer, S, Kesselring, J 1992Severe traumatic brain injury-epidemiology and outcome after 3 years.Disability Rehab142326Google Scholar
- Badcock, K 1998Head injury in South Australia: Incidence of hospital attendance and disability based on a one-year sample.Community Health StudiesXII428436Google Scholar
- Caldwell, M, McGovern, EM 1993Fatal trauma: a five year review in a Dublin hospital.Int J Med Sci162309312Google Scholar
- Chiu, W, Yeh, K, Li, Y, Gan, Y, Chen, H, Hung, C 1997Traumatic brain injury registry in Taiwan.Neurol Res19262264Google Scholar
- Engberg, A 1995Severe traumatic brain injury – epidemiology, external causes, prevention, and rehabilitation of mental and physical sequalae.Acta Neurol Scand929151Google Scholar
- Gururaj G, Sastry Koeluri V, Chandramouli B, Subbakrishna D (2004) Neurotrauma registry in the NIMHANS. National Institute of Mental Health & Neurosciences, Bangalore, IndiaGoogle Scholar
- Hawley, C, Ward, A, Long, J, Owen, D, Magnay, A 2003Prevalence of traumatic brain injury amongst children admitted to hospital in one health district: a population-based study. Injury.Intl J Care Injured34256260Google Scholar
- Hukkelhoven, C, Steyerberg, E, Farace, E, Habbema, D, Marshall, L, Maas, A 2002Regional differences in patient characteristics, case management and outcomes in traumatic brain injury: experience from the tirilazad trials.Neurosurgery97549557Google Scholar
- Ingebrigtsen, T, Mortensen, K, Romner, B 1998The epidemiology of hospital-referred head injury in Northern Norway.Neuroepidemiol17139146Google Scholar
- Johansson, E, Ronnkvist, M, Fugl-Meyer, A 1991Traumatic brain injuries in Northern Sweden.Scand J Rehab Med23179185Google Scholar
- Kleiven, S, Peloso, P, Holst, H 2003The epidemiology of head injuries in Sweden from 1987 to 2000.Injury Control Safety Promotion10173180Google Scholar
- Kraus J, McArthur D (2004) Brain and spinal cord injury. In: Nelson M, Tanner C et al (eds) Neuroepidemiology: from principles to practice. Oxford University PressGoogle Scholar
- Langlois J, Rutland-Brown W, Thomas K (2004) Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Atlanta, GeorgiaGoogle Scholar
- Marshal L (1995) Discussion to Servadei et al Neurosurgery 37: 906–907Google Scholar
- Murray, G Teasdale, G Braakman, R Cohadon, F Dearden, M Iannotti, F Karimi, A Lapierre, F Maas, A Ohman, J Persson, L Servadei, F Stocchetti, N Trojanowski, T Unterberg, A on behalf of the European Brain Injury Consortium1999The European Brain Injury Consortium Survey of head injuries.Acta Neurochir (Wein)141223236Google Scholar
- Murray J, Lopez A (1996) The global burden of disease. World Health Organization, GenevaGoogle Scholar
- O’Brien, D, Phillips, J 1996Head injuries in the Republic of Ireland: a neurosurgical audit.Irish Med J89216218Google Scholar
- Paden M, McGee K, Krug E (eds) (2002) Injury: a leading cause of the global burden of disease. WHO, GenevaGoogle Scholar
- Santos, M, De Sousa, L, Castro-Caldas, A 2003Epidemiology of traumatic brain injury in Portugal.Acta Med Portugues167176Google Scholar
- Servadei, F, Verlicchi, A, Soldano, F, Zanotti, B, Piffer, S 2002Descriptive epidemiology of head injury in Romagna and Trentino.Neuroepidemiol21297304Google Scholar
- Tate, R, McDonald, S, Lulham, J 1998Incidence of hospital-treated traumatic brain injury in an Australian community. Australia and New Zealand.J Public Health22419423Google Scholar
- Torner J, Choi S, Barnes T (1999) Epidemiology of head injuries. In: Marion D (ed). Traumatic brain injury. Thieme, New YorkGoogle Scholar