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A population‐based study on epidemiology of intensive care unit treated traumatic brain injury in Iceland
Author(s) -
Jonsdottir G. M.,
Lund S. H.,
Snorradottir B.,
Karason S.,
Olafsson I. H.,
Reynisson K.,
Mogensen B.,
Sigvaldason K.
Publication year - 2017
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12869
Subject(s) - medicine , glasgow coma scale , traumatic brain injury , intensive care unit , injury severity score , population , incidence (geometry) , poison control , injury prevention , epidemiology , emergency medicine , abbreviated injury scale , intensive care , glasgow outcome scale , pediatrics , intensive care medicine , surgery , psychiatry , physics , environmental health , optics
Background Traumatic brain injury is a worldwide health issue and a significant cause of preventable deaths and disabilities. We aimed to describe population‐based data on intensive care treated traumatic brain injury in Iceland over 15 years period. Methods Retrospective review of all intensive care unit admissions due to traumatic brain injury at The National University Hospital of Iceland 1999–2013. Data were collected on demographics, mechanism of injury, alcohol consumption, glasgow come scale upon admission, Injury Severity Scoring, acute physiology and chronic health evaluation II score, length of stay, interventions and mortality (defined as glasgow outcome score one). All computerized tomography scans were reviewed for Marshall score classification. Results Intensive care unit admissions due to traumatic brain injury were 583. The incidence decreased significantly from 14/100.000/year to 12/100.000/year. Males were 72% and the mean age was 41 year. Majority of patients (42%) had severe traumatic brain injury. The most common mechanism of injury was a fall from low heights (36.3%). The mortality was 18.2%. Increasing age, injury severity score, Marshall score and acute physiology and chronic health evaluation II score are all independent risk factors for death. Glasgow coma scale was not an independent prognostic factor for outcome. Conclusions Incidence decreased with a shift in injury mechanism from road traffic accidents to falls and an increased rate of traumatic brain injury in older patients following a fall from standing or low heights. Mortality was higher in older patients falling from low heights than in younger patients suffering multiple injuries in road traffic accidents. Age, injury severity score, acute physiology and chronic health evaluation II score and Marshall score are good prognostic factors for outcome. Traumatic brain injury continues to be a considerable problem and the increase in severe traumatic brain injury in the middle age and older age groups after a seemingly innocent accident needs a special attention.