Abstract
PurposeThe association of TBI with socioeconomic characteristics of patients has not been studied extensively. The objective of this study was to analyse the differences in injury characteristics and outcome in TBI patients based on their occupational status.MethodsData on patients from 13 centres based in Austria, Croatia, Slovakia, Bosnia and Herzegovina, and Macedonia were included in the analysis. Demographic characteristics, injury characteristics, treatment and outcome at various post-injury stages were compared according to occupational status. Logistic regression was used to adjust for the effect of co-variates. ICU mortality, hospital mortality, 6 months mortality, and outcome at 6 months were used as dependent variables.ResultsOverall, 886 patients were analysed with a mean age of 45.5 years. High-level falls were most prevalent in the blue-collar group (19%), most low-level falls occurred in the retired group. Traffic accidents were most common in students. The injuries were most severe in the blue-collar group and students. Highest mortalities and unfavourable outcomes were in the retired, students and white-collar workers had the best outcomes. Compared to retired patients, all groups had higher odds of favourable outcome at 6 months after adjusting for co-variates—OR from 2.2 (95% CI 1.1–4.6) for entrepreneurs to 3.6 (95% CI 1.8–7.2) for the blue-collar group.ConclusionOur paper provides clues pertaining specifically to variations in patterns and outcomes of TBI according to occupational status which can inform prevention and planning of services and can serve to plan priorities for further research.
Highlights
Traumatic brain injuries (TBI) have been identified as a major public health problem [1, 2]
Most published studies of associations between Socioeconomic status (SES) and injuries focus on paediatric populations with fewer using cohorts of TBI cases from general populations, and their results are conflicting: some studies showed a longer stay in hospital [14], increased 30 day mortality [15], higher risk of injury death [16] and worse non-fatal outcome [8] in more deprived patients; some studies showed associations only in certain subtypes of injuries, such as fighting injuries or sports/recreational injuries [17]; others did not observe any significant differences in outcome based on SES [13, 18, 19]
In a similar manner we hypothesized that TBI will display distinctive patterns of cause, occurrence and outcome based on SES
Summary
Traumatic brain injuries (TBI) have been identified as a major public health problem [1, 2]. They are among the most important causes of morbidity and mortality among all age Socioeconomic status (SES) is in general considered to be an important determinant of general morbidity and mortality [5,6,7]. Previous studies have shown that the context of the injury such as mechanism [20], place of occurrence of the injury [21], age group or social group [22] shows distinctive patterns as to severity, extent and overall outcome of TBI. The objective of this study was to analyse the differences in injury characteristics, treatment, and outcome at various stages post-injury in 886 patients with TBI based on the occupational status of the patient
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