Abstract
BackgroundA number of patients who sustain a traumatic brain injury (TBI) require surgical intervention due to acute intracranial bleeding. The aim of this retrospective study was to assess the national trends of acute craniotomies following TBI in the Finnish adult population.MethodsThe data were collected retrospectively from the Finnish Care Register for Health Care (1997–2018). The study cohort covered all first-time registered craniotomies following TBI in patients aged 18 years or older. A total of 7627 patients (median age = 59 years, men = 72%) were identified.ResultsThe total annual incidence of acute trauma craniotomies decreased by 33%, from 8.6/100,000 in 1997 to 5.7/100,000 in 2018. The decrease was seen in both genders and all age groups, as well as all operation subgroups (subdural hematoma, SDH; epidural hematoma, EDH; intracerebral hematoma, ICH). The greatest incidence rate of 15.4/100,000 was found in patients 70 years or older requiring an acute trauma craniotomy. The majority of surgeries were due to an acute SDH and the patients were more often men. The difference between genders decreased with age (18–39 years = 84% men, 40–69 = 78% men, 70 + years = 55% men). The median age of the patients increased from 58 to 65 years during the 22-year study period.ConclusionsThe number of trauma craniotomies is gradually decreasing; nonetheless, the incidence of TBI-related craniotomies remains high among geriatric patients. Further studies are needed to determine the indications and derive evidence-based guidelines for the neurosurgical care of older adults with TBIs to meet the challenges of the growing elderly population.
Highlights
Acute intracranial bleeding can be life-threatening following traumatic brain injury (TBI)
To identify patients treated with acute TBI-related craniotomy, the criteria for selecting the patients were as follows: any of the diagnosis codes were trauma to the head and any of the procedures performed were either evacuation of epidural hematomas (EDH) (NCSP code: AAD00), evacuation of acute subdural hematomas (SDH) (AAD05), or evacuation of traumatic intracerebral hematomas (ICH) (AAD15)
The median age of the patients was 59 years and during the 22-year study period the median age increased from 58 years in 1997 to 65 years in 2018
Summary
Acute intracranial bleeding can be life-threatening following traumatic brain injury (TBI). The rates of people requiring neurosurgery for an intracranial abnormality, in consecutive series of patients presenting to the ED following head trauma, vary across studies, but are often reported to range between approximately 5% and 37% in the group of moderate to severe TBI [9, 21, 25, 33]. A number of patients who sustain a traumatic brain injury (TBI) require surgical intervention due to acute intracranial bleeding. The aim of this retrospective study was to assess the national trends of acute craniotomies following TBI in the Finnish adult population. Further studies are needed to determine the indications and derive evidence-based guidelines for the neurosurgical care of older adults with TBIs to meet the challenges of the growing elderly population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
