The long journey towards uniform epidemiological monitoring of TBI around the globe

Abstract

Reliable epidemiological data and improved awareness of traumatic brain injury (TBI) are both essential to fully understand the scale and socioeconomic burden of this condition, including our ability to plan and implement prevention measures, and to allocate health-care resources. 1 Maas AIR Menon DK Adelson PD et al. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017; 16: 987-1048 Summary Full Text Full Text PDF PubMed Scopus (1061) Google Scholar Although accomplishing these tasks, at first glance, might be considered straightforward, reality has proven the contrary. To date, all attempts to harmonise data collection and analyses across Europe and USA still confirm wide variation and discrepancies in reported incidence and mortality. 1 Maas AIR Menon DK Adelson PD et al. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017; 16: 987-1048 Summary Full Text Full Text PDF PubMed Scopus (1061) Google Scholar , 2 Li M Zhao Z Yu G Zhang J Epidemiology of traumatic brain injury over the world: a systematic review. Austin Neurol & Neurosci. 2016; 1: 1007 Google Scholar , 3 Majdan M Plancikova D Brazinova A et al. Epidemiology of traumatic brain injuries in Europe: a cross-sectional analysis. Lancet Public Health. 2016; 1: e76-e83 Summary Full Text Full Text PDF PubMed Scopus (228) Google Scholar These differences are mostly attributable to methodological diversity, including differences in case ascertainment, non-standardised definitions of TBI, and variations in hospital admission policies. 1 Maas AIR Menon DK Adelson PD et al. Traumatic brain injury: integrated approaches to improve prevention, clinical care, and research. Lancet Neurol. 2017; 16: 987-1048 Summary Full Text Full Text PDF PubMed Scopus (1061) Google Scholar , 2 Li M Zhao Z Yu G Zhang J Epidemiology of traumatic brain injury over the world: a systematic review. Austin Neurol & Neurosci. 2016; 1: 1007 Google Scholar , 3 Majdan M Plancikova D Brazinova A et al. Epidemiology of traumatic brain injuries in Europe: a cross-sectional analysis. Lancet Public Health. 2016; 1: e76-e83 Summary Full Text Full Text PDF PubMed Scopus (228) Google Scholar Moreover, robust data for many parts of the world, particularly for low-to-middle-income countries (LMICs) where TBI is likely to occur much more frequently, are almost entirely absent. Traumatic brain injury in ChinaChina has more patients with traumatic brain injury (TBI) than most other countries in the world, making this condition a major public health concern. Population-based mortality of TBI in China is estimated to be approximately 13 cases per 100 000 people, which is similar to the rates reported in other countries. The implementation of various measures, such as safety legislation for road traffic, establishment of specialised neurosurgical intensive care units, and the development of evidence-based guidelines, have contributed to advancing prevention and care of patients with TBI in China. Full-Text PDF