Frequency Of Traumatic Brain Injury Research Articles

Sensory functions and their relation to balance metrics: a secondary analysis of the LIMBIC-CENC multicenter cohort.

Among patients with traumatic brain injury (TBI), balance problems often persist alongside hearing and vision impairments that lead to poorer outcomes of functional independence. As such, the ability to regain premorbid independent gait may be dictated by the level of sensory acuity or processing decrements that are shown following TBI assessment. This study explores the relationships between standardized sensory acuity and processing outcomes to postural balance and gait speed. Secondary analysis was performed on the Long-Term Impact of Military- Relevant Brain Injury Consortium Chronic Effects of Neurotrauma Consortium LIMBIC (CENC) data set. Separate regression analyses were carried out for each of the balance assessments (via Computerized Dynamic Posturography, CDP) and walking speed. TBI frequency was significantly related to the majority of single CDP outcomes (i.e., Conditions 2-6), while various sensory processing outcomes had task-specific influences. Hearing impairments and auditory processing decrements presented with lower CDP scores (CDP Conditions 3,5,6, and 1-3 respectively), whereas greater visual processing scores were associated with better CDP scores for Conditions 2,5, and 6. In sum, patients with TBI had similar scores on static balance tests compared to non-TBI, but when the balance task got more difficult patients with TBI scored worse on the balance tests. Additionally, stronger associations with sensory processing than sensory acuity measures may indicate that patients with TBI have increased fall risk.

Self-reported traumatic brain injury in a sample of impulsive violent offenders: neuropsychiatric correlates and possible "dose effects".

Traumatic brain injury (TBI) is a major public health problem that may be associated with numerous behavioral problems, including impulsivity, aggression and violence. Rates of self-reported TBI are high within offender populations, but the extent to which TBI is causally implicated in causing illegal behavior is unclear. This study examined the psychological and functional correlates of histories of traumatic brain injury in a sample of impulsive violent offenders. Study participants, all men, had been recruited to participate in a randomized controlled trial of sertraline to reduce recidivism. Study entry criteria were an age of at least 18 years, a documented history of two or more violent offenses and a score of 70 or above on the Barratt Impulsiveness Scale. An extensive list of standardized questionnaires was administered to obtain information on previous TBI and other neuropsychiatric conditions or symptoms. In the sample of 693 men, 66% were aged between 18 and 35 years old, and 55% gave a history of TBI ("TBI+"). Overall, 55% of study participants reported at least one TBI. High levels of neuropsychiatric symptomatology were reported. In 75% of TBI+ individuals, their most severe TBI (by self-report) was associated with loss of consciousness (LOC) < 30 min. Compared to TBI- (those without history of TBI) participants, TBI+ individuals were more impulsive (Eysenck Impulsivity), irritable, angry, and reported higher levels of assaultive behavior, depressive symptomology, alcohol use disorder, suicidal ideation, suicide attempts, and lower quality of life. Potential "dose effects" of TBI severity and frequency in terms of neuropsychiatric symptomatology were identified. Like other studies of offender populations, single and multiple TBIs were very common. The associations of TBI, TBI severity, and TBI frequency (i.e., TBI "burden") with adverse neuropsychiatric phenomena suggest TBI contributes importantly to offender morbidity but the select nature of the sample and cross-sectional study design constrain the interpretation of these findings.

Traumatic Brain Injury in Child Burn.

BACKGROUNDBurns are one of the most important health problems in communities. Traumatic injuries, especially Traumatic Brain Injury (TBI) associated with burns, may increase disability and mortality. In addition to preventing burns, any action for a better treatment approach and early detection of concomitant traumatic injuries can reduce complications, disability, and treatment costs. We aimed to investigate the outcome of children with burn injury with and without TBI.METHODSIn this cross-sectional study, 392 children with burn injuries treated at Motahari Hospital in Tehran, Iran from 2018-2019 were enrolled. Patient demographics, burn injury information and TBI-related information including head trauma and fracture were recorded in a checklist. Patients were divided into two groups of death (24 people) or discharge (368 people) in terms of outcome and the underlying variables were compared in the two groups.RESULTSThere was no significant difference between the mean age of patients and gender in the two groups. The difference in the length of hospital stay, inhalation injury and skull fracture in the two groups was not statistically significant. The mean burn severity based on Total Body Surface Area (TBSA) and the frequency of TBI in the deceased group was significantly higher (P=0.001).CONCLUSIONThe severity of burns based on TBSA and TBI is associated with increased mortality among children with burn injuries. The results suggest the need to examine children with burn injuries for TBI using clinical examination or imaging.

Порушення натрієвого балансу у хворих з ураженням гіпоталамо-гіпофізарної ділянки при черепно-мозковій травмі

Актуальність. Черепно-мозкова травма (ЧМТ) до цього часу залишається провідною причиною смерті людей працездатного віку. В Україні частота ЧМТ щорічно становить у різних регіонах від 2,3 до 6 випадків (у середньому 4–4,2) на 1000 населення. Пацієнти з первинним ураженням головного мозку і гіпоталамо-гіпофізарної системи становлять групу ризику з розвитку набряку головного мозку через виникнення у них порушення водно-електролітної рівноваги та відповідно порушення рівноваги осмолярності між клітинним та позаклітинним простором. Порушення водно-електролітного балансу як наслідок ураження гіпоталамо-гіпофізарної системи при ЧМТ в літературі висвітлено недостатньо. Мало вивчені особливості функціонування центральних та периферичних ланцюжків ендокринної системи залежно від локалізації, характеру і тяжкості травми. Недостатньо вивчене питання про діагностичні та прогностичні цінності різних показників волемічного статусу у хворих із ЧМТ. Мета: вивчити види дизнатріємії у хворих з ізольованою ЧМТ і ураженням гіпоталамо-гіпофізарної ділянки головного мозку; вияснити вплив виду порушення натрієвого балансу на летальність у хворих із ЧМТ та ураженням гіпоталамо-гіпофізарної ділянки головного мозку. Матеріали та методи. Нами було обстежено 74 пацієнтів (чоловіків/жінок = 60/14) із вогнищевим забоєм головного мозку й ураженням гіпоталамічної ділянки. Серед 74 хворих з ізольованою ЧМТ і ураженням гіпоталамо-гіпофізарної ділянки головного мозку в 47 хворих було діагностовано гіповолемію, що поєднувалась з гіпонатріємією. У 15 хворих було виявлено гіпернатріємію з гіперволемією. Моніторинг внутрішньочерепного тиску здійснювали за допомогою поліфункціонального монітора (Monitor Model BSM-3562 (Nihon Konden Corporation, Японія, 2018)) із лінією для інвазивного вимірювання тиску. Постійне неінвазивне вимірювання оксигенації тканин органів (rSO2) проводили на моніторі Somanetics Invos Oximeter Cerebral/Somatik (Covidien, Mansfield, MA, США, 2020). В усіх хворих визначали рівень електролітів плазми крові. Висновки. У хворих із ЧМТ і ураженням гіпоталамо-гіпофізарної системи виникають різнонаправлені зміни водно-натрієвого балансу, що вимагають диференційованого підходу до їх лікування. Зважаючи на невелику кількість спостережень, ми не наважуємося пов’язувати вид дизнатріємії у хворих із ЧМТ і ураженням гіпоталамо-гіпофізарної ділянки головного мозку з летальністю. Вважаємо за доцільне продовжувати дослідження в цьому напрямку.

Usability of the Level of the S100B Protein, the Gosling Pulsatility Index, and the Jugular Venous Oxygen Saturation for the Prediction of Mortality and Morbidity in Patients with Severe Traumatic Brain Injury.

The high frequency of traumatic brain injury imposes severe economic stress on health and insurance services. The objective of this study was to analyze the association between the serum S100B protein, the Gosling pulsatility index (PI), and the level of oxygen saturation at the tip of the internal jugular vein (SjVO2%) in patients diagnosed with severe TBI. The severity of TBI was assessed by a GCS score ≤ 8 stratified by Glasgow outcome scale (GOS) measured on the day of discharge from the hospital. Two groups were included: GOS < 4 (unfavorable group (UG)) and GOS ≥ 4 (favorable group (UG)). S100B levels were higher in the UG than in the FG. PI levels in the UG were also substantially higher than in the FG. There were similar levels of SjVO2 in the two groups. This study confirmed that serum S100B levels were higher in patients with unfavorable outcomes than in those with favorable outcomes. Moreover, a clear demarcation in PI between unfavorable and FGs was observed. This report shows that mortality and morbidity rates in patients with traumatic brain injury can be assessed within the first 4 days of hospitalization using the S100B protein, PI values, and SjVO2.

E-bike and classic bicycle-related traumatic brain injuries presenting to the emergency department

BackgroundE-bike usage is increasingly popular and concerns about e-bike-related injuries and safety have risen as more injured e-bikers attend the emergency department (ED). Traumatic brain injury (TBI) is the main...

Traumatic brain injury among two-wheeled motor vehicle riders in Utsunomiya, Japan: a comparison between mopeds and motorcycles.

Two-wheeled motor vehicles are dichotomized into mopeds and motorcycles (MCs) based on their engine capacity. While efforts have been made, mostly by European researchers, to evaluate the possible difference in the frequency/severity of riders' traumatic brain injury (TBI) between the two categories, the results have been inconsistent. To evaluate whether such differences exist in Japan, a single-center, retrospective observational study was conducted on two-wheeled motor vehicle riders wearing a helmet during high-energy road traffic accident (RTA). Between January 2011 and December 2017, 127 moped and 128 MC helmeted riders involved in RTAs had been treated in our institution. Moped riders were significantly older than MC riders (50.7 ± 25.0years vs. 35.1 ± 18.6years, p = 0.04). The frequency of TBI was significantly higher in moped riders than in MC riders (21.3% vs. 10.9%; p = 0.03). However, the frequency of other bodily injuries did not differ significantly. Among the riders with TBI, neither injury severity nor outcomes differed significantly. Multivariate regression analysis showed that the presence of altered mental status was predictive of TBI (OR 23.398; 95% CI 9.187-59.586; p < 0.001). Moped riders trended to have a higher likelihood of sustaining TBI (OR 2.122; 95% CI 0.870-5.178; p = 0.098). Mopeds are frequently utilized by elderly in Japan, which may have been causally associated with the higher frequency of TBI in moped riders, while other causes, including the difference in helmet type, may also be involved. This study is limited by its small sample size and retrospective design, and multi-center prospective studies are warranted.

Impact of previous work in the conditions of industrial noise on the development of sensorineural hearing loss in the outcome of a military injury.

The results of a survey of militia members - industrial workers aged 35-39 years who had previously worked in the conditions of industrial noise are presented. As a result of a military trauma (combined head injury, acutrauma, barotrauma) they developed sensorineural hearing loss. The level of hearing loss and the degree of involvement in the pathological process of the sound-perceiving apparatus is related to the length of work experience in the conditions of industrial noise. For persons who worked in conditions of constant low-amplitude broadband noise (n=30), hearing loss is more pronounced compared to persons (n=30) who worked in conditions of pulsed high-frequency high-amplitude noise. In the control group (35-39 years, n=30), who previously worked outside of industrial noise, the level of hearing loss is determined by the frequency of traumatic brain injury and is associated with the formation of post-traumatic osteochondrosis and vertebrobasilar insufficiency.

Systematic review and meta-analysis found significant risk of brain injury and neurosurgery in alert children after a post-traumatic seizure.

This study aimed to determine the frequency of traumatic brain injury (TBI) on neuroimaging and the need for emergency neurosurgery in children with normal mental status following a post-traumatic seizure (PTS). We searched six electronic databases from inception to October 15, 2018, to identify studies including children under 18years with head injury and a Glasgow Coma Score of 15 after an immediate PTS. Relevant non-English articles were translated to determine eligibility. We performed random effect meta-analyses and assessed heterogeneity with I2 . The pooled estimate of the frequency of TBI, from seven studies, was 13.0% (95% CI: 4.0-26.1; I2 =81%). Data on the need of emergency neurosurgery were reported in four studies and the pooled estimate of its frequency was 2.3% (95% CI: 0.0-9.9; I2 =86%). Two studies reported on children with isolated PTS without any other signs of head injury, representing 0.1% of patients in both studies, for a total of 76 children. Of these, only three had TBI and one underwent neurosurgery. Children with immediate PTS and normal mental status frequently have TBI with a substantial need for neurosurgery. Clinicians should strongly consider neuroimaging for these children, although prolonged observation may be considered for those with isolated PTS.

Value of diagnostic and therapeutic laparoscopy for patients with blunt abdominal trauma: A 10-year medical center experience.

Laparoscopy has been used for the diagnosis and treatment for hemodynamically stable patients with penetrating abdominal trauma. This study evaluated whether diagnostic and therapeutic laparoscopy can be used as effectively in select patients with blunt abdominal trauma. All hemodynamically stable patients undergoing operations for blunt abdominal trauma over a 10-year period (2006–2015) at a tertiary medical center were included. Patients undergoing laparotomy were categorized as group A. Patients who underwent laparoscopy were categorized as group B. The clinical outcomes of the 2 groups were compared. There were 139 patients in group A and 126 patients in group B. Group A patients were more severely injured (mean injury severity score of 23.3 vs. 18.9, P < .001) and had a higher frequency of traumatic brain injuries (25.2% vs. 14.3%, P = .039). The sensitivity and specificity of diagnostic laparoscopy for patients in group B was 99.1% and 100.0%, respectively. No non-therapeutic laparotomies were performed in group B, and the success rate of therapeutic laparoscopy was 92.0% (103/112) for patients with significant intra-abdominal injuries. Patients in the 2 groups had similar perioperative and postoperative outcomes in terms of operation times, blood loss, blood transfusion requirements, mortality, and complications (all, P > .05). Laparoscopy is a feasible and safe tool for the diagnosis and treatment of hemodynamically stable patients with blunt abdominal trauma who require surgery.

Seizures After Traumatic Brain Injury: Conduct CT

Research Article| September 01 2017 Seizures After Traumatic Brain Injury: Conduct CT AAP Grand Rounds (2017) 38 (3): 32. https://doi.org/10.1542/gr.38-3-32 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Seizures After Traumatic Brain Injury: Conduct CT. AAP Grand Rounds September 2017; 38 (3): 32. https://doi.org/10.1542/gr.38-3-32 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: seizures, traumatic brain injuries Source: Badawy MK, Dayan PS, Tunik MG, et al. Prevalence of brain injuries and recurrence of seizures in children with posttraumatic seizures. Acad Emerg Med. 2017; 24(5): 595– 605; doi: https://doi.org/10.1111/acem.13168Google Scholar Investigators from the Pediatric Emergency Care Applied Research Network (PECARN) conducted a secondary analysis to evaluate the frequency of traumatic brain injuries (TBIs) and short-term seizure recurrence in children with posttraumatic seizures (PTS). Children who were <18 years old and received blunt head trauma that was evaluated at 1 of 25 participating PECARN EDs from 2004 to 2006 were included. All clinical data were obtained via chart review. The main exposure was PTS, defined as a witnessed seizure episode that occurred after the traumatic event. PTS timing was categorized as immediate (on impact), within 30 minutes, or >30 minutes after the traumatic event. PTS duration was categorized as <1 minute, 1 to <5 minutes, 5–15 minutes, and >15 minutes. The main outcome measures were (a) the presence of TBIs on CT images, defined as the presence of any intracranial hemorrhage, cerebral edema, pneumocephalus, or skull fracture; (b) the need for neurosurgical intervention; and (c) recurrent seizures within 1 week of the ED visit. Investigators calculated the frequencies of each outcome, the type of TBIs identified, the association of PTS timing and duration with presence of TBI, and the frequencies of neurosurgical intervention and recurrent seizures in those with PTS but no TBI. There were 42,424 participants included in the analysis, with 536 (1.3%) having PTS. Of those with PTS who had CT results (n = 466), 72 had TBIs (15.4%). The most common TBIs identified were cerebral contusion (5.6%) and subarachnoid hemorrhage (5.4%). The frequency of TBI increased as the timing and duration of PTS increased. Of the 72 patients with PTS who had TBIs on CT images, 20 (27.8%) underwent neurosurgery, and 15 (20.8%) had recurrent seizures. Of those with no TBI on CT images or no CT performed (n = 457), 5 (1.1%) had recurrent seizures, and none required neurosurgical intervention. The investigators conclude that children with PTS have a high likelihood of TBI on CT images, and a high proportion of those with TBI on CT images require neurosurgical interventions and have recurrent seizures. Dr Bratton has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. TBIs are known to cause early and late PTS. Risk factors for “early” PTS (occurring within 7 days of injury) include severe and/or penetrating brain injuries, subdural hematoma, cerebral contusions, depressed skull fractures, retained bone or metal fragments, focal neurological deficits, loss of consciousness, Glasgow Coma Scale (GCS) score <10, prolonged posttraumatic amnesia, and age <2 years.1 The incidence and prognosis of early PTS have been more closely evaluated for pediatric severe TBI (GCS 3–8) when compared to moderate (GCS 9–12) or mild (13–15) TBI. The results of the current... You do not currently have access to this content.

Prevalence of Brain Injuries and Recurrence of Seizures in Children With Posttraumatic Seizures

Computed tomography (CT) is often used in the emergency department (ED) evaluation of children with posttraumatic seizures (PTS); however, the frequency of traumatic brain injuries (TBIs) and short-term seizure recurrence is lacking. Our main objective was to evaluate the frequency of TBIs on CT and short-term seizure recurrence in children with PTS. We also aimed to determine the associations between the likelihood of TBI on CT with the timing of onset of PTS after the traumatic event and duration of PTS. Finally, we aimed to determine whether patients with normal CT scans and normal neurological examinations are safe for discharge from the ED. This was a planned secondary analysis from a prospective observational cohort study to derive and validate a neuroimaging decision rule for children after blunt head trauma at 25 EDs in the Pediatric Emergency Care Applied Research Network. We evaluated children<18 years with head trauma and PTS between June 2004 and September 2006. We assessed TBI on CT, neurosurgical interventions, and recurrent seizures within 1week. Patients discharged from the ED were contacted by telephone 1 week to 3 months later. Of 42,424 children enrolled, 536 (1.3%, 95% confidence interval [CI]= 1.2%-1.4%) had PTS. A total of 466 of 536 (86.9%, 95% CI= 83.8%-89.7%) underwent CT in the ED. TBIs on CT were identified in 72 (15.5%, 95% CI= 12.3%-19.1%), of whom 20 (27.8%, 95% CI= 17.9%-39.6%) underwent neurosurgical intervention and 15 (20.8%, 95% CI= 12.2%-32.0%) had recurrent seizures. Of the 464 without TBIs on CT (or no CTs performed), 457 had recurrent seizure status known, and five (1.1%, 95 CI= 0.4%-2.5%) had recurrent seizures; four of five presented with Glasgow Coma Scale scores<15. None of the 464 underwent neurosurgical intervention. We found significant associations between likelihood of TBI on CT with longer time until the PTS after the traumatic event (p=0.006) and longer duration of PTS (p<0.001). Children with PTS have a high likelihood of TBI on CT, and those with TBI on CT frequently require neurosurgical interventions and frequently have recurrent seizures. Those without TBIs on CT, however, are at low risk of short-term recurrent seizures, and none required neurosurgical interventions. Therefore, if CT-negative and neurologically normal, patients with PTS may be safely considered for discharge from the ED.

Traumatic Brain Injury in Iraq and Afghanistan Veterans: New Results From a National Random Sample Study.

This study randomly sampled post-9/11 military veterans and reports on causes, predictors, and frequency of traumatic brain injury (TBI) (N=1,388). A total of 17.3% met criteria for TBI during military service, with about one-half reporting multiple head injuries, which were related to higher rates of posttraumatic stress disorder, depression, back pain, and suicidal ideation. The most common mechanisms of TBI included blasts (33.1%), objects hitting head (31.7%), and fall (13.5%). TBI was associated with enlisted rank, male gender, high combat exposure, and sustaining TBI prior to military service. Clinical and research efforts in veterans should consider TBI mechanism, effects of cumulative TBI, and screening for premilitary TBI.

Traumatic Brain Injuries and Special Education Services in the Schools

ABSTRACTThe purpose of this study is to replicate a study conducted by Hux, Marquardt, Skinner, and Bond (1999) in which the researchers explored the frequency of traumatic brain injuries (TBI) in the special education population as compared to the frequency of TBI among students in general education. Hux and colleagues (1999) found that roughly one-quarter of their sample received evaluations for special education services at some point, and that almost half their sample had sustained at least one TBI. Similarly, the current study explored the frequency of TBI in both general education and special education groups in a kindergarten through twelfth grade school. Results indicated that the sample in the current study reported a lower incidence rate of TBI than the general population as well as that in the 1999 study by Hux and colleagues. Additionally, only one student in the current sample (5% of TBI group) reported a history of TBI along with receiving special education services. Discrepancies between the current study and the Hux and colleagues (1999) study are explored, and possible reasons for the discrepancies are discussed.

Traumatic Brain Injury in Spinal Cord Injury: Frequency and Risk Factors.

The frequency of traumatic brain injury (TBI) co-occurring with traumatic spinal cord injury (tSCI) is unclear despite a number of past studies; as well, limited research has examined predictors of co-morbid TBI in tSCI patients. (1a) To summarize past literature on comorbid diagnosis of TBI in tSCI in order to reexamine the frequency of dual diagnosis in a study designed to obviate past methodological limitations; (1b) to compare dual-diagnosis frequency with vs without the inclusion of diagnostically ambiguous cases; and (2) to measure risk factors for tSCI and comorbid TBI. Ninety-one of 135 eligible adults with tSCI, 3 to 6 months postinjury, were prospectively recruited from a tertiary inpatient tSCI rehabilitation program. TBI diagnosis was based on comprehensive, validated clinical neurological and neuroimaging measures. Objective 1: 39.6% of the tSCI patients sustained a concomitant TBI, but when ambiguous cases were removed from analysis, frequency rose to 58.1%. Objective 2: Motor vehicle collisions were most likely to yield a comorbid TBI diagnosis, but 31.6% of falls also resulted in TBI. Patients with cervical and thoracic injuries showed a very similar frequency of comorbid TBI. Varied methodological approaches, particularly the decision to include/exclude ambiguous cases, likely explain disparate past estimates of TBI in tSCI. However, even this study's lower frequency estimate, at nearly 40%, is clinically important. The prevailing assumption that dual diagnosis is less common in thoracic than cervical spine injuries was not supported. Finally, while comorbid TBI most frequently occurred in motor vehicle collisions, nearly a third of tSCIs sustained in falls resulted in comorbid TBI in our sample.

Prospective Associations Between Traumatic Brain Injury and Postdeployment Tinnitus in Active-Duty Marines.

To examine whether cause, severity, and frequency of traumatic brain injury (TBI) increase risk of postdeployment tinnitus when accounting for comorbid posttraumatic stress disorder. Self-report and clinical assessments were done before and after an "index" deployment to Iraq or Afghanistan. Assessments took place on Marine Corps bases in southern California and the VA San Diego Medical Center. Participants were 1647 active-duty enlisted Marine and Navy servicemen who completed pre- and postdeployment assessments of the Marine Resiliency Study. The main outcome was the presence of tinnitus at 3 months postdeployment. Predeployment TBI increased the likelihood of new-onset postdeployment tinnitus (odds ratio [OR] = 1.86; 95% confidence interval [CI], 1.28-2.70). Deployment-related TBIs increased the likelihood of postdeployment tinnitus (OR = 2.65; 95% CI, 1.19-5.89). Likelihood of new-onset postdeployment tinnitus was highest for those who were blast-exposed (OR = 2.93; 95% CI, 1.82-6.17), who reported moderate-severe TBI symptoms (OR = 2.22; 95% CI, 1.22-3.40), and who sustained multiple TBIs across study visits (OR = 2.27; 95% CI, 1.44-4.24). Posttraumatic stress disorder had no effect on tinnitus outcome. Participants who were blast-exposed, sustained multiple TBIs, and reported moderate-severe TBI symptoms were most at risk for new-onset tinnitus.

Analysis of Mortality and Epidemiology in 2617 Cases of Traumatic Brain Injury : Korean Neuro-Trauma Data Bank System 2010-2014.

ObjectiveThe aims of the Korean Neuro-Trauma Data Bank System (KNTDBS) are to evaluate and improve treatment outcomes for brain trauma, prevent trauma, and provide data for research. Our purpose was to examine the mortality rates following traumatic brain injury (TBI) in a retrospective study and to investigate the sociodemographic variables, characteristics, and causes of TBI-related death based on data from the KNTDBS.MethodsFrom 2010 to 2014, we analyzed the data of 2617 patients registered in the KNTDBS. The demographic characteristics of patients with TBI were investigated. We divided patients into 2 groups, survivors and nonsurvivors, and compared variables between the groups to investigate variables that are related to death after TBI. We also analyzed variables related to the interval between TBI and death, mortality by region, and cause of death in the nonsurvivor group.ResultsThe frequency of TBI in men was higher than that in women. With increasing age of the patients, the incidence of TBI also increased. Among 2617 patients, 688 patients (26.2%) underwent surgical treatment and 125 patients (4.7%) died. The age distributions of survivors vs. nonsurvivor groups and mortality rates according the severity of the brain injury, surgical treatment, and initial Glasgow Coma Scale (GCS) scores were statistically significantly different. Among 125 hospitalized nonsurvivors, 70 patients (56%) died within 7 days and direct brain damage was the most common cause of death (80.8%). The time interval from TBI to death differed depending on the diagnosis, surgical or nonsurgical treatment, severity of brain injury, initial GCS score, and cause of death, and this difference was statistically significant.ConclusionUsing the KNTDBS, we identified epidemiology, mortality, and various factors related to nonsurvival. Building on our study, we should make a conscious effort to increase the survival duration and provide rapid and adequate treatment for TBI patients.

Comparability of national estimates for traumatic brain injury-related medical encounters.

To describe similarities and differences in the number of civilian traumatic brain injury (TBI)-related hospitalizations and emergency department visits between national databases that capture US hospital data. TBI-related hospitalizations included in the National Hospital Discharge Survey (NHDS) and Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) and emergency department visits in the National Hospital Ambulatory Medical Care Survey (NHAMCS) and HCUP Nationwide Emergency Department Sample (HCUP-NEDS) for 2006-2010. Cross-sectional design. Nationwide counts of TBI-related medical encounters. Overall, the frequency of TBI is comparable when comparing NHDS with HCUP-NIS and NHAMCS with HCUP-NEDS. However, annual counts in both NHDS and NHAMCS are consistently unstable when examined in smaller subgroups, such as by age group and injury mechanism. Injury mechanism is consistently missing from many more records in NHDS compared with HCUP-NIS. Given the large sample size of HCUP-NIS and HCUP-NEDS, these data can offer a valuable resource for examining TBI-related hospitalization and emergency department visits, especially by subgroup. These data hold promise for future examinations of annual TBI counts, but ongoing comparisons with national probability samples will be necessary to ensure that HCUP continues to track with estimates from these data.

Traumatic brain injury in later life increases risk for Parkinson disease.

Traumatic brain injury (TBI) is thought to be a risk factor for Parkinson disease (PD), but results are conflicting. Many studies do not account for confounding or reverse causation. We sought to address these concerns by quantifying risk of PD after TBI compared to non-TBI trauma (NTT; defined as fractures). Using inpatient/emergency department (ED) International Classification of Disease, Ninth Revision code data for California hospitals from 2005-2006, we identified patients aged ≥55 years with TBI (n = 52,393) or NTT (n = 113,406) and without baseline PD or dementia who survived hospitalization. Using Kaplan-Meier estimates and Cox proportional hazards models (adjusted for age, sex, race/ethnicity, income, comorbidities, health care use, and trauma severity), we estimated risk of PD after TBI during follow-up ending in 2011. We also assessed interaction with mechanism of injury (fall vs nonfall) and effect of TBI severity (mild vs moderate/severe) and TBI frequency (1 TBI vs >1 TBI). TBI patients were significantly more likely to be diagnosed with PD compared to NTT patients (1.7% vs 1.1%, p < 0.001, adjusted hazard ratio [HR] = 1.44, 95% confidence interval [CI] = 1.31-1.58). Risk of PD was similar for TBI sustained via falls versus nonfalls (interaction p = 0.6). Assessment by TBI severity (mild TBI: HR = 1.24, 95% CI = 1.04-1.48; moderate/severe TBI: HR = 1.50, 95% CI = 1.35-1.66) and TBI frequency (1 TBI: HR = 1.45, 95% CI = 1.30-1.60; >1 TBI: HR = 1.87, 95% CI = 1.58-2.21) revealed a dose response. Among patients aged ≥55 years presenting to inpatient/ED settings with trauma, TBI is associated with a 44% increased risk of developing PD over 5 to 7 years that is unlikely to be due to confounding or reverse causation.

Traumatic brain injury rates and sequelae: A comparison of prisoners with a matched community sample in Australia

Aim: To compare rates of past reported traumatic brain injury (TBI) in a prisoner sample with those in a control group drawn from the same location of usual residence.Method: The prisoner group comprised a consecutive sample of men (n = 200) received into custody and screened by face-to-face interview. The control group comprised men (n = 200) matched for location of usual residence screened by telephone interview. Participants were asked about past TBIs and screened for drug and alcohol abuse, impulsivity and dissocial personality disorder.Results: Eighty-two per cent of prisoners and 71.5% of community participants reported at least one past TBI of any severity (i.e. with or without a loss of consciousness (LOC)) and 64.5% of prisoners and 32.2% of community participants reported at least one TBI associated with a LOC. Prisoners were more likely to report persisting side-effects of TBI and were much more likely to screen positive for impulsivity and dissocial personality disorder. Multivariate analyses found no significant association between TBI frequency or severity and custody/community group membership.Conclusions: High reported rates of TBI in prisoner populations may reflect the excess of socio-demographic risk factors for TBI. Results of the current study do not support a role for TBI as causally related to criminal conduct.