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Journal Article

Citation

Walder B, Haller G, Rebetez MM, Delhumeau C, Bottequin E, Haller CS, Schoettker P, Brodmann M, Stover J, Zuercher M, Haller A, Waeckerlin A, Haberthür C, Fandino J, Osterwalder J, Patrick R. J. Neurotrauma 2013; 30(23): 1934-1942.

Affiliation

University Hospital of Geneva, Division of Anaesthesiology, Rue Gabrielle-Perret-Gentil 4, Geneva 14, Switzerland, CH-1211 ; Bernhard.Walder@hcuge.ch.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2013.2955

PMID

23822874

Abstract

This adult cohort determined the incidence and patients' short term outcomes of severe traumatic brain injury (TBI) in Switzerland, and age-related differences. A prospective cohort study with a follow-up at 14 days was performed. Patients ≥16 years sustaining severe TBI and admitted to one of 11 trauma centers were included. Severe TBI was defined by Abbreviated Injury Scale of the head (HAIS) >3. The centers participated from ½ to 3 years. The results are presented as percentages, medians, interquartile ranges (IQR). Subgroup analyses were performed for patients ≤65 years (younger) and >65 (elderly). Severe TBI was observed in 921 patients (median age 55 years; IQR 33-71); 683 (74.2%) were male. Females were older [median age 67 years (IQR 42-80)] than males [52 (IQR 31-67), p<0.00001]. The estimated incidence was 10.58 per 100'000 inhabitants per year. Blunt trauma was observed in 879 patients (95.4%) and multiple trauma in 283 (30.7%). Median GCS on scene was 9 (IQR 4-14; 8 in younger, 12 in elderly) and in emergency departments 5 (IQR 3-14; 3 in younger, 8 in elderly). Trauma mechanisms: 484 patients with falls [52.6%; younger: 242 patients (50.0%), elderly: 242 (50.0%)], 291 with road traffic accidents [31.6%; younger: 237 patients (81.4%), elderly: 54 (18.6%)], and 146 with others (15.8%). Mortality was 30.2% (24.5% in younger, 40.9% in elderly). Median GCS at 14 days was 15 (IQR 14-15) without differences amongst subgroups. The estimated incidence of severe TBI in Switzerland was low, the age was high and the mortality considerable. Elderly had higher initial GCS, a higher death rate, but high GCS at 14 days.


Language: en

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