Citation

Bloom BM, Newcombe V, Roberts I. Emerg. Med. J. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, BMJ Publishing Group)

DOI

10.1136/emermed-2021-212076

PMID

34815268

Abstract

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide.1 In survivors, disability may persist for years after the initial injury. Even mild TBI can result in cognitive deficits, somatic symptoms (eg, headaches), mental health problems (eg, depression) and an increased risk of dementia.2 3 Accurate estimates of the incidence and prevalence of TBI are needed to inform polices on prevention, resource allocation and to meet the needs of those who have sustained a TBI. A recent Lancet Neurology Commission recommended that defining and recording accurate measurements of incidence, mortality and rates of access hospital care in patients with TBI is essential.1

A recent analysis of the effect of the Scottish Intercollegiate Guidelines Network head injury guideline, National Institute for Health and Care Excellence (NICE) Guideline 176 (Head injury: assessment and early management), a National Institute for Health Research (NIHR) evidence summary, and numerous peer-reviewed articles and web pages all cite an oft-used statistic that '1.4 million people attend emergency departments in England and Wales with a recent head injury each year'.4-6 This number has been reported in the medical literature for more than a quarter of a century and forms the basis of our understanding of the public health burden from TBI.

The source of this statistic for England and Wales is elusive. There is no citation of its origin in the NICE guideline, a common source for contemporary use. An early use is in a 1996 case series of patients with head injury on warfarin.7 This article references a 1976 Department for Health and Social Security report on head injuries which is only available on paper at the National Archives.8 Although this report describes hospital admissions for head injury, it does not include data on ED attendance numbers or rates...

Language: en

Keywords

trauma; head