TY  - JOUR
PY  - 2013//
TI  - Severe traumatic brain injury in a high-income country: An epidemiological study
JO  - Journal of neurotrauma
A1  - Walder, Bernhard
A1  - Haller, Guy
A1  - Rebetez, Marie My Lien
A1  - Delhumeau, Cécile
A1  - Bottequin, Ezra
A1  - Haller, Chiara Simone
A1  - Schoettker, Patrick
A1  - Brodmann, Monika
A1  - Stover, John
A1  - Zuercher, Mathias
A1  - Haller, Alois
A1  - Waeckerlin, Adrian
A1  - Haberthür, Christoph
A1  - Fandino, Javier
A1  - Osterwalder, Joseph
A1  - Patrick, Ravussion
SP  - 1934
EP  - 1942
VL  - 30
IS  - 23
N2  - 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.<p />  <p>Language: en</p>
LA  - en
SN  - 0897-7151
UR  - http://dx.doi.org/10.1089/neu.2013.2955
ID  - ref1
ER  -