Traumatic Brain Injury as a Risk Factor for Stroke (original) (raw)
Related papers
Predictive Factors and the Role of Traumatic Brain Injury in Stroke
2018
Background: Traumatic brain injury (TBI) is the leading cause of mortality and invalidity worldwide. Objective: To explore whether traumatic brain injury may be a risk factor for subsequent stroke and to evaluate the role of other risk factors correlated with TBI and stroke. Methods: We analysed 643 patients presented in the emergency department of Trauma UHC, from 1 st of June 2011-1 st of December 2011. We evaluated the following factors: age, gender, and severity of head trauma, type of head trauma, systemic hypertension, atrial fibrillation, and diabetes mellitus. Results: During 1-year of follow upperiod 32 (4.97%) strokes occurred in TBI patients. The evaluation was done in correlation with the other risk factors taken into account in the study. conclusions: The role of TBI is underestimated in the evaluation of stroke. This study demonstrated that during the first year after TBI, 13.53 % of patients experienced stroke. After careful statistical correlations with the selected co-morbidities, we found that the diagnosis of stroke was strongly related with TBI.
Risk and Mortality of Traumatic Brain Injury in Stroke Patients
Journal of Head Trauma Rehabilitation, 2014
Objective: Patients with stroke had higher incidence of falls and hip fractures. However, the risk of traumatic brain injury (TBI) and post-TBI mortality in patients with stroke was not well defined. Our study is to investigate the risk of TBI and post-TBI mortality in patients with stroke. Methods: Using reimbursement claims from Taiwan's National Health Insurance Research Database, we conducted a retrospective cohort study of 7622 patients with stroke and 30 488 participants without stroke aged 20 years and older as reference group. Data were collected on newly developed TBI after stroke with 5 to 8 years' follow-up during 2000 to 2008. Another nested cohort study including 7034 hospitalized patients with TBI was also conducted to analyze the contribution of stroke to post-TBI in-hospital mortality. Results: Compared with the nonstroke cohort, the adjusted hazard ratio of TBI risk among patients with stroke was 2.80 (95% confidence interval = 2.58-3.04) during the follow-up period. Patients with stroke had higher mortality after TBI than those without stroke (10.2% vs 3.2%, P < .0001) with an adjusted relative risk (RR) of 1.46 (95% confidence interval = 1.15-1.84). Recurrent stroke (RR = 1.60), hemorrhagic stroke (RR = 1.68), high medical expenditure for stroke (RR = 1.80), epilepsy (RR = 1.79), neurosurgery (RR = 1.94), and hip fracture (RR = 2.11) were all associated with significantly higher post-TBI mortality among patients with stroke. Conclusions: Patients with stroke have an increased risk of TBI and in-hospital mortality after TBI. Various characteristics of stroke severity were all associated with higher post-TBI mortality. Special attention is needed to prevent TBI among these populations.
Journal of Neurological Surgery Part A: Central European Neurosurgery, 2015
Background: The vast majority of hospital admitted patients with traumatic brain injury (TBI) will have intracranial injury identified by neuroimaging, requiring qualified staff and hospital beds. Moreover, increased pressure in health care services is expected because of an aging population. Thus, a regular evaluation of characteristics of hospital admitted patients with TBI is needed. Oslo TBI Registry-Neurosurgery prospectively register all patients with TBI identified by neuroimaging admitted to a trauma center for southeast part of Norway. The purpose of this study is to describe this patient population with respect to case load, time of admission, age, comorbidity, injury mechanism, injury characteristics, length of stay, and 30-days survival. Methods: Data for 5 years was extracted from Oslo TBI Registry-Neurosurgery. Case load, time of admission, age, sex, comorbidity, injury mechanism, injury characteristics, length of stay, and 30-days survival was compiled and compared. Results: From January 1st, 2015 to December 31st, 2019, 2153 consecutive patients with TBI identified by neuroimaging were registered. The admission rate of TBI of all severities has been stable year-round since 2015. Mean age was 52 years (standard deviation 25, range 0-99), and 68% were males. Comorbidities were common; 28% with pre-injury ASA score of ≥3 and 25% used antithrombotic medication. The dominating cause of injury in all ages was falls (55%) but increased with age. Upon admission, the head injury was classified as mild TBI in 46%, moderate in 28%, and severe (Glasgow coma score ≤ 8) in 26%. Case load was stable without seasonal variation. Majority of patients (68%) were admitted during evening, night or weekend. 68% was admitted to intensive care unit. Length of hospital stay was 4 days (median, interquartile range 3-9). 30-day survival for mild, moderate and severe TBI was 98, 94 and 69%, respectively. Conclusions: The typical TBI patients admitted to hospital with abnormal neuroimaging were aged 50-79 years, often with significant comorbidity, and admitted outside ordinary working hours. This suggests the necessity for allhour presence of competent health care professionals.
A Retrospective Study of Traumatic Brain Injuries at a Tertiary Care Hospital in AP
IOSR Journals , 2019
Introduction: Traumatic brain injury (TBI) is one of the most devastating types of injury. It affects all ages; however majority of road traffic injuries (RTI) occurs in young adults of productive age group. As per report by the ministry of road transport, Government of India (2007) 1.4 lakhs road accident happened in 2007 with 40,612 people killed and 1.5 lakhs people injured. Hence, India is leading the world in fatalities due to road accidents. TBI is also associated with significant socioeconomic losses in India as well as in other developing countries. Materials and Methods: The prospective study was conducted over a period of 24 months from July 2016 to June 2018 in Department of Neurosurgery, Kurnool medical College and Govt general hospital, Kurnool, AP. A total of 1378 patients presenting with head injury to our major trauma referral center were included in the study. All patients were subjected to detailed primary head-to-toe clinical survey to rule out involvement of other organ systems, following initial stabilization. During the post-resuscitative period an accurate history was taken from the family and/or eyewitnesses along with meticulous neurological and systemic examination including Glasgow Coma Score (GCS). This was followed by neuroimaging along with imaging of other relevant systems. Results: Over the two-year study period, 1378 patients were includedin the study. Out of which 1057 (76.7%) were males and 321(23.3%) were females. The mean age at presentation was 29.2 years (3 months-72 years). The most common age groupwas 21-30 years with 470 (34.1%) patients, followed by 331(24.02%) patients between 31-40 years (Table I).Majority (58.3% n=803) of patients arrived at the A & Edepartment between 2-6 hours following trauma. Only 17.2%(n=237) patients were brought at the A & E within 2 hourswhile 338 (24.5%) patients reached A & E more than 6 hoursafter injury. Conclusion: By improving our system with better reporting and documentation of cases, we will be able to make a better plan to decrease the incidence of TBI and their timely appropriate multimodality approaches to achieve better outcome of these cases within our limited resources.
Hospital Practices and Research, 2021
Background: Traumatic brain injury (TBI) is the damage to brain tissue and disruption of the brain function caused by an external mechanical force as evidenced by documented medical records. Objectives: The study aimed to estimate the prevalence of TBI through age-groups, severity, and mechanism of TBI. Methods: This cross-sectional study contained all TBI patients who were admitted at the main level one trauma center hospital located in southeastern Iran. Results: The number of reported patients was 445 young and old adults with TBI. In total, the mean age of the patients was 32.35 ranging from 17 to >80 years. Of the studied patients 361 (81.1%) were male and 84 (18.9%) were women. The most common principal severity of TBI among patients aged 20–29 years was moderate. This corresponds with the age groups that are known to be at higher risk for three levels of TBI. Car accident multiple trauma and head trauma show severity of TBI in both genders. Conclusion: The research findings determined the lack of ignoring the traffic control system in southeastern Iran that was the main cause of the injury; consequently, the focus of all essentials in traffic management should be considered for this problem. It must be noted that the incidence of TBI is necessary as there remains no cure for mild-to-severe TBI. As the evidence for effectiveness and specific treatment is limited, it must be subjected to demanding research. Keywords: Traumatic Brain Injuries, Trauma Center, Epidemiology, Injury Characteristics
Characteristics and clinical outcome of traumatic brain injury in Lombok, Indonesia
Interdisciplinary Neurosurgery, 2019
Background: Traumatic brain injury (TBI) has risen sharply, mainly due to increased use of motorized vehicles in countries with low and middle income. Traffic accidents are the main cause of TBI (60%) followed by falls (20%-25%) and violence (10%). Computed tomography (CT) is recommended for initial assessment in emergency services. Not only provides information and diagnosis to identify surgical needs, but also helps in evaluating patients and outcomes. Method: A retrospective study conducted using medical record data of neurosurgery patients who met the inclusion criteria in West Nusa Tenggara General Hospital in 2015 until 2017. The sample size is determined by consecutive sampling method. Result: Sample size was 209 patients. Male patients more common than female (78.95%). The highest age group at 21-30 years (21.53%) with average age was 31.66 years old. The initial median GCS was 10 points. The most common cause was motor vehicle accidents (MVA) with 176 cases (84.21%). The highest mortality rate was found in the severe brain injury group with 31 patients (14.83%). Average duration of treatment were 7.58 days. Conclusion: There was a significant relationship between age, initial GCS value, mortality rate, and length of stay for TBI patients with outcome predictions based on CT Marshall classification.
Romanian Journal of Morphology and Embryology, 2020
Deaths caused by traumatic brain injury (TBI) increase in incidence every year worldwidely, mainly in developing countries. Thus, World Health Organization (WHO) estimates that in 2020, TBI will become the third main cause of death. In our study, we evaluated the deaths caused by TBI recorded within the Institute of Forensic Medicine of Craiova, Romania, between 2011 and 2017. Therefore, according to age, the cases were divided into two groups: people aged 0-18 years old (including 18 years old) and people aged over 18 years old (a total of 1005 cases, of which 971 were adults and 34 included in the age group 0-18 years old). In both groups, most patients were males from the rural area. In adults, falling was the main legal entity of the cases, followed by car accidents (which were the most common in children). In both groups, in car accidents, most of them were pedestrians and car occupants. Various aggressions (human, animal, self-injury) were found in 94 (9.68%) of the adult cases and in four (11.76%) cases of children. Another parameter under study was the blood alcohol concentration, being observed that most of the subjects with positive blood alcohol content died from car accidents. By evaluating the Glasgow Coma Scale (GCS) score as a prognostic factor, most of the subjects presented third and fourth degree coma at admission; still, 5.14% of the adult patients who deceased had GCS score 15 at admission, death occurring probably by developing some intracranial hematomas in time. Regarding the morphology of the lesions, most patients presented various forms of cranial fractures, 185 (19.05%) adults in association with extradural hemorrhages/hematomas, but also there were four cases with extradural hematomas without any cranial fractures. In children, there was highlighted a single case of extradural hemorrhage under the fracture line. Seventy-eight percent of the adults and 44.12% of children presented subdural hematomas associated with other meningo-cerebral lesions. Also, 83.63% of the adults and 97% of children presented brain contusions. In both groups, brain laceration was observed in approximately 50% of the cases.
An Epidemiologic Study of Traumatic Brain Injuries in Emergency Department
SBMU publishing, 2015
Introduction: Traumatic brain injuries (TBI) are one of the most important causes of death in patients under the age of 25 years and is responsible for one third of total deaths caused by trauma. Therefore, knowing its epidemiologic pattern in different populations seems vital. Therefore, this study aims to examine the epidemiologic pattern of TBI in emergency department. Methods: In this cross-sectional study, the profiles of 1000 patients affected by TBI were selected using simple random sampling. The examined variables in this study included demographic, season, mechanism of injury, accompanying injuries, level of consciousness, hospitalization duration, computed tomography (CT) scan results, needing surgery, admission to intensive care unit, and outcome of the patient. In the end, independent risk factors for the death of patients were determined. Results: 1000 patients suffering from were studied (81.8% male; mean age 38.5±21.7 years). The frequency of their referral to hospital in spring (31.4%) was more (p<0.01). 45.9% of the patients had a level of consciousness less than 9 based on the Glasgow Coma Scale (GCS). Subdural (45.9%) and epidural bleeding (23.7%) were the most common findings in CT scans in this study (p<0.001). Finally, 233 (23.3%) of the patients were dead. Over 60 years of age, falling and motorcycle accidents, intracranial hemorrhage accompanied by brain contusion, subdural bleeding, a GCS of less than 9, and the need to be admitted to intensive care unit were independent risk factors of death in TBI. Conclusion: Age Over 60 years, falling and motorcycle accidents, intracranial hemorrhage accompanied by brain contusion, subdural bleeding, a GCS of less than 9, and need to be admitted to intensive care unit were independent risk factors for the death in TBI patients.
Pattern of Traumatic Brain Injury at King Abdulaziz University Hospital
مجلة جامعة الملك عبدالعزيز-العلوم الطبية
Traumatic brain injury is a common problem in society leading to morbidity and mortality. This study describes pattern of traumatic brain injury at King Abdulaziz University Hospital, and identify the demographic and clinical factors affected in the survivors' hospital length of stay. A retrospective study performed in January 2003 till January 2009. The incidence of traumatic brain injury requiring admission in relation to annual emergency room is 75/100,000 patients; mean age is 9.5 ± 4 years with ~81% of injuries occurring at < 30 years. Severe traumatic brain injury accounts for 15.1% of cases, whereas moderate traumatic brain injury accounts for 10.4% and mild traumatic brain injury accounts for 74.5%. Mechanisms of injuries: 46.5%, falling from a height, 26.7% motor vehicle collisions, 10.4% pedestrian-vehicle collisions and 10.4% assault victims. Factors affecting the hospital length of stay: Admission Glasgow Coma Scale (p < 0.001), loss of consciousness p < 0.001, presence of motor weakness p < 0.001, female gender p < 0.03, patients' age p < 0.001 and the nationality p < 0.001. Characteristics of traumatic brain injury: Young age, the mechanism of injury (mainly falls) and type of injury (mainly concussion). Tentatively, the patients' length of stay is predicted on the demographic and clinical data.