The incidence of traumatic brain injury in Tehran, Iran (original) (raw)
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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
The incidence of traumatic brain injury in Tehran, Iran: a population based study
The American surgeon, 2011
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Cureus, 2021
The objectives of this study are to explore the most common causes, patterns, and severities of head traumas, to evaluate the outcomes of traumatic head injury (TBI) patients followed in the clinic, and to calculate the prevalence of admitted cases. Methods In our retrospective cohort study, we included all the cases of adults above 18 years old diagnosed with head traumas (171 patients). The inclusion criteria were patients who presented to the emergency department at National Guard Health Affairs (NGHA), Jeddah, Saudi Arabia from 2016 to 2020. Patients were categorized according to their Glasgow Coma Scale (GCS) score upon admission. Results Of the 171 patients in this study, 151 (88.3%) were males and 20 (11.7%) were females. The median age of our patients was 31 years. Most of the cases had no medical illnesses 124 (72.5%). The most common mechanism of injury was motor vehicle accidents (MVAs) in the majority of our cases (105, 61.4%), followed by falls from heights (34, 19.9%). The commonest computed tomography (CT) finding was subdural hematoma (47, 27.4%). The majority of the associated injuries were thoracic cases (43, 25.1%), followed by spinal (40, 23.4%). Most of the patients were admitted to NGHA (120, 70.2%), while the rest (51, 29.8%) were transferred from other hospitals. Of the total of 171 patients, 134 (78.4%) were treated conservatively. There were no associations between mortality nor length of stay and patients' demographics, except for GCS on admission showed a significant p-value (<0.005). Conclusion In this study, it was found that the most common causes of TBI are MVAs followed by falls from heights. Therefore, preventive measures such as traffic safety rules need to be addressed.
Epidemiology of Traumatic Brain Injury in Iran: A Systematic Review and Meta-Analysis
Iranian Journal of Public Health
Background: Traumatic brain injury (TBI) is one of leading cause of death and disability in Iran that has serious consequences on people’s health. Understanding of epidemiology of TBI can be helpful for policy making in health care management. Therefore, this study aimed to examine the epidemiology of TBI in Iran. Methods: PubMed, Web of Science, Scopus, Google scholar, and internal databases including, SID, Magiran, and IranMedex were searched to identify the relevant published studies up to Feb 2022. Moreover, the references list of key studies was scanned to find more records. The Joanna Briggs Institute (JBI) tool was used to assess the quality of included studies. The Excel and Comprehensive Meta-Analysis software were to analyze the data. Results: Overall, 23,446 patients from 15 studies were included in the study. The overall mean age of the patients was 31.36 ± 0.13 yr (95%CI: 31.10 to 31.61). The majority of the patients were male (74.37%), with a male to female ratio of 3:...
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.
Adaptation of Traumatic Brain Injury Guideline in Iran
Trauma Monthly, 2016
Context: The National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country. Evidence Acquisition: The guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed. Results: The following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge. Conclusions: The evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.
Adaptation of Traumatic Brain Injury Guidelines in Iran
Trauma monthly, 2016
Context: The National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country. Evidence Acquisition: The guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed. Results: The following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge. Conclusions: The evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.
Characteristics of Traumatic Brain Injury among Accident and Falling Down Cases
Acta medica Iranica, 2015
Motor vehicle and falling down are responsible for the most number of traumatic injuries. This study aimed to compare the characteristics of traumatic brain injury among accident and falling down cases. In this analytical cross-sectional study, data were collected from the records of cadavers who died due to accident or falling down and referred to Kahrizak dissection hall, Tehran forensic medicine organization during 2013. A total of 237 subjects (183 (77.2%) accident and 54 (22.8%) falling down) with a mean age of 35.62 (SD=15.75) were evaluated. A number of 213 (89.9%) were male. From accident group, scalp injury was seen in 146 (79.8%), scalp abrasion in 122 (66.7%), scalp laceration in 104 (56.8%), sub skull bruising in 176 (96.3%), skull fracture in 119 (65%), hemorrhage in 166 (90.7%), Subdural hemorrhage (SDH) in 155 (84.7%), Subarachnoid hemorrhage (SAH) in 161 (88%), Epidural hemorrhage (EDH) in 41 (22.4%), contusion in 140 (76.5%), and skull base fracture in 140 (76.5%) o...
Severe Traumatic Brain Injury in a High-Income Country: An Epidemiological Study
Journal of Neurotrauma, 2013
This adult cohort determined the incidence and patients' short-term outcomes of severe traumatic brain injury (sTBI) in Switzerland and age-related differences. A prospective cohort study with a follow-up at 14 days was performed. Patients ‡ 16 years of age sustaining sTBI and admitted to 1 of 11 trauma centers were included. sTBI was defined by an Abbreviated Injury Scale of the head (HAIS) score > 3. The centers participated from 6 months to 3 years. The results are presented as percentages, medians, and interquartile ranges (IQRs). Subgroup analyses were performed for patients £ 65 years (younger) and > 65 (elderly). sTBI 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 Glasgow Coma Score (GCS) on the 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 included the following: 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 among subgroups. Estimated incidence of sTBI in Switzerland was low, age was high, and mortality considerable. The elderly had higher initial GCS and a higher death rate, but high GCS at 14 days.
Repetitive Traumatic Brain Injury in Patients From Kashan, Iran
Trauma Monthly, 2016
Background: Traumatic brain injury (TBI) is a worldwide problem, especially in countries with high incidence of road traffic accidents such as Iran. Patients with a single occurrence of TBI have been shown to be at increased risk to sustain future TBI. Objectives: The aim of this study was to present the incidence and characteristics of repeated TBI (RTBI) in Iranian patients. Patients and Methods: During one year, all admitted TBI patients with prior TBI history were enrolled into the study. In each patient, data such as age, gender, past medical history, injury cause, anatomic site of injury, TBI severity, clinical findings and CT scan findings were collected. Results: RTBI comprised 2.5% of TBI cases (41 of 1629). The incidence of RTBI per 100,000 individuals per years was 9.7. The main cause of RTBI was road traffic accident (68.3%); 9.7 % of cases had preexisting seizure/epilepsy disorder; 36.6% of patients with RTBI had pervious ICU admission due to severe TBI. Ten patients had Glasgow coma scale (GCS) ≤ 13 (24.4%). Seizure was seen in seven patients (17.1%). Thirty-nine percent of patients with RTBI had associated injuries. Eleven patients had abnormal CT scan findings (26.9%). Conclusions: Considering the high incidence of trauma in developing countries, RTBI may also be more common compared with that of developed countries. This mandates a newer approach to preventive strategies, particularly in those with a previous experience of head injury.