Fatal Traumatic Brain Injury, West Virginia, 1989–1998

Adekoya, Nelson; Majumder, Ranjit K.

doi:10.1016/j.phr.2004.07.006

Cited by 16 publications

(11 citation statements)

References 36 publications

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“…These conditions are the reason why the CFR was higher in less populated areas, and why hospital mortality was lower in cases who lived closer to a hospital admitting TBI cases. A comparable finding was published in a study from the United States [ 6 ]: the CFR tended to decrease with an increase in population density (with the notable exception of the District of Columbia).…”

Section: Discussionsupporting

confidence: 85%

Epidemiology of traumatic brain injury in Austria

Mauritz

Bražinová²,

Majdán³

et al. 2013

Wien Klin Wochenschr

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SummaryBackgroundTraumatic brain injury (TBI) is an important cause of preventable deaths. The goal of this study was to provide data on epidemiology of TBI in Austria.MethodsData on all hospital discharges, outpatients, and extra- as well as in-hospital deaths due to TBI were collected from various sources for the years 2009–2011. Population data (number of male/female people per age-group, population of Austrian cities, towns, and villages) for 2009–2011 were collected from the national statistical office. Incidence, case fatality rate(s) (CFR), and mortality rate(s) (MR) were calculated for the whole population and for age groups.ResultsIncidence (303/100,000/year), CFR (3.6 %), and MR (11/100,000/year) of TBI in Austria are comparable with those from other European countries. We found a high rate of geriatric TBI. The ratio between male and female cases was 1.4:1 for all cases, and was 2.2:1 for fatal cases. The most common mechanism was falls; traffic accidents accounted for only 7 % of the cases. Males died more frequently from traffic accidents and suicides, and females died more frequently from falls. CFRs and MRs increased with increasing age. CFRs were higher in patients from less populated areas, and MRs were lower in cases who lived closer to hospitals that admitted TBI.ConclusionsThe high rate of geriatric TBI warrants better prevention of falls in this age group.

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Section: Discussionsupporting

confidence: 85%

Epidemiology of traumatic brain injury in Austria

Mauritz

Bražinová²,

Majdán³

et al. 2013

Wien Klin Wochenschr

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“…Our findings suggest that systematic differences in care and/or treatment could be contributing to increased mortality in children sustaining TBIs in rural locations. Currently, longer transport times are thought to be associated with the increased risk of injury mortality in rural areas (Adekoya and Majumder 2004 ; Tiesman et al 2007 ). Studies have reported decreased chances of survival with transportation times from injury scene to initial care over 30 min (Grossman et al 1997 ).…”

Section: Discussionmentioning

confidence: 99%

“…Among the few TBI studies that include pediatric populations in the US, injury severity has consistently been reported to be higher in rural compared to urban locations (Reid et al 2001 ; Gabella et al 1997 ; Chapital et al 2007 ). In contrast, studies examining urban/rural differences in pediatric TBI mortality have reported mixed results (Gabella et al 1997 ; Chapital et al 2007 ; Adekoya and Majumder 2004 ). Compared to children in metropolitan locations, children in rural areas had a higher frequency of motor vehicle related mechanisms of injury, which are known to be associated with increased injury severity compared to other mechanisms, potentially helping explain severity and mortality differences across regions (Reid et al 2001 ; Gabella et al 1997 ; Chapital et al 2007 ; Thurman et al 1999 ).…”

Section: Introductionmentioning

confidence: 99%

Urban/Rural disparities in Oregon pediatric traumatic brain injury

Leonhard

Wright

et al. 2015

Inj. Epidemiol.

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BackgroundTraumatic brain injury (TBI) greatly contributes to morbidity and mortality in the pediatric population. We examined potential urban/rural disparities in mortality amongst Oregon pediatric patients with TBI treated in trauma hospitals.MethodsWe conducted a retrospective study of children ages 0–19 using the Oregon Trauma Registry for years 2009–2012. Geographic location of injury was classified using the National Center for Health Statistics Urban/Rural Classification Scheme. Incidence rates were calculated using Census data for denominators. Associations between urban/rural injury location and mortality were assessed using multivariable logistic regression, controlling for potential confounders. Generalized estimating equations were used to help account for clustering of data within hospitals.ResultsOf 2794 pediatric patients with TBI, 46.6 % were injured in large metropolitan locations, 24.8 % in medium/small metropolitan locations, and 28.6 % in non-metropolitan (rural) locations. Children with rural locations of injury had a greater annualized TBI incidence rate, at 107/100,000 children per year, than those from large metropolitan areas (71/100,000 per year). Compared to children injured in urban locations, those in rural locations had more than twice the crude odds of mortality (odds ratio [OR], 2.5; 95 % CI, 1.6–4.0). This association remained significant (OR, 1.8; 95 % CI, 1.04–3.3) while adjusting for age, gender, race, insurance status, injury severity, and type of TBI (blunt vs. penetrating).ConclusionWe observed higher rates of TBI and greater proportions of severe injury in rural compared to urban areas in Oregon. Rural children treated in the trauma system for TBI were more likely to die than urban children after controlling for demographic and injury factors associated with urban/rural residence. Further research is needed to examine treatment disparities by urban/rural location. Future work should also identify interventions that can reduce risk of TBI and TBI-related mortality among children, particularly those who live in rural areas.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-015-0063-2) contains supplementary material, which is available to authorized users.

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“…This may cause differences in the admitted population since TBI related to falls are milder than road traffic related accidents. Except for the UK, assault‐ and violence‐related injuries do not constitute a problem in Europe yet, differently from the USA (Adekoya, 2004). European data on mortality are lower than published data for the US (30/10 5 /year) (Kraus et al., 1984) and much lower than data from South Africa (81/10 5 /year) (Nell and Brown 1991) and Colombia (120/10 5 /year) (Gutierrez et al., 2000).…”

Section: Discussionmentioning

confidence: 99%