Severity, Causes and Outcomes of Traumatic Brain Injuries Occurring at Different Locations: Implications for Prevention and Public Health

Abstract

SUMMARYAim: Traumatic brain injuries (TBI) are a major public health problem. Although they are well studied, information on some aspects, such as the place of occurrence, is limited. The aim of this study was to describe the patterns of severity, causes and outcomes of TBI occurring at different locations and to identify the primary populations at risk of suffering TBI at each of the analysed locations.Methods: 1,818 patients with TBI admitted to hospitals in Austria, Slovakia, Croatia, Bosnia, and Macedonia were analysed. Primary populations at risk, injury severity and extent along with short/long-term outcomes were analysed for TBI at each location.Results: The highest mean age (57.9 years, p < 0.001) was observed in injuries at home. The distribution of injury causes across the group was significantly different (p < 0.001), with falls (39%) and traffic accidents (30%) being predominant. TBI occurring on roads or highways were the most severe (mean ISS = 32.5, p < 0.001; mean GCS = 7.8, p < 0.001). Injuries at home had the worst outcome (50% mortality, p < 0.001 and 70% unfavourable outcome, p < 0.001) whereas TBI at sport facilities or outdoors had the best outcome (24% mortality, 44% unfavourable outcome). When adjusted for age and severity, TBI occurring at home had the highest odds of mortality (OR = 3.12, 95% CI = 1.86-5.25) and unfavourable outcome (OR = 2.51, 95% CI = 1.54-4.08), compared to sports facility and outdoors as a reference.Conclusions: TBI at different locations display distinctive patterns as to causes, severity, outcome and populations at risk. Location is therefore a relevant epidemiological aspect of TBI and we advocate its inclusion in future studies. Definitions of primary populations at risk at different locations could help in targeted public health actions.

Characteristics and outcome of severe traumatic brain injuries based on occupational status

“…Previous studies have shown that the context of the injury such as mechanism [ 20 ], place of occurrence of the injury [ 21 ], age group or social group [ 22 ] shows distinctive patterns as to severity, extent and overall outcome of TBI. In a similar manner we hypothesized that TBI will display distinctive patterns of cause, occurrence and outcome based on SES.…”

Relationship between Self-Esteem and Self-Consciousness in Adolescents: An Eye-Tracking Study

“…Recent longitudinal studies have also demonstrated that sustained or worsening disordered behaviors and low self-esteem in adolescents are precursors of depressive symptoms [47,48]. It should be noted that depression in adolescence has been associated with negative attributional style, limited interpersonal relationships, increased likelihood of social isolation, and overall maladjustment as well as low self-esteem [49-51]. In addition, lower self-esteem and negative emotions in adolescents sequentially mediate the relationship between body dissatisfaction and disordered eating [52].…”

Interrater Reliability of Three Versions of the Chedoke Arm and Hand Activity Inventory

“…1,5,6 The variability of the diagnosis is a result of differing inclusion criteria and definitions of what constitutes an ABI or TBI. 7 ABI is often associated with comorbidities-for example, estimates indicate that as many as 70% of individuals have sustained concomitant injuries. 4,8 Regardless of whether an ABI is caused by traumatic or non-traumatic events, the clinical course is similar.…”