Epidemiology of Traumatic Brain Injury

Introduction

Epidemiological data reviews facilitate prevention strategies by identifying key risk factors for traumatic brain injury that contribute to the oldest age groups and other populations with risk groups in the 19th century.

Understanding the overall incidence and severity along with recognizing the mechanism of injury allows us to develop appropriate health care from low-level and emergency medical care to neurological rehabilitation do we thereby determine the training needs of health professionals. It also allows for us to estimate future socioeconomic needs and reduce the burden on society and governments.

Worldwide

Traumatic brain injury is estimated to affect more than 54 to 60 million people each year resulting in hospitalization or death. Of all types of injuries, those affecting the brain are among those most likely to result in death or permanent disability. [1] .

According to the Global Burden of Disease Study 2016 [2], there are 27.08 million new cases of traumatic brain injury with an age-adjusted incidence of 369 per 100000 per year. The age ratio (ASR) is a measure of how many if any population has fixed age structure).

Onset Elapsed 2016 Counts 2016 Age – Standardized Degree (per 100000) Percent Change inage-age-age-age-age-Standardistrates 1990-20162016 Countsss2016 Age Standardized Standards (per 100000 Percentage) Change inage-age-age-age- age inage-age-age-age inage-age-age-age-age-age-age-age-age inage-age-age-global 27082033 3 (3327020291 to 243020291 to 30291 to 30298.110) 8 to 5·5)55495674(53400547 to 57626214)759(731 to 788)8·4(7·7 to 9·2)

Age-standardized incidence rate of traumatic brain injury per 100,000 population, men and women, 2016 [3]

For a detailed breakdown of the incidence and prevalence of traumatic brain injury in 2016 by continent and country, you can access the Global Burden of Traumatic Brain and Spinal Cord Injury Study 2016 here.

The leading causes of traumatic brain injury vary by age, socioeconomic factors, and geographic region, so any planned intervention must take this variability into account. Traumatic brain injury cases nearly triple proportionally in low- and middle-income countries (LMICs) Higher than the high-income countries (HICs) with the highest overall burden in Southeast Asia and the Western Pacific. [4]

Age-related differences in traumatic brain injury showed the highest prevalence in three main age groups:

1. Early childhood (falls are the main cause)
2. Late adolescence/early adulthood (road traffic accidents (RTAs) are the leading cause)
3. Elderly (falls being the main cause)

Child injuries are most likely to occur in the poorest countries, where WHO claims LMICs occur in 98% of cases, five times more frequently than in industrialized countries. [1] Over the past 20 years, the incidence of falls among older adults has increased. Gender differences also present a global trend Except for the 8th and 9th decades of life, the ratio of males worldwide varies from 1.5:1 to 2.5:1.

In recent studies, falls have been identified as the leading cause of traumatic brain injury (attributable trauma increased from 43% to 54% between 2003 and 2012), followed by road traffic accidents (attributable trauma increased from 2003 24% in 2012) [5] Violent sports-related injuries and Work injury.

The leading causes of traumatic brain injury can vary by country’s geographic region of income and political environment (i.e. conflict zones). The proportion of traumatic brain injuries from road traffic crashes was highest in Africa and South-East Asia (both 56%), North America is the lowest (25%), while South America, the Caribbean, and sub-Saharan Africa have the highest rates of violence-related traumatic brain injury in the world.

According to the Chinese study, the rates of traumatic brain injury in rural and urban areas were 9.7 and 6.3 per 100,000, respectively, compared with 172.1 and 97.8 per 100,000 in the U.S. study. [1]

Brain injury is a leading cause of death and disability worldwide, and traumatic brain injury is a leading cause of seizures. However, in recent years we have observed a decline in post-traumatic brain injury mortality.

The case fatality rate (CFR) is determined by the severity and age of the traumatic brain injury as follows:

• General case fatality rate 0.9 to 7.6 per 100 traumatic brain injury patients
• The case fatality rate for severe traumatic brain injury ranges from 29 to 55 per 100 traumatic brain injury patients
• The average death rate was 10.53 per 100,000 people per year, with 68% of those dying before reaching the hospital.

There is a strong link between traumatic brain injury and alcohol consumption. In the United Kingdom, the incidence of head injury among patients with acute poisoning is estimated to be as high as 65%. In Asia, a large number of nocturnal RTAs in Asia are alcohol-related (10-30% depending on country). [1] Alcoholism also presents serious difficulties in the diagnosis of post-traumatic brain injury.

An estimated 80% of people with traumatic brain injury-related injuries live in LMICs, yet at the same time, only 2% of people in these areas have access to rehabilitation services that improve their quality of life. High-income countries have successfully reduced Number of overall TBI and TBI-related injuries after implementation of preventive measures Stricter safety measures Legislative reform Education of the general public Evidence-based guidelines for treating survivors of traumatic brain injury.

United States

Each year, 2 million Americans are treated and discharged from hospital emergency rooms with a traumatic brain injury. An estimated 56,000 people died from traumatic brain injuries, while an estimated 80,000 people were discharged from hospitals with some traumatic brain injuries Brain injury-related impairment that requires assistance with activities of daily living. An estimated 5.3 million Americans are living with traumatic brain injury-related injuries today, costing the country more than $56 billion a year when cost of care and lost income are taken into account.

Most studies show that men are more likely to suffer traumatic brain injuries than women. The age group with the highest incidence of traumatic brain injury was between the ages of 15 and 24, and the risk was also significantly higher for those under the age of 5 or over the age of 75. Between 20 – 30% Older adults who fall suffer moderate to severe injuries, including bruising hip fractures or head trauma.

As a result of the Global War on Terrorism (GWOT), veterans were recognized by the Department of Defense as the largest group of traumatic brain injury survivors in the United States between 2000 and 2017, with 350,000 of them living with a traumatic brain injury. [6] The nature of the current battle The incidence of blast-related traumatic brain injury has increased, with an estimated 15% of all active-duty military personnel serving in Iraq and Afghanistan suffering a traumatic brain injury, recognizing that this figure may be underestimated due to reporting and data collection limitations. underestimated. Improved armor and Emergency medicine programs improve survival rates. Due to the longitudinal nature of the problem, cumulative damage effect symptoms overlap with PTSD with peak socioeconomic problems Occurs within 30-40 years of conflict.

Europe

In the European Union, brain injuries cause 1.5 million hospitalizations and 57,000 deaths each year. The incidence rate was 287 per 100,000 and the mortality rate was 15 per 100,000, with some countries such as the UK reporting significantly higher rates of 453 per 100,000, of which 10.9% were considered to be Moderate to severe. The differences in incidence rates are related to data collection methods rather than actual differences in incidence rates. [7] The most prevalent population includes male urban dwellers and children, most commonly due to RTIs peaking in the late afternoon and early evening. [1]

Leading causes of traumatic brain injury vary by age: falls are the leading cause of traumatic brain injury in people 65 and older; transportation is the leading cause of traumatic brain injury in people younger than 65. Motor vehicle accidents, including motorcycles Cyclists and pedestrians account for 50% of all traumatic brain injuries. According to an epidemiological analysis by Peeters et al. [8], Scandinavian countries reported more fall-related traumatic brain injuries. Estimates indicate that sports-related brain injuries cause nearly 300,000 injuries each year Winter sports like skiing and skating linked to nearly 20,000 brain injuries

Latin America and the Caribbean 

The epidemiology of traumatic brain injury in Latin America and the Caribbean is largely dependent on socioeconomic status, with road traffic injuries (RTI) and violence being the leading causes, with violence-related traumatic brain injury being the leading cause of TBI-related deaths . The incidence is Much higher, about 360 per 100,000 people per year. The highest risk is in men (83%), and the age group with higher incidence is young adults.

Asia

The transition we are witnessing in low- and middle-income countries has created new and multiple risks of traumatic brain injury, including increased motorization and urbanization and increases in non-communicable diseases. Hence, the increasingly traumatic trend Brain injury and resulting disability are similar to those in high-income countries. [9] With inadequate medical care and weak prevention strategies, the socioeconomic burden of traumatic brain injury has been increasing.

According to GBD 2016 [2], the incidence of RTIs falls and violence-related traumatic brain injuries has increased dramatically, with the highest rates in India, China, and other Asian countries. Causes of falls are distributed differently in Asia compared to the rest of the world 77% of traumatic brain injuries are caused by war, but only 3% of traumatic brain injuries are caused by war. However, due to inefficient data collection mechanisms and differences in definition and evaluation protocols, the data need to be treated with caution.

Asian men from LMIC are more vulnerable to traumatic brain injury due to greater exposure to risk factors. According to Raja [10] 75% of traumatic brain injury related admissions in Lahore region were male patients. Similar gender differences observed in Singapore and China 75% of people with severe traumatic brain injury are men.

Regarding age, data from Asia show similar patterns to other regions, with children under 11 years of age at greater risk of traumatic brain injury, with more than 50% of injuries among children aged 4-6 years related to falls, with a higher prevalence among boys.

Traumatic brain injury is a leading cause of mortality and socioeconomic loss in India. Rates of fall-related traumatic brain injury with skull fractures and long-term intracranial injuries are much higher in India than in other countries The rate for Indian males is 50.3 per 100,000 compared to a global average of 13.3 per 100,000.

According to Pauvanachandra and Hyder [9], at any given time, approximately 1 million people in India require rehabilitation from the aftermath of a traumatic brain injury. Traumatic brain injury is the leading cause of traumatic injury and the fifth leading cause of death among young people in China. RTA accounts for 61% of traumatic brain injuries, one-third of motorcyclists, 31% of pedestrians and only 14% of car users.

There is no consistent data collection process in the Middle East and other Asian regions, but some local studies are emerging, such as in Yemen, where the prevalence of traumatic brain injury was 210 per 100,000, with domestic violence and falls being the leading causes, followed by after is regional trade agreements.