The burden of traumatic brain injury from low-energy falls among patients from 18 countries in the CENTER-TBI Registry

Autor: Lecky F. E., Otesile O., Marincowitz C., Majdan M., Nieboer D., Lingsma H. F., Maegele M., Citerio G., Stocchetti N., Steyerberg E. W., Menon D. K., Maas A. I. R., Akerlund C., Amrein K., Andelic N., Andreassen L., Anke A., Antoni A., Audibert G., Azouvi P., Azzolini M. L., Bartels R., Barzo P., Beauvais R., Beer R., Bellander B. -M., Belli A., Benali H., Berardino M., Beretta L., Blaabjerg M., Bragge P., Brazinova A., Brinck V., Brooker J., Brorsson C., Buki A., Bullinger M., Cabeleira M., Caccioppola A., Calappi E., Calvi M. R., Cameron P., Lozano G. C., Carbonara M., Cavallo S., Chevallard G., Chieregato A., Clusmann H., Coburn M., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Dark P., Dawes H., de Keyser V., Degos V., Corte F. D., den Boogert H., Depreitere B., Dilvesi D., Dixit A., Donoghue E., Dreier J., Duliere G. -L., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Foks K., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gantner D., Gao G., George P., Ghuysen A., Giga L., Glocker B., Golubovic J., Gomez P. A., Gratz J., Gravesteijn B., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Haitsma I., Helbok R., Helseth E., Horton L., Huijben J., Hutchinson P. J., Jacobs B., Jankowski S., Jarrett M., Jiang J. -Y., Johnson F., Jones K., Karan M., Kolias A. G., Kompanje E., Kondziella D., Kornaropoulos E., Koskinen L. -O., Kovacs N., Kowark A., Lagares A., Lanyon L., Laureys S., Ledoux D., Lefering R., Legrand V., Lejeune A., Levi L., Lightfoot R., Castano-Leon A. M., Manara A., Manley G., Martino C., Marechal H., Mattern J., McMahon C., Melegh B., Menovsky T., Mikolic A., Misset B., Muraleedharan V., Murray L., Negru A., Nelson D., Newcombe V., Nyiradi J., Ore-Sic M., Ortolano F., Palotie A., Parizel P. M., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Piippo-Karjalainen A., Pirinen M., Ples H., Polinder S., Pomposo I., Posti J. P., Puybasset L., Radoi A., Ragauskas A., Raj R., Rambadagalla M., Rhodes J., Richardson S., Richter S., Ripatti S., Rocka S., Roe C., Roise O., Rosand J., Rosenfeld J. V., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rueckert D., Rusnak M., Sahuquillo J., Sakowitz O., Sanchez-Porras R., Sandor J., Schafer N., Schmidt S., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Sewalt C., Skandsen T., Smielewski P., Sorinola A., Stamatakis E., Stanworth S., Stevens R., Stewart W., Sundstrom N., Takala R., Tamas V., Tamosuitis T., Taylor M. S., Ao B. T., Tenovuo O., Theadom A., Thomas M., Tibboel D., Timmers M., Tolias C., Trapani T., Tudora C. M., Unterberg A., Vajkoczy P., Vallance S., Valeinis E., Vamos Z., van der Jagt M., van der Steen G., van der Naalt J., van Dijck J. T. J. M., van Essen T. A., van Hecke W., van Heugten C., van Praag D., Vyvere T. V., van Wijk R. P. J., Vargiolu A., Vega E., Velt K., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Volovici V., von Steinbuchel N., Voormolen D., Vulekovic P., Wang K. K. W., Wiegers E., Williams G., Wilson L., Winzeck S., Wolf S., Yang Z., Ylen P., Younsi A., Zeiler F. A., Zelinkova V., Ziverte A., Zoerle T.
Přispěvatelé: Molecular Neuroscience and Ageing Research (MOLAR), Lecky, Fiona E [0000-0001-6806-0921], Otesile, Olubukola [0000-0002-3374-0932], Marincowitz, Carl [0000-0003-3043-7564], Majdan, Marek [0000-0001-8037-742X], Nieboer, Daan [0000-0002-4403-6537], Lingsma, Hester F [0000-0003-2063-9533], Citerio, Giuseppe [0000-0002-5374-3161], Stocchetti, Nino [0000-0003-3250-6834], Steyerberg, Ewout W [0000-0002-7787-0122], Menon, David K [0000-0002-3228-9692], Maas, Andrew IR [0000-0003-1612-1264], Apollo - University of Cambridge Repository, Ragauskas, Arminas, Rocka, Saulius, Tamosuitis, Tomas, Vilcinis, Rimantas, Ročka, Saulius, Tamošuitis, Tomas, Maas, Andrew I R [0000-0003-1612-1264], Lecky, Fiona E. [0000-0001-6806-0921], Lingsma, Hester F. [0000-0003-2063-9533], Steyerberg, Ewout W. [0000-0002-7787-0122], Menon, David K. [0000-0002-3228-9692], Maas, Andrew I. R. [0000-0003-1612-1264], Lecky, F. E., Otesile, O., Marincowitz, C., Majdan, M., Nieboer, D., Lingsma, H. F., Maegele, M., Citerio, G., Stocchetti, N., Steyerberg, E. W., Menon, D. K., Maas, A. I. R., Akerlund, C., Amrein, K., Andelic, N., Andreassen, L., Anke, A., Antoni, A., Audibert, G., Azouvi, P., Azzolini, M. L., Bartels, R., Barzo, P., Beauvais, R., Beer, R., Bellander, B. -M., Belli, A., Benali, H., Berardino, M., Beretta, L., Blaabjerg, M., Bragge, P., Brazinova, A., Brinck, V., Brooker, J., Brorsson, C., Buki, A., Bullinger, M., Cabeleira, M., Caccioppola, A., Calappi, E., Calvi, M. R., Cameron, P., Lozano, G. C., Carbonara, M., Cavallo, S., Chevallard, G., Chieregato, A., Clusmann, H., Coburn, M., Coles, J., Cooper, J. D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Dark, P., Dawes, H., de Keyser, V., Degos, V., Corte, F. D., den Boogert, H., Depreitere, B., Dilvesi, D., Dixit, A., Donoghue, E., Dreier, J., Duliere, G. -L., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V. L., Foks, K., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gantner, D., Gao, G., George, P., Ghuysen, A., Giga, L., Glocker, B., Golubovic, J., Gomez, P. A., Gratz, J., Gravesteijn, B., Grossi, F., Gruen, R. L., Gupta, D., Haagsma, J. A., Haitsma, I., Helbok, R., Helseth, E., Horton, L., Huijben, J., Hutchinson, P. J., Jacobs, B., Jankowski, S., Jarrett, M., Jiang, J. -Y., Johnson, F., Jones, K., Karan, M., Kolias, A. G., Kompanje, E., Kondziella, D., Kornaropoulos, E., Koskinen, L. -O., Kovacs, N., Kowark, A., Lagares, A., Lanyon, L., Laureys, S., Ledoux, D., Lefering, R., Legrand, V., Lejeune, A., Levi, L., Lightfoot, R., Castano-Leon, A. M., Manara, A., Manley, G., Martino, C., Marechal, H., Mattern, J., Mcmahon, C., Melegh, B., Menovsky, T., Mikolic, A., Misset, B., Muraleedharan, V., Murray, L., Negru, A., Nelson, D., Newcombe, V., Nyiradi, J., Ore-Sic, M., Ortolano, F., Palotie, A., Parizel, P. M., Payen, J. -F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Piippo-Karjalainen, A., Pirinen, M., Ples, H., Polinder, S., Pomposo, I., Posti, J. P., Puybasset, L., Radoi, A., Ragauskas, A., Raj, R., Rambadagalla, M., Rhodes, J., Richardson, S., Richter, S., Ripatti, S., Rocka, S., Roe, C., Roise, O., Rosand, J., Rosenfeld, J. V., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rueckert, D., Rusnak, M., Sahuquillo, J., Sakowitz, O., Sanchez-Porras, R., Sandor, J., Schafer, N., Schmidt, S., Schoechl, H., Schoonman, G., Schou, R. F., Schwendenwein, E., Sewalt, C., Skandsen, T., Smielewski, P., Sorinola, A., Stamatakis, E., Stanworth, S., Stevens, R., Stewart, W., Sundstrom, N., Takala, R., Tamas, V., Tamosuitis, T., Taylor, M. S., Ao, B. T., Tenovuo, O., Theadom, A., Thomas, M., Tibboel, D., Timmers, M., Tolias, C., Trapani, T., Tudora, C. M., Unterberg, A., Vajkoczy, P., Vallance, S., Valeinis, E., Vamos, Z., van der Jagt, M., van der Steen, G., van der Naalt, J., van Dijck, J. T. J. M., van Essen, T. A., van Hecke, W., van Heugten, C., van Praag, D., Vyvere, T. V., van Wijk, R. P. J., Vargiolu, A., Vega, E., Velt, K., Verheyden, J., Vespa, P. M., Vik, A., Vilcinis, R., Volovici, V., von Steinbuchel, N., Voormolen, D., Vulekovic, P., Wang, K. K. W., Wiegers, E., Williams, G., Wilson, L., Winzeck, S., Wolf, S., Yang, Z., Ylen, P., Younsi, A., Zeiler, F. A., Zelinkova, V., Ziverte, A., Zoerle, T., Public Health, Neurology, Neurosurgery, Intensive Care, Pediatric Surgery, Lecky, F, Otesile, O, Marincowitz, C, Majdan, M, Nieboer, D, Lingsma, H, Maegele, M, Citerio, G, Stocchetti, N, Steyerberg, E, Menon, D, Maas, A
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Critical Care and Emergency Medicine
Traumatic Brain Injury
Epidemiology
Comorbidity
Traumatic/diagnostic imaging
Diagnostic Radiology
Risk Factors
Acute care
Brain Injuries
Traumatic
80 and over
Prevalence
Public and Occupational Health
Brain Damage
Hospital Mortality
Registries
Israel
Tomography
Trauma Medicine
Aged
80 and over
low-energy falls
Emergency Service
Radiology and Imaging
Physics
Traumatic Injury Risk Factors
General Medicine
Middle Aged
Prognosis
Hospitals
X-Ray Computed
Europe
Physical sciences
Hospitalization
Neurology
Cohort
Platelet aggregation inhibitor
Medicine
Falls
Female
Emergency Service
Hospital
Traumatic Injury
Cohort study
Research Article
Adult
medicine.medical_specialty
Adolescent
Traumatic brain injury
Imaging Techniques
Death Rates
FOS: Physical sciences
Neuroimaging
Risk Assessment
Europe/epidemiology
Hospital
Young Adult
Population Metrics
SDG 3 - Good Health and Well-being
Diagnostic Medicine
Internal medicine
medicine
Humans
Disease burden
Israel/epidemiology
Aged
Medicine and health sciences
Population Biology
Biology and life sciences
business.industry
Emergency department
medicine.disease
Triage
Computed Axial Tomography
Health Care
Research and analysis methods
Brain Injuries
Traumatic/diagnostic imaging
Energy Transfer
Health Care Facilities
Medical Risk Factors
Brain Injuries
Accidental Falls
Human medicine
business
Tomography
X-Ray Computed
Neurotrauma
Neuroscience
Zdroj: PLoS Medicine, Vol 18, Iss 9, p e1003761 (2021)
PLOS MEDICINE, 18(9):e1003761. PUBLIC LIBRARY SCIENCE
PLoS medicine
Centre TBI Investigators 2021, ' The burden of traumatic brain injury from low-energy falls among patients from 18 countries in the CENTER-TBI Registry: A comparative cohort study ', PLOS Medicine, vol. 18, no. 9, e1003761 . https://doi.org/10.1371/journal.pmed.1003761
Lecky, F E, Otesile, O, Marincowitz, C, Majdan, M, Nieboer, D, Lingsma, H F, Maegele, M, Citerio, G, Stocchetti, N, Steyerberg, E W, Menon, D K, Maas, A I R & CENTER-TBI investigators and participants 2021, ' The burden of traumatic brain injury from low-energy falls among patients from 18 countries in the CENTER-TBI Registry : A comparative cohort study ', PLoS Medicine, vol. 18, no. 9, e1003761 . https://doi.org/10.1371/journal.pmed.1003761
PLoS Medicine
PLoS Medicine, 18(9). PUBLIC LIBRARY SCIENCE
PLoS Medicine, San Francisco, CA : Public library of science, 2021, vol. 18, iss. 9, art. no. e1003761, p. 1-22
PLoS Medicine, 18(9):e1003761. Public Library of Science
ISSN: 1549-1277
1549-1676
DOI: 10.1371/journal.pmed.1003761
Popis: Funder: ZNS - Hannelore Kohl Stiftung; funder-id: http://dx.doi.org/10.13039/501100007731
Funder: OneMind (USA)
Funder: Integra LifeSciences; funder-id: http://dx.doi.org/10.13039/100009006
Background: Traumatic brain injury (TBI) is an important global public health burden, where those injured by high-energy transfer (e.g., road traffic collisions) are assumed to have more severe injury and are prioritised by emergency medical service trauma triage tools. However recent studies suggest an increasing TBI disease burden in older people injured through low-energy falls. We aimed to assess the prevalence of low-energy falls among patients presenting to hospital with TBI, and to compare their characteristics, care pathways, and outcomes to TBI caused by high-energy trauma. Methods and findings: We conducted a comparative cohort study utilising the CENTER-TBI (Collaborative European NeuroTrauma Effectiveness Research in TBI) Registry, which recorded patient demographics, injury, care pathway, and acute care outcome data in 56 acute trauma receiving hospitals across 18 countries (17 countries in Europe and Israel). Patients presenting with TBI and indications for computed tomography (CT) brain scan between 2014 to 2018 were purposively sampled. The main study outcomes were (i) the prevalence of low-energy falls causing TBI within the overall cohort and (ii) comparisons of TBI patients injured by low-energy falls to TBI patients injured by high-energy transfer—in terms of demographic and injury characteristics, care pathways, and hospital mortality. In total, 22,782 eligible patients were enrolled, and study outcomes were analysed for 21,681 TBI patients with known injury mechanism; 40% (95% CI 39% to 41%) (8,622/21,681) of patients with TBI were injured by low-energy falls. Compared to 13,059 patients injured by high-energy transfer (HE cohort), the those injured through low-energy falls (LE cohort) were older (LE cohort, median 74 [IQR 56 to 84] years, versus HE cohort, median 42 [IQR 25 to 60] years; p < 0.001), more often female (LE cohort, 50% [95% CI 48% to 51%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001), more frequently taking pre-injury anticoagulants or/and platelet aggregation inhibitors (LE cohort, 44% [95% CI 42% to 45%], versus HE cohort, 13% [95% CI 11% to 14%]; p < 0.001), and less often presenting with moderately or severely impaired conscious level (LE cohort, 7.8% [95% CI 5.6% to 9.8%], versus HE cohort, 10% [95% CI 8.7% to 12%]; p < 0.001), but had similar in-hospital mortality (LE cohort, 6.3% [95% CI 4.2% to 8.3%], versus HE cohort, 7.0% [95% CI 5.3% to 8.6%]; p = 0.83). The CT brain scan traumatic abnormality rate was 3% lower in the LE cohort (LE cohort, 29% [95% CI 27% to 31%], versus HE cohort, 32% [95% CI 31% to 34%]; p < 0.001); individuals in the LE cohort were 50% less likely to receive critical care (LE cohort, 12% [95% CI 9.5% to 13%], versus HE cohort, 24% [95% CI 23% to 26%]; p < 0.001) or emergency interventions (LE cohort, 7.5% [95% CI 5.4% to 9.5%], versus HE cohort, 13% [95% CI 12% to 15%]; p < 0.001) than patients injured by high-energy transfer. The purposive sampling strategy and censorship of patient outcomes beyond hospital discharge are the main study limitations. Conclusions: We observed that patients sustaining TBI from low-energy falls are an important component of the TBI disease burden and a distinct demographic cohort; further, our findings suggest that energy transfer may not predict intracranial injury or acute care mortality in patients with TBI presenting to hospital. This suggests that factors beyond energy transfer level may be more relevant to prehospital and emergency department TBI triage in older people. A specific focus to improve prevention and care for patients sustaining TBI from low-energy falls is required.
Databáze: OpenAIRE
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