Monash University, Melbourne, VIC
Monash University, Melbourne, VIC.
Med J Aust. 2016 Jun 20;204(11):407. doi: 10.5694/mja15.01369.
To describe the incidence and causes of hospitalisation for severe traumatic brain injury (TBI) in Victoria over a 9-year period.
DESIGN, SETTING AND PARTICIPANTS: A retrospective review of data from the population-based Victorian State Trauma Registry for hospitalised cases of severe TBI, 2006-2014.
Temporal trends in the incidence of severe TBI and in causes of injury.
There were 2062 patients hospitalised with severe TBI in Victoria during the 9-year study period. The incidence of severe TBI declined significantly over this period, from 5.0 to 3.2 cases per 100000 population per year, mainly because of reductions in severe TBI resulting from motor vehicle crashes (incidence rate ratio [IRR], 0.89; 95% CI, 0.86-0.92; P < 0.001), which largely involved people in the 15-34-year-old age group (64.7%). A decline was also observed in severe TBI in motorcyclists, but this was not statistically significant (IRR, 0.94; 95% CI, 0.89-1.00; P = 0.06). The incidence of severe TBI resulting from low falls, which occurred mostly in people aged 65 years or more (68.1%), increased (IRR, 1.04; 95% CI, 1.00-1.08; P = 0.03). The overall incidence of severe TBI resulting from intentional events was 0.60 cases per 100000 population, and declined over the study period (IRR, 0.95; 95% CI, 0.91-1.00; P = 0.03).
The decline in the incidence of motor vehicle-related severe TBI suggests that road injury prevention measures have been effective. Additional targeted measures for reducing the incidence of major head injuries from falls should be explored.
描述维多利亚州 9 年来严重创伤性脑损伤(TBI)住院治疗的发病率和原因。
设计、地点和参与者:对基于人群的维多利亚州创伤登记处 2006-2014 年严重 TBI 住院病例数据进行回顾性分析。
严重 TBI 发病率和损伤原因的时间趋势。
在 9 年的研究期间,维多利亚州有 2062 名患者因严重 TBI 住院治疗。严重 TBI 的发病率在此期间显著下降,从每 100000 人口 5.0 例降至 3.2 例/年,主要原因是机动车事故导致的严重 TBI 发生率下降(发病率比 [IRR],0.89;95%CI,0.86-0.92;P<0.001),其中主要涉及 15-34 岁年龄组的人群(64.7%)。摩托车手发生严重 TBI 的情况也有所下降,但统计学上无显著性差异(IRR,0.94;95%CI,0.89-1.00;P=0.06)。老年人(65 岁及以上)高发的低坠伤所致严重 TBI 的发病率增加(IRR,1.04;95%CI,1.00-1.08;P=0.03)。总体而言,因故意事件导致的严重 TBI 发病率为每 100000 人口 0.60 例,且在研究期间呈下降趋势(IRR,0.95;95%CI,0.91-1.00;P=0.03)。
机动车相关严重 TBI 发病率的下降表明,道路伤害预防措施已取得成效。应探索减少跌倒所致严重头部损伤发生率的针对性措施。