Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York; Program in Global Surgery and Social Change, Harvard Medical School, Boston; Department of Plastic and Oral Surgery, Boston Children's Hospital, Boston, USA.
Department of Surgery, Bhabha Atomic Research Centre Hospital, Mumbai, India.
Neurol India. 2017 Mar-Apr;65(2):305-314. doi: 10.4103/neuroindia.NI_719_16.
Over a quarter of the world's trauma deaths occur in India, with traumatic brain injury (TBI) as the leading cause of death and disability within trauma. With little known about TBI in India, we set out to do a systematic review to characterize the quantitative literature on TBI in India.
The following databases were searched from their inception to December 31, 2015: PubMed, Cochrane, Web of Science, and the World Health Organization's Global Health Library, using the keywords: neurotrauma, brain injury, traumatic brain injury, TBI, head injury, and India. Articles were screened by two independent reviewers, with disagreements arbitrated by discussion or a third reviewer.
A total of 72 manuscripts were included, encapsulating 19962 patients over 27 years in 14 states of India. The sample-size-weighted mean age was 31.3 years, male-to-female ratio was 3.8:1, and sample-size-weighted mean in-hospital mortality was 24.6%. Age and mortality did not change significantly over time. Road traffic accidents (55.5%) and falls (29.2%) were the most commonly reported mechanisms of injury for TBI in India. The mean quality of reporting on TBI in India was 65.7%, according to the appropriate EQUATOR guideline score.
The quality of reporting of quantitative studies published on TBI in India is low, and future methodological excellence should be ensured. The demographics and outcomes identified can be used as an epidemiological baseline for future research on TBI in India. Future research can build upon this platform to develop and refine context-appropriate policy recommendations and treatment protocols.
全球超过四分之一的创伤死亡发生在印度，创伤性脑损伤（TBI）是创伤死亡和致残的主要原因。由于对印度 TBI 的了解甚少，我们进行了系统评价，以描述印度 TBI 的定量文献。
从创建之初到 2015 年 12 月 31 日，我们在以下数据库中进行了搜索：PubMed、Cochrane、Web of Science 和世界卫生组织全球卫生图书馆，使用的关键词为：神经创伤、脑损伤、创伤性脑损伤、TBI、头部损伤和印度。文章由两名独立的审查员进行筛选，有分歧的地方通过讨论或第三名审查员进行裁决。
共纳入 72 篇文章，涵盖了印度 14 个邦 27 年来的 19962 名患者。样本量加权平均年龄为 31.3 岁，男女比例为 3.8:1，样本量加权平均住院死亡率为 24.6%。年龄和死亡率在时间上没有明显变化。道路交通伤（55.5%）和跌倒（29.2%）是印度 TBI 最常见的损伤机制。根据适当的 EQUATOR 指南评分，印度 TBI 报告的平均质量为 65.7%。
印度发表的 TBI 定量研究报告的质量较低，应确保未来方法的卓越性。确定的人口统计学和结果可作为印度未来 TBI 研究的流行病学基线。未来的研究可以在此基础上进行，以制定和完善适合国情的政策建议和治疗方案。
