One Health Research Group, Faculty of Health Science, Universidad de Las Américas, Quito, Ecuador,
Programa de Biomedicina, Universitat de Barcelona, Barcelona, Spain,
Neuroepidemiology. 2020;54(1):33-44. doi: 10.1159/000502580. Epub 2019 Aug 28.
Traumatic brain injury (TBI) is a public health problem worldwide. Information regarding TBI from low- and middle-income countries is scarce. The objectives of this study are to determine the incidence, mortality and geodemographic distribution of TBI in Ecuador.
A population-based analytical study from 2004 to 2016 was conducted in Ecuador. Men and women with a diagnosis of TBI from all ages (0-110 years) were included. Data was obtained from official hospital-discharges records and retrieved from the National Institute of Statistics and Census (INEC) Database. We analyzed data by region, province and canton with a monthly resolution. The incidence, mortality, case fatality rates and the risk of developing TBI within the population were calculated based on the last 13 years of available data.
A total of 124,576 hospital admissions and 5,264 deaths due to TBI were registered in Ecuador from 2004 to 2016. The overall TBI-related hospital admission rate was 70.68 per 100,000. The sex- and age-specific rate was 90.1 per 100,000 for men and 64.1 per 100,000 for women. Mestizos' population has the highest adjusted incidence rate of 195.6 per 100,000, followed by the indigenous with 61.4 per 100,000 and Afro-Americans with 14.2 per 100,000. The overall annual mortality rate during the study ranged from 2.11 to 3.35 per 100,000. Case fatality rates were significantly higher in older populations, becoming fatal in up to 27% of men >90 years/old and in 15% of women older than 90 years/old.
This is the first recorded epidemiological study of the socio-demographic distribution of TBI in Ecuador to date. The study found that young men were almost 4 times more likely to be hospitalized due to TBI than women of this age. Fatalities due to TBI were less likely to occur among younger age groups, increasing significantly among the elderly population. The national incidence rate of TBI has been decreasing since 2011, which coincides with the introduction of stricter alcohol regulation, suggesting that this measure might have played a role in this reduction.
创伤性脑损伤（TBI）是一个全球性的公共卫生问题。来自中低收入国家的 TBI 信息十分匮乏。本研究旨在确定厄瓜多尔 TBI 的发病率、死亡率和地理人口分布。
这是一项基于人群的分析性研究，时间范围为 2004 年至 2016 年，纳入了所有年龄段（0-110 岁）的 TBI 男性和女性患者。数据来自官方医院出院记录，并从国家统计和人口普查研究所（INEC）数据库中检索。我们按月分辨率分析了区域、省和省会的数据。根据过去 13 年的可用数据，计算了人口中 TBI 的发病率、死亡率、病死率和发病风险。
2004 年至 2016 年，厄瓜多尔共登记了 124576 例因 TBI 住院和 5264 例 TBI 死亡。总体 TBI 相关住院率为每 10 万人 70.68 例。按性别和年龄划分，男性每 10 万人 90.1 例，女性每 10 万人 64.1 例。梅斯蒂索人（西班牙人和印第安人的混血后裔）的人口发病率最高，调整后的发病率为每 10 万人 195.6 例，其次是印第安人（每 10 万人 61.4 例）和非裔美国人（每 10 万人 14.2 例）。研究期间，总体年死亡率范围为每 10 万人 2.11-3.35 例。年龄较大的人群病死率明显较高，90 岁以上男性病死率高达 27%，90 岁以上女性病死率为 15%。
这是迄今为止厄瓜多尔 TBI 社会人口分布的第一项记录性流行病学研究。研究发现，年轻男性因 TBI 住院的可能性几乎是同龄女性的 4 倍。TBI 死亡率在年轻人群中较低，在老年人群中显著增加。自 2011 年以来，TBI 的全国发病率一直在下降，这与更严格的酒精法规的出台相符，这表明这一措施可能在这一下降中发挥了作用。
