Karamian Armin, Lucke-Wold Brandon, Seifi Ali
Shahid Beheshti University of Medical Sciences, School of Medicine, Tehran, Iran,
Department of Neurosurgery, University of Florida, Gainesville, Florida, USA.
Neuroepidemiology. 2024 Aug 22:1-10. doi: 10.1159/000540676.
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. It has been estimated that 64-74 million individuals experience TBI from all causes each year. Due to these variations in reporting TBI prevalence in the general population, we decided to perform a meta-analysis of published studies to better understand the prevalence of TBI in the general adult population of the USA which can help health decision-makers in determining general policies to reduce TBI cases and their costs and burden on the healthcare system.
Our meta-analysis was performed using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist. The study protocol was registered with PROSPERO (CRD42024534598). A comprehensive literature search of PubMed from the National Library of Medicine and Google Scholar was performed from database inception to April 2024. Sixteen studies that evaluated the US general population met our inclusion criteria. A meta-analysis using a random-effects model was performed to estimate the prevalence of TBI in the general adult population of the USA.
The total sample consisted of 27,491 individuals, of whom 4,453 reported a lifetime history of TBI with loss of consciousness (LOC) (18.2%, 95% CI 14.4-22.7%). Some studies did not report relevant information based on gender, but based on available data, among males, 1,843 individuals out of 8,854 reported a lifetime history of TBI with LOC (20.8%). Among females, 1,363 individuals out of 11,943 reported a lifetime history of TBI with LOC (11.4%). The odds of sustaining TBI in males were higher than in females with moderate heterogeneity between studies (OR = 2.09, 95% CI 1.85-2.36, p < 0.01, I2 = 40%).
The prevalence of TBI in the US general population is 18.2%, making it a major public health concern. In addition, males were more than twice as likely as females to sustain TBI with LOC. Considering the irreparable long-term adverse effects of TBI on survivors, their families, and the healthcare system, prevention strategies can facilitate substantial reductions in TBI-related permanent disabilities and medical care costs.
创伤性脑损伤（TBI）是全球范围内导致死亡和残疾的主要原因。据估计，每年有6400万至7400万人因各种原因发生TBI。由于普通人群中TBI患病率报告存在这些差异，我们决定对已发表的研究进行荟萃分析，以更好地了解美国普通成年人群中TBI的患病率，这有助于卫生决策者制定总体政策，以减少TBI病例及其对医疗系统的成本和负担。
我们的荟萃分析使用系统评价和荟萃分析的首选报告项目（PRISMA）清单进行。研究方案已在PROSPERO（CRD42024534598）注册。从数据库建立到2024年4月，对美国国立医学图书馆的PubMed和谷歌学术进行了全面的文献检索。16项评估美国普通人群的研究符合我们的纳入标准。采用随机效应模型进行荟萃分析，以估计美国普通成年人群中TBI的患病率。
总样本包括27491人，其中4453人报告有TBI伴意识丧失（LOC）的终生病史（18.2%，95%CI 14.4 - 22.7%）。一些研究未报告基于性别的相关信息，但根据现有数据，在男性中，8854人中有1843人报告有TBI伴LOC的终生病史（20.8%）。在女性中，11943人中有1363人报告有TBI伴LOC的终生病史（11.4%）。男性发生TBI的几率高于女性，研究之间存在中度异质性（OR = 2.09，95%CI 1.85 - 2.36，p < 0.01，I2 = 40%）。
美国普通人群中TBI的患病率为18.2%，使其成为一个主要的公共卫生问题。此外，男性发生TBI伴LOC的可能性是女性的两倍多。考虑到TBI对幸存者、其家庭和医疗系统造成的不可挽回的长期不良影响，预防策略可以大幅减少与TBI相关的永久性残疾和医疗费用。
