Epidemiology of traumatic brain injury in eastern China, 2004: a prospective large case study.

BACKGROUND: Traumatic brain injury (TBI) is the leading cause of death for traumatic injury, which is the fifth highest killer in China and the highest killer in adults under 40 years of age. But, there is a lack of epidemiologic data of TBI in China during the past decade. This study aimed to investigate the epidemiologic data of TBI in eastern China, based on a prospective multicenter trial.

METHODS: Data were collected from the 77 hospitals by standardized structured questionnaires in this region during the 1-year period (2004).

RESULTS: A total of 14,948 of cases of traumatic brain injury were identified from 77 hospitals in eastern China. There were 11,446 men (76.6%) and 3,502 women (25.4%). Male adolescents and young adults were affected more often by brain injury. Traffic accidents (60.9%), knock on head (13.4%), and falls (13.1%) were the leading causes of patients with TBI. Approximately one-thirds of the traffic-related TBI were motorcyclists, 31% were pedestrians, and 21.9% were cyclists, whereas motor vehicle occupants only counted for 14% of the cases. The distribution of head injury severity, on the basis of Glasgow Coma Scale scores, was mild in 62%, moderate in 18.1%, and severe in 20% for all cases. The traffic accidents caused the most of severe injuries, which accounted for about 70.4%. Based on Glasgow Outcome Scale assessment, 10.8% of the patients died, 2.6% were in vegetation status, 2.2% had severe disability, 7.2% had moderate disability, and 77.3% had good recovery. And, the outcome depended on age, injury mechanism and initial Glasgow Coma Scale score.

CONCLUSIONS: The prospective cohort study shows an alteration of TBI during the past decade in eastern China. It is essential to establish a standardized surveillance system of TBI incidence, risk factors, causes, and outcomes for development of new, more effective, targeted strategies to prevent TBI.