Epidemiology, Prehospital Characteristics and Outcomes of Severe Traumatic Brain Injury in The Netherlands: The BRAIN-PROTECT Study

BRAIN-PROTECT collaborators., Sebastiaan M Bossers*, Christa Boer, Frank W Bloemers, Esther M M Van Lieshout, Dennis Den Hartog, Nico Hoogerwerf, Gerard Innemee, Joukje van der Naalt, Anthony R Absalom, Saskia M Peerdeman, Matthijs de Visser, Marcel A de Leeuw, Lothar A Schwarte, Stephan A Loer, Patrick Schober

*Corresponding author for this work

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Abstract

Objective

A thorough understanding of the epidemiology, patient characteristics, trauma mechanisms, and current outcomes among patients with severe traumatic brain injury (TBI) is important as it may inform potential strategies to improve prehospital emergency care. The aim of this study is to describe the prehospital epidemiology, characteristics and outcome of (suspected) severe TBI in the Netherlands.

Methods

The BRAIN-PROTECT study is a prospective observational study on prehospital management of patients with severe TBI in the Netherlands. The study population comprised all consecutive patients with clinical suspicion of TBI and a prehospital GCS score

Results

Data from 2,589 patients, of whom 2,117 (81.8%) were transferred to a participating trauma center, were analyzed. The incidence rate of prehospitally suspected and confirmed severe TBI were 3.2 (95% CI: 3.1;3.4) and 2.7 (95% CI: 2.5;2.8) per 100,000 inhabitants per year, respectively. Median patient age was 46 years, 58.4% were involved in traffic crashes, of which 37.4% were bicycle related. 47.6% presented with an initial GCS of 3. The median time from HEMS dispatch to hospital arrival was 54 minutes. The overall 30-day mortality was 39.0% (95% CI: 36.8;41.2).

Conclusion

This article summarizes the prehospital epidemiology, characteristics and outcome of severe TBI in the Netherlands, and highlights areas in which primary prevention and prehospital care can be improved.

Keywords

  • brain injuries
  • traumatic
  • emergency medical services
  • air ambulances
  • treatment outcome
  • epidemiology
  • characteristics
  • incidence rate
  • GUIDELINES
  • MORTALITY
  • SCALE

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