Epidemiological study of traumatic brain injury in a tertiary care centre in South India

Prasanth Asher, Jijo Joseph Joseph, Varun Singh Pendro, Anilkumar Peethambaran, Rajmohan Bhanu Prabhakar


Background: This study investigated the epidemiological pattern of traumatic brain injury (TBI) in our hospital, so as to juxtapose with available statistics and formulate recommendations for patient betterment.

Methods: The Government Medical College, Thiruvananthapuram was the setting of this cross-sectional longitudinal study and included all patients admitted with clinical/radiological evidence of TBI over a period of three months (October 2019 to December 2019). Details regarding mechanism of injury and the socioeconomic background of the subjects were collected during the stay in hospital, by means of a semi structured questionnaire. SPSS software was used to analyze the data collected.

Results: Out of 658 patients included in the study, majority of the subjects belonged to the age group 30-60 years. About 80% of subjects were males. 63% were manual laborers. Majority of the patients had about 10-15 days’ stay in the hospital. Road traffic accidents were the most common mechanism of injury and involved two wheelers mainly. Lack of helmet and restraining seat belt was noted in a sizeable percent of the subjects. Loss of consciousness was the most common complaint and GCS in the majority of subjects ranged from 9-13. Subdural hematomas and hemorrhagic contusions were the most common CT findings. 39.7% of the patients had associated spinal injury. About 48% of the subjects were operated. There was 7% mortality.

Conclusions: Road traffic accidents accounted for the majority of traumatic brain injury incidents and a sizeable portion of patients required expert neurosurgical care.


Epidemiology, TBI, Kerala

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Cole TB. Global road safety crisis remedy sought: 1.2 million killed, 50 million injured annually. JAMA. 2004;291:2531-2.

Menon DK, Schwab K, Wright DW, Maas AI, Demographics and Clinical Assessment Working Group of the International and Interagency Initiative toward Common Data Elements for Research on Traumatic Brain Injury and Psychological Health Position statement: definition of traumatic brain injury. Arch Phys Med Rehabil. 2010;91:1637-40.

Global Burden of Disease Study 2016. Traumatic Brain Injury and Spinal Cord Injury Collaborators. Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(1):56-87.

A systematic review of brain injury epidemiology in Europe. Tagliaferri F, Compagnone C, Korsic M, Servadei F, Kraus J Acta Neurochir (Wien). 2006; 148(3):255-68.

Laccarino C, Carretta A, Nicolosi F, Morselli C. Epidemiology of severe traumatic brain injury. Journal of Neurosurgical Science. 2018;62(5):535-41.

Langlois JA, Marr A, Mitchko J, Johnson RL. Tracking the silent epidemic and educating the public: CDC’s traumatic brain injuryassociated activities under the TBI Act of 1996 and the Children’s Health Act of 2000. J Head Trauma Rehabil. 2005;20:196-204.

Teasdale G, Jennett B. Assessment of coma and impaired consciousness a practical scale. Lancet 1974;2:81-4.

Association for the Advancement of Automotive Medicine (AAAM), The Abbreviated Injury Scale, 1990 Revision. Des Plains, IL: Association for the Advancement of Automotive Medicine. 1990.

Rimel RW, Giordani B, Barth JT, Boll TJ, Jane JA. Disability caused by minor head injury. Neurosurgery. 1981;9:221-8.

Rimel RW, Giordani B, Barth JT, Jane JA. Moderate head injury: completing the clinical spectrum of brain trauma. Neurosurgery. 1982;11:344-51.

Guerrero JL, Thurman DJ, Sniezek JE. Emergency department visits associated with traumatic brain injury: United States, 1995‐1996. Brain Inj. 2000;14:181-6.

Jager TE, Weiss HB, Coben JH. Traumatic brain injuries evaluated in U.S. emergency departments, 1992‐1994. Acad Emerg Med. 2000;7:134-40.

Annegers JF, Grabow JD, Kurland LT. The incidence, causes, and secular trends of head trauma in Olmsted County, Minnesota, 1935‐1974. Neurology. 1980;30:912-9.

Kraus JF, Black MA, Hessol N. The incidence of acute brain injury and serious impairment in a defined population. Am J Epidemiol 1984;119:186-201.

Tiret L, Hausherr E, Thicoipe M. The epidemiology of head trauma in Aquitaine (France), 1986: a community‐based study of hospital admissions and deaths. Int J Epidemiol. 1990;19:133-40.

Injury prevention and recreational all-terrain vehicle use: the impact of helmet use in West Virginia. Miller M, Davidov D, Tillotson R, Whiteman C, Marshall T, Lander O W V Med J. 2012;108(3):96-101.

Selassie AW, Zaloshnja E, Langlois JA, Miller T, Jones P, Steiner C. Incidence of long-term disability following traumatic brain injury hospitalization in the United States. JHead Trauma Rehabil. 2008;23(2):123-31.