Traumatic brain injury in the Republic of Ireland twenty-five years on: a comparison of two cohorts from a neurosurgical unit

ABSTRACT

Objective

We assessed for change in the number of admissions, demographics, mechanism, severity, operative management, length of stay, and in-hospital mortality of Traumatic Brain Injury (TBI) in patients admitted to a Neurosurgical Unit (NSU) in the Republic of Ireland in 2017 compared to 25 years previously.

Method

We performed a retrospective cohort study of TBI admissions during 2017 and compared the results with a prospective cohort study covering a one-year period across 1992 and 1993.

Results

In 2017, 184 patients (5.78 per 100,000) were admitted, compared to 225 in 1992/1993 (7.31 per 100,000). Mean age increased by 8.5 years. The contribution of road traffic collisions (RTCs) decreased by 62% while sports injuries increased by 300%, led by soccer. Falls replaced RTCs as the leading mechanism of injury. We report a decrease in severe injuries (GCS≤8) of 52% while mild injuries (GCS≥13) increased by 58%. The number undergoing neurosurgery remained comparable (2017: 55%, 1992/1993: 48%), as did in-hospital mortality (13%, 16%). Mean length of stay decreased by four days.

Conclusion

There has been a sizable change in the landscape of TBI as seen in the Republic of Ireland’s national NSU including in demographics, mechanism of injury, and injury severity.

KEYWORDS:

• ‘head injury’
• ‘road traffic collisions’
• ‘sports injuries’
• ‘falls’
• ‘Ireland’
• ‘traumatic brain injury’

Abbreviations

ABI	=	Acquired-Brain Injury
EVD	=	External Ventricular Drain
GCS	=	Glasgow Coma Scale
HIPE	=	The Hospital In-Patient Enquiry system
ICP	=	Intracranial Pressure
ICU	=	Intensive Care Unit
MTA	=	Major Trauma Audit
NOCA	=	National Office of Clinical Audit
NSU	=	Neurosurgical Unit
RTC	=	Road Traffic Collision
TARN	=	Trauma Audit and Research Network
TBI	=	Traumatic Brain Injury

Disclosure statement

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Additional information

Funding

No funding was received for this research.