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Open Access Research article

The epidemiology of hospital treated traumatic brain injury in Scotland

Tara Shivaji1, Andrew Lee2, Nadine Dougall3*, Thomas McMillan4 and Cameron Stark15

Author Affiliations

1 Department of Public Health NHS Highland, Assynt House, Beechwood Park, Inverness IV2 3BW, Scotland

2 Information Services Division, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9 EB, Scotland

3 NMAHP Research Unit, School of Nursing, Midwifery & Health, Unit 13 Scion House, University of Stirling, Stirling FK9 4NF, Scotland

4 Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, Scotland

5 Centre for Rural Health, University of Aberdeen, Centre for Health Sciences, Old Perth Road, Inverness IV2 3JH, Scotland

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BMC Neurology 2014, 14:2  doi:10.1186/1471-2377-14-2

Published: 6 January 2014

Abstract

Background

Traumatic Brain Injury (TBI) is an important global public health problem made all the more important by the increased likelihood of disability following a hospital admission for TBI. Understanding those groups most at risk will help inform interventions designed to prevent causes of TBI, such as falls prevention measures. This study identifies the rate of hospitalisation episodes of TBI in Scotland, explores causes of TBI admissions, and trends in hospitalisation episodes by age and gender over a twelve year period using routinely collected hospital data.

Methods

A retrospective analysis of routine hospital episode data identified records relating to TBI for the twelve years between 1998 and 2009. Descriptive and joinpoint regression analysis were used, average annual percentage changes (AAPC) and annual percentage change (APC) in rates were calculated.

Results

Between 1998 and 2009 there were 208,195 recorded episodes of continuous hospital care in Scotland as a result of TBI. Almost half (47%) of all TBIs were the result of falls, with marked peaks observed in the very young and the oldest groups. The AAPC of hospitalization episode rates over the study period for boys and girls aged 0-14 were -4.9% (95% CI -3.5 to-6.3) and -4.7% (95% CI -2.6 to -6.8) respectively. This reduction was not observed in older age groups. In women aged 65 and over there was an APC of 3.9% (95% CI 1.2 to 6.6) between 2004 and 2009.

Conclusions

Hospitalisation for TBI is relatively common in Scotland. The rise in the age-adjusted rate of hospitalisation episodes observed in older people indicates that reduction of TBI should be a public health priority in countries with an ageing population. Public health interventions such as falls prevention measures are well advised and evaluations of such interventions should consider including TBI hospitalisation as an alternative or supplementary outcome measure to fractured neck of femur. Further research is needed to advance understanding of the associations of risk factors with increased incidence of TBI hospital episodes in the elderly population.

Keywords:
Traumatic brain injury; Accidental falls; Patient admissions; Epidemiology; Scotland; Trends