Trends in civilian penetrating brain injury: A review of 26,871 patients

• Published in: The American journal of surgery Vol. 218; no. 2; pp. 255 - 260
• Main Authors: Skarupa, David J., Khan, Muhammad, Hsu, Albert, Madbak, Firas G., Ebler, David J., Yorkgitis, Brian, Rahmathulla, Gazanfar, Alcindor, Dunbar, Joseph, Bellal
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2019; Elsevier Limited
• Subjects: Adolescent; Adult; Brain; Brain Injuries, Traumatic - epidemiology; Brain Injuries, Traumatic - mortality; Female; Firearms; Gunshot; Head injuries; Head Injuries, Penetrating - epidemiology; Head Injuries, Penetrating - mortality; Humans; Incidence; Injury analysis; Intubation; Male; Middle Aged; Mortality; Patients; Penetrating injury; Retrospective Studies; Suicide; Time Factors; Traumatic brain injury; Trends; Young Adult; United States > US; Traumatic brain injury; Trends; Penetrating injury; Gunshot
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.11.034

The aim of our study is to analyze the 5 years' trends, mortality rate, and factors that influence mortality after civilian penetrating traumatic brain injury (pTBI). We performed a 5-year-analysis of all trauma patients diagnosed with pTBI in the TQIP. Our outcome measures were trends of pTBI. A total of 26,871 had penetrating brain injury over the 5-year period. Mean age was 36.2 ± 18 years. Overall 55% of the patients had severe TBI and mortality rate was 43.8%. There was an increase in the rate of pTBI from 3042/100,000 (2010) to 7578/100,000 trauma admissions (2014) (p < 0.001). The mortality rate has increased from 35% (2010) to 48% (2011) (p < 0.001) followed by a linear decrease in mortality to 40% (2014). Independent predictors of mortality were age, pre-hospital intubation, suicide attempt, and craniotomy/craniectomy. Incidence and mortality for patients who are brought to hospitals following pTBI have gradually increased over the five-year period. Self-inflicted injury and prehospital intubation were the two most significant predictors of mortality. •The incidence and mortality rates after civilian penetrating TBI have increased.•Self-inflicted injuries and pre-hospital intubation are predictors of mortality.•Injury prevention awareness focused on suicide might help reduce self-inflicted injuries.