Zusammenfassung
ZIELE: Das Ziel der vorliegenden Arbeit ist es, anhand von Spitalsaufnahmen die Epidemiologie von Patienten mit schwerem Schädelhirntrauma (SHT) darzustellen. PATIENTEN UND METHODEN: Es standen Datensätze von 492 Patienten zur Verfügung, die von 5 österreichischen Zentren in die Studie inkludiert worden waren. Alters- und Geschlechtsverteilung, Ausbildung, Beruf, Unfallort und-mechanismus, Alkoholisierung, Art und Schweregrad des Traumas, Begleitverletzungen, sowie Dauer und Ergebnis der Intensivbehandlung wurden für jedes der beteiligten Zentren evaluiert. ERGEBNISSE: Die Stichprobe repräsentiert ungefähr 13% aller Fälle von schwerem SHT, welche während des Studienzeitraums in österreichischen Spitälern behandeltwurden. Das mittlere Alter betrug 48 ± 21 Jahre, und die Mehrzahl (72%) der Patienten war männlich. Die Unfälle ereigneten sich am häufigsten auf der Straße (50%), zu Hause (44%), in freier Natur (10%) und am Arbeitsplatz (7%). Verkehrsunfall (44%), Sturz (< 3 m; 30%), Fall (> 3 m; 11%) und Sportunfall (5%) waren die häufigsten Ursachen. Unter den Verkehrsunfällen waren Autolenker und -beifahrer am häufigsten (45%) betroffen, gefolgt von Fußgängern (20%), Motorradfahrern (19%) und Radfahrern (16%). Für die meisten der untersuchten Variablen fanden sich signifikante Unterschiede zwischen den Zentren. Das SHT war in 10% mit einer Rückenmarksverletzung und in 38% mit anderen schweren Verletzungen kombiniert. Die Intensivstations-Mortalität betrug 31,7%. Zwischen Unfallmechanismus und Verletzungsschwere oder Behandlungsergebnis fanden sich keine signifikanten Korrelationen. SCHLUSSFOLGERUNGEN: Die Epidemiologie des schweren SHT in Österreich ist nicht sehr verschieden von der in anderen Industrieländern. Die häufigste Ursache ist der Verkehrsunfall, was die Bedeutung der Verhütung dieser Unfälle aufzeigt. Die spezifischen Risken Älterer und die Verhütung von Unfällen im häuslichen Bereich verdienen besondere Beachtung.
Summary
OBJECTIVES: The goal of this paper is to describe the hospital-based epidemiology of severe TBI in Austria. PATIENTS AND METHODS: Data sets from 492 patients included in the study by 5 Austrian hospitals were available. Age and gender distribution, education, occupation, location of trauma, mechanism of injury, alcohol use, type and severity of injury, associated injuries, length of intensive care unit stay, and intensive care unit outcome were evaluated for each of the 5 centers. RESULTS: The sample represents roughly 13% of all cases with severe TBI which were treated in Austrian hospitals during the study period. Mean age was 48 ± 21 years, and most patients were male (72%). The most important trauma locations were roads (50%), home (24%), outdoors (10%), and workplace (7%). Transportrelated trauma was the most important mechanism (44%) followed by falls < 3 m (30%), falls > 3 m (11%), and sports injuries (5%). Detailed analysis of transport-related trauma showed that car accidents (45%) were most common, followed by pedestrian (20%), motorbike (19%), and bicycle (16%) accidents. Significant differences between the centers were found for most of the variables analyzed. The severe traumatic brain injury was associated with spinal cord injury in 10%, and with severe multiple trauma in 38% of cases. Intensive care mortality was 31.7%. There were no significant correlations between mechanisms of injury and severity of trauma, nor between mechanisms and ICU outcome. CONCLUSIONS: Epidemiology of severe traumatic brain injuries in Austria is not much different from other industrialized countries. Traffic accidents are responsible for the majority of traumas, stressing the importance of road injury prevention. Attention should also be paid to the specific risks of older people and to prevent injuries at home.
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Rosso, A., Brazinova, A., Janciak, I. et al. Severe Traumatic Brain Injury in Austria II: Epidemiology of hospital admissions. Wien Klin Wochenschr 119, 29–34 (2007). https://doi.org/10.1007/s00508-006-0761-4
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DOI: https://doi.org/10.1007/s00508-006-0761-4