title: Epidemiology of traumatic comas: a prospective population-based study.
abstract: OBJECTIVE
  Most studies on patients with severe brain injury (SBI) are based on data from specialized centres. This prospective epidemiologic study included all patients in a defined region with a coma lasting more than 24 hours or leading to a death.
  
  
  METHODS
  All patients with a SBI admitted to an emergency department in the region were included during a 1-year period. A data form was completed with initial neurological state, CT scan lesions and associated injuries. Outcome at the end of acute hospitalization was assessed from medical notes.
  
  
  RESULTS
  Two hundred and forty-eight patients were registered. Annual incidence was 8.5/100 000 population. Median age was 41 years. Traffic crashes were the most frequent cause (59%). Falls occurred in 30% (16% from a high level, 14% from one level). Initial GCS was above 8 in 31%, and patients with a neurological deterioration were older (52 vs 32 years). Death occurred in 52% of the cohort. Outcome was related to CT scan diagnosis, delay before eye opening and delay before obeying commands. CONCLUSION. This population-based cohort of patients with SBI was different from patients selected in trauma centres. The patients were older, more often injured in falls and their mortality rate remained very high.
authors.affiliation: Department of Anesthesia, University Hospital of Bordeaux, France. francoise.masson@chu-bordeaux.fr
authors.forename: Françoise
authors.initials: F
authors.lastname: Masson
authors.forename: Michel
authors.initials: M
authors.lastname: Thicoipe
authors.forename: Tarak
authors.initials: T
authors.lastname: Mokni
authors.forename: Paul
authors.initials: P
authors.lastname: Aye
authors.forename: Philippe
authors.initials: P
authors.lastname: Erny
authors.forename: Philippe
authors.initials: P
authors.lastname: Dabadie
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D020207:Coma, Post-Head Injury / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods