Traumatic brain injuries caused by traffic accidents in five European countries: outcome and public health consequences.
BACKGROUND
Road traffic accidents (RTAs) have been identified by public health organizations as being of major global concern. Traumatic brain injuries (TBIs) are among the most severe injuries and are in a large part caused by RTA. The objective of this article is to analyse the severity and outcome of TBI caused by RTA in different types of road users in five European countries.


METHODS
The demographic, severity and outcome measures of 683 individuals with RTA-related TBI from Austria, Slovakia, Bosnia, Croatia and Macedonia were analysed. Five types of road users (car drivers, car passengers, motorcyclists, bicyclists and pedestrians) were compared using univariate and multivariate statistical methods. Short-term outcome [intensive care unit (ICU) survival] and last available long-term outcome of patients were analysed.


RESULTS
In our data set, 44% of TBI were traffic related. The median age of patients was 32.5 years, being the lowest (25 years) in car passengers. The most severe and extensive injuries were reported in pedestrians. Pedestrians had the lowest rate of ICU survival (60%) and favourable long-term outcome (46%). Drivers had the highest ICU survival (73%) and car passengers had the best long-term outcome (59% favourable). No differences in the outcome were found between countries with different economy levels.


CONCLUSIONS
TBI are significantly associated with RTA and thus, tackling them together could be more effective. The population at highest risk of RTA-related TBI are young males (in our sample median age: 32.5 years). Pedestrians have the most severe TBI with the worst outcome. Both groups should be a priority for public health action.
Faculty of Health Care and Social Work, Department of Public Health, Trnava University, Slovak Republic. mmajdan@igeh.org
Marek
M
Majdan
Walter
W
Mauritz
Ingrid
I
Wilbacher
Ivan
I
Janciak
Alexandra
A
Brazinova
Martin
M
Rusnak
Johannes
J
Leitgeb
D000063:Accidents, Traffic / Q000191:economics* / Q000639:trends*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001317:Austria / Q000453:epidemiology; D001642:Bicycling / Q000293:injuries; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D001930:Brain Injuries / Q000150:complications* / Q000453:epidemiology / Q000534:rehabilitation; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009049:Motorcycles; D016017:Odds Ratio; D018843:Republic of North Macedonia / Q000453:epidemiology; D012737:Sex Factors; D018154:Slovakia / Q000453:epidemiology; D015599:Trauma Severity Indices; D055815:Young Adult