title: Epidemiology and clinical characteristics of traumatic brain injuries in a rural setting in Maharashtra, India. 2007-2009.
abstract: BACKGROUND
  Though some studies have described traumatic brain injuries in tertiary care, urban hospitals in India, very limited information is available from rural settings.
  
  
  OBJECTIVE
  To evaluate and describe the epidemiological and clinical characteristics of patients with traumatic brain injury and their clinical outcomes following admission to a rural, tertiary care teaching hospital in India.
  
  
  METHODS
  Retrospective, cross-sectional, hospital-based study from January 2007 to December 2009.
  
  
  METHODS
  Epidemiological and clinical data from all patients with traumatic brain injury (TBI) admitted to the neurosurgery service of a rural hospital in district Wardha, Maharashtra, India, from 2007 to 2009 were analyzed. The medical records of all eligible patients were reviewed and data collected on age, sex, place of residence, Glasgow Coma Scale (GCS) score, mechanism of injury, severity of injury, concurrent injuries, length of hospital stay, computed tomography (CT) scan results, type of management, indication and type of surgical intervention, and outcome.
  
  
  METHODS
  Data analysis was performed using STATA version 11.0.
  
  
  RESULTS
  The medical records of 1,926 eligible patients with TBI were analyzed. The median age of the study population was 31 years (range <1 year to 98 years). The majority of TBI cases occurred in persons aged 21 - 30 years (535 or 27.7%), and in males (1,363 or 70.76%). Most patients resided in nearby rural areas and the most frequent external cause of injury was motor vehicle crash (56.3%). The overall TBI-related mortality during the study period was 6.4%. From 2007 to 2009, TBI-related mortality significantly decreased (P < 0.01) during each year (2007: 8.9%, 2008: 8.5%, and 2009: 4.9%). This decrease in mortality could be due to access and availability of better health care facilities.
  
  
  CONCLUSIONS
  Road traffic crashes are the leading cause of TBI in rural Maharashtra ffecting mainly young adult males. At least 10% of survivors had moderate or more severe TBI-related disabilities. Future research should include prospective, population based studies to better elucidate the incidence, prevalence, and economic impact of TBI in rural India.
authors.affiliation: Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore, India.
authors.forename: Amit
authors.initials: A
authors.lastname: Agrawal
authors.forename: Sagar
authors.initials: S
authors.lastname: Galwankar
authors.forename: Vikas
authors.initials: V
authors.lastname: Kapil
authors.forename: Victor
authors.initials: V
authors.lastname: Coronado
authors.forename: Sridhar V
authors.initials: SV
authors.lastname: Basavaraju
authors.forename: Lisa C
authors.initials: LC
authors.lastname: McGuire
authors.forename: Rajnish
authors.initials: R
authors.lastname: Joshi
authors.forename: Syed Z
authors.initials: SZ
authors.lastname: Quazi
authors.forename: Sankalp
authors.initials: S
authors.lastname: Dwivedi