title: Trends in epidemiological and clinical characteristics in severe traumatic brain injury: Analysis of the past 25 years of a single centre data base.
abstract: To describe the demographic and clinical profiles of a cohort of environmentally representative severe traumatic brain injury (TBI) cases collected for the past 25 years and to analyse the changes that occurred by dividing the analysis period into 3 equal time periods.
  
  
  
  This was an observational cohort study of consecutive adult patients (>14 years of age) with severe closed TBI (Glasgow Coma Scale score [GCS]≤8) who were admitted during the first 48h after injury to the 12 de Octubre hospital from 1987 to 2012. The most relevant epidemiological and clinical variables reported in the literature were defined and compared in 3 equal time periods (1987-1995, 1996-2004 and 2005-2014).
  
  
  
  There was a 13% reduction in the frequency of severe TBI from the first to the last time period. An increase in the mean age from 35 to 43 years was observed, whereas the frequency of severe TBI according to sex remained approximately the same during the last decades of life. A distinct change was observed in the injury mechanism; traffic accidents decreased from 76% to 55%, particularly those involving 4-wheeled vehicles. However, falls increased significantly, especially in older women, and contusion and subdural haematoma were the most frequent structural injuries. Motor scores could not be reliably assessed for the last time period because of early intubation and sedative drug use.
  
  
  
  TBI epidemiology in Western countries has changed. This trend was also observed in our environment as an increase in mean age, which reflected the increase in falls among elderly patients.
authors.affiliation: Department of Neurosurgery, 12 de Octubre University Hospital, Complutense University, Madrid, Spain. Electronic address: pedroantonio.gomez@salud.madrid.org.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Gómez
authors.affiliation: Department of Neurosurgery, 12 de Octubre University Hospital, Complutense University, Madrid, Spain.
authors.forename: Ana M
authors.initials: AM
authors.lastname: Castaño-Leon
authors.affiliation: Clinical Research Unit, IMAS12-CIBERESP, 12 de Octubre University Hospital, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: de-la-Cruz
authors.affiliation: Clinical Research Unit, IMAS12-CIBERESP, 12 de Octubre University Hospital, Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Lora
authors.affiliation: Department of Neurosurgery, 12 de Octubre University Hospital, Complutense University, Madrid, Spain.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Lagares
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis* / Q000453:epidemiology*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D055815:Young Adult
keywords: Epidemiology; Epidemiología; GCS; Mecanismo; Mechanism; Severe traumatic brain injury; Traumatismo craneal grave