title: Traumatic brain injury in Portugal: trends in hospital admissions from 2000 to 2010.
abstract: BACKGROUND
  Traumatic brain injury has a considerable socio-economic impact, being a major cause of morbi-mortality, often with permanent disability. We sought to characterize health resource utilization of adult traumatic brain injury patients in Portugal between 2000 and 2010.
  
  
  METHODS
  Retrospective study of medical records of adult patients with ICD9 diagnostic code of traumatic brain injury included in the National Diagnosis Related Groups Database from 2000-2010. Descriptive statistical analysis was performed and trends during the decade were evaluated.
  
  
  RESULTS
  We analysed 72 865 admissions to 111 hospitals, 64.1% males, mean age 57.9 ± 21.8 years (18-107). We found a decrease in number of traumatic brain injury in younger patients and an increase in older ones. The number of traffic accidents decreased and the number of falls increased. There was an increase of moderate to severe traumatic brain injury admissions: 47.2% in 2000 / 80% in 2010. Patients admitted in Intensive Care have nearly doubled (15.8% vs 29.5%) as well as the number submitted to neurosurgical procedures (8.2% vs 15.2%). Total mortality increased from 7.1% to 10.6%.
  
  
  CONCLUSIONS
  The decrease of traumatic brain injury may be associated with the trauma prevention campaigns, road network improvement and health politics. The increase in mortality may be related to better pre-hospital care, enabling more severe cases to arrive in hospital alive, and although treated more frequently in Intensive Care and requiring more neurosurgical procedures, they end up having higher mortality. Also this may be due to an increase in patients' age and worse pre-morbid status.
  
  
  CONCLUSIONS
  Traumatic brain injury in Portugal is changing. Although hospital admissions due to global traumatic brain injury have decreased, mortality rate has increased.
authors.affiliation: Intensive Care Department. Neurocritical Care Unit. Hospital São João. University of Porto. Porto. Portugal.
authors.forename: Celeste
authors.initials: C
authors.lastname: Dias
authors.affiliation: Neurology Department. Hospital Escala. Braga. Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Rocha
authors.affiliation: Intensive Care Department. Neurocritical Care Unit. Hospital São João. University of Porto. Porto. Portugal.
authors.forename: Eduarda
authors.initials: E
authors.lastname: Pereira
authors.affiliation: Neurosurgery Department. Hospital São João. University of Porto. Porto. Portugal.
authors.forename: António
authors.initials: A
authors.lastname: Cerejo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult