Epidemiology of traumatic brain injury in Europe.
BACKGROUND
Traumatic brain injury (TBI) is a critical public health and socio-economic problem throughout the world, making epidemiological monitoring of incidence, prevalence and outcome of TBI necessary. We aimed to describe the epidemiology of traumatic brain injury in Europe and to evaluate the methodology of incidence studies.


METHODS
We performed a systematic review and meta-analyses of articles describing the epidemiology of TBI in European countries. A search was conducted in the PubMed electronic database using the terms: epidemiology, incidence, brain injur*, head injur* and Europe. Only articles published in English and reporting on data collected in Europe between 1990 and 2014 were included.


RESULTS
In total, 28 epidemiological studies on TBI from 16 European countries were identified in the literature. A great variation was found in case definitions and case ascertainment between studies. Falls and road traffic accidents (RTA) were the two most frequent causes of TBI, with falls being reported more frequently than RTA. In most of the studies a peak TBI incidence was seen in the oldest age groups. In the meta-analysis, an overall incidence rate of 262 per 100,000 for admitted TBI was derived.


CONCLUSIONS
Interpretation of published epidemiologic studies is confounded by differences in inclusion criteria and case ascertainment. Nevertheless, changes in epidemiological patterns are found: falls are now the most common cause of TBI, most notably in elderly patients. Improvement of the quality of standardised data collection for TBI is mandatory for reliable monitoring of epidemiological trends and to inform appropriate targeting of prevention campaigns.
University of Antwerp, Antwerp, Belgium.
Wouter
W
Peeters
University of Antwerp, Antwerp, Belgium.
Ruben
R
van den Brande
Department of Public Health, Centre for Medical Decision Making, Erasmus MC, Rotterdam, The Netherlands.
Suzanne
S
Polinder
Faculty of Health Sciences and Social Work, Trnava University, Trnava, Slovak Republic.
Alexandra
A
Brazinova
Department of Public Health, Centre for Medical Decision Making, Erasmus MC, Rotterdam, The Netherlands.
Ewout W
EW
Steyerberg
Department of Public Health, Centre for Medical Decision Making, Erasmus MC, Rotterdam, The Netherlands.
Hester F
HF
Lingsma
University of Antwerp, Antwerp, Belgium. andrew.maas@uza.be.|Department of Neurosurgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium. andrew.maas@uza.be.
Andrew I R
AI
Maas
D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000453:epidemiology*; D005060:Europe; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged
Epidemiology; External cause; Incidence; Mortality; Systematic review; Traumatic brain injury