title: Epidemiology of Traumatic Brain Injuries at a Major Government Hospital in Cambodia.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is a critical public health problem worldwide with a significant socioeconomic burden. Although improved safety regulations in high-income countries have resulted in a decline in traffic-related TBI, the incidence of TBI in low-income countries is on the rise. We illustrate the trends and factors involved in TBI in a large Cambodian governmental hospital in Phnom Penh. In addition, suggestions for improvement of the country's road traffic safety are discussed.
  
  
  METHODS
  This is a cross-sectional study of all patients who presented with traumatic brain injury to Department of Neurosurgery at Preah Kossamak Hospital in Phnom Penh, Cambodia between November 2013 and March 2016.
  
  
  RESULTS
  TBIs in Cambodia are on the rise; 34% occur during rush hour, 5-9 pm, and 40% during the weekend. The vast majority (74%) occur as the result of road traffic accidents, of which 81% are motorcycle related. Helmet wear remains low at 13%, and recent alcohol use was reported as 38%. The most common diagnosis is skull fracture. The subdural to epidural hematoma ratio was 1:1.05. Lastly, in both subdural and epidural hematomas the frontal lobe was most commonly involved, with 60% of epidural hematomas associated with a lucid interval.
  
  
  CONCLUSIONS
  Our study suggests prevention and management of TBIs can have a measurable public health impact in Cambodia. Initiative examples include helmet safety awareness campaigns, stricter penalties, improvement of prehospital care, and more efficient triage. A high proportion of unhelmeted motorcycle accidents correlates with an increase in epidural hematomas.
authors: University of Texas Southwestern Medical Center, Dallas, Texas, USA; Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia, USA. Electronic address: Sophie.Peeters@UTsouthwestern.edu.
authors: Sophie
authors: S
authors: Peeters
authors: Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia, USA.
authors: Caitlin
authors: C
authors: Blaine
authors: Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia, USA.
authors: Iv
authors: I
authors: Vycheth
authors: Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia, USA.
authors: Sam
authors: S
authors: Nang
authors: Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia, USA.
authors: Din
authors: D
authors: Vuthy
authors: Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia, USA; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.
authors: Kee B
authors: KB
authors: Park
mesh_terms: D000063:Accidents, Traffic / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology*; D000070642:Brain Injuries, Traumatic / Q000453:epidemiology*; D002160:Cambodia / Q000453:epidemiology; D002648:Child; D003906:Developing Countries / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017678:Sex Distribution; D012887:Skull Fractures / Q000453:epidemiology*; D055815:Young Adult
keywords: Cambodia; Helmet; Low-income countries; Neurosurgery; Road traffic accidents; Traumatic brain injury