title: A population-based study on epidemiology of intensive care unit treated traumatic brain injury in Iceland.
abstract: BACKGROUND
  Traumatic brain injury is a worldwide health issue and a significant cause of preventable deaths and disabilities. We aimed to describe population-based data on intensive care treated traumatic brain injury in Iceland over 15 years period.
  
  
  METHODS
  Retrospective review of all intensive care unit admissions due to traumatic brain injury at The National University Hospital of Iceland 1999-2013. Data were collected on demographics, mechanism of injury, alcohol consumption, glasgow come scale upon admission, Injury Severity Scoring, acute physiology and chronic health evaluation II score, length of stay, interventions and mortality (defined as glasgow outcome score one). All computerized tomography scans were reviewed for Marshall score classification.
  
  
  RESULTS
  Intensive care unit admissions due to traumatic brain injury were 583. The incidence decreased significantly from 14/100.000/year to 12/100.000/year. Males were 72% and the mean age was 41 year. Majority of patients (42%) had severe traumatic brain injury. The most common mechanism of injury was a fall from low heights (36.3%). The mortality was 18.2%. Increasing age, injury severity score, Marshall score and acute physiology and chronic health evaluation II score are all independent risk factors for death. Glasgow coma scale was not an independent prognostic factor for outcome.
  
  
  CONCLUSIONS
  Incidence decreased with a shift in injury mechanism from road traffic accidents to falls and an increased rate of traumatic brain injury in older patients following a fall from standing or low heights. Mortality was higher in older patients falling from low heights than in younger patients suffering multiple injuries in road traffic accidents. Age, injury severity score, acute physiology and chronic health evaluation II score and Marshall score are good prognostic factors for outcome. Traumatic brain injury continues to be a considerable problem and the increase in severe traumatic brain injury in the middle age and older age groups after a seemingly innocent accident needs a special attention.
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: G M
authors.identifier: http://orcid.org/0000-0003-2124-2810
authors.initials: GM
authors.lastname: Jonsdottir
authors.affiliation: Center of Public Health Sciences, University of Iceland, Reykjavik, Iceland.
authors.forename: S H
authors.initials: SH
authors.lastname: Lund
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: B
authors.initials: B
authors.lastname: Snorradottir
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, The National University Hospital of Iceland, Reykjavik, Iceland.|Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
authors.forename: S
authors.initials: S
authors.lastname: Karason
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavik, Iceland.|Department of Neurosurgery, The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: I H
authors.initials: IH
authors.lastname: Olafsson
authors.affiliation: Department of Radiology, The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: K
authors.initials: K
authors.lastname: Reynisson
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavik, Iceland.|Department of Emergency, The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: B
authors.initials: B
authors.lastname: Mogensen
authors.affiliation: Department of Anesthesia and Intensive Care Medicine, The National University Hospital of Iceland, Reykjavik, Iceland.
authors.forename: K
authors.initials: K
authors.lastname: Sigvaldason
mesh_terms: D018806:APACHE; D000058:Accidental Falls / Q000706:statistics & numerical data; D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000070642:Brain Injuries, Traumatic / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015600:Glasgow Coma Scale; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult