Incidence of emergency neurosurgical TBI procedures: a population-based study
Abstract Background The rates of emergency neurosurgery in traumatic brain injury (TBI) patients vary between populations and trauma centers. In planning acute TBI treatment, knowledge about rates and incidence of emergency neurosurgery at the population level is of importance for organization and p...
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-021-00561-w |
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| author | Cathrine Tverdal Mads Aarhus Pål Rønning Ola Skaansar Karoline Skogen Nada Andelic Eirik Helseth |
| author_facet | Cathrine Tverdal Mads Aarhus Pål Rønning Ola Skaansar Karoline Skogen Nada Andelic Eirik Helseth |
| author_sort | Cathrine Tverdal |
| collection | DOAJ |
| description | Abstract Background The rates of emergency neurosurgery in traumatic brain injury (TBI) patients vary between populations and trauma centers. In planning acute TBI treatment, knowledge about rates and incidence of emergency neurosurgery at the population level is of importance for organization and planning of specialized health care services. This study aimed to present incidence rates and patient characteristics for the most common TBI-related emergency neurosurgical procedures. Methods Oslo University Hospital is the only trauma center with neurosurgical services in Southeast Norway, which has a population of 3 million. We extracted prospectively collected registry data from the Oslo TBI Registry – Neurosurgery over a five-year period (2015–2019). Incidence was calculated in person-pears (crude) and age-adjusted for standard population. We conducted multivariate multivariable logistic regression models to assess variables associated with emergency neurosurgical procedures. Results A total of 2151 patients with pathological head CT scans were included. One or more emergency neurosurgical procedure was performed in 27% of patients. The crude incidence was 3.9/100,000 person-years. The age-adjusted incidences in the standard population for Europe and the world were 4.0/100,000 and 3.3/100,000, respectively. The most frequent emergency neurosurgical procedure was the insertion of an intracranial pressure monitor, followed by evacuation of the mass lesion. Male sex, road traffic accidents, severe injury (low Glasgow coma score) and CT characteristics such as midline shift and compressed/absent basal cisterns were significantly associated with an increased probability of emergency neurosurgery, while older age was associated with a decreased probability. Conclusions The incidence of emergency neurosurgery in the general population is low and reflects neurosurgery procedures performed in patients with severe injuries. Hence, emergency neurosurgery for TBIs should be centralized to major trauma centers. |
| first_indexed | 2024-04-11T20:45:06Z |
| format | Article |
| id | doaj.art-359b2cb6e535433c9ac4e53326b2a92d |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-04-11T20:45:06Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-359b2cb6e535433c9ac4e53326b2a92d2022-12-22T04:04:03ZengBMCBMC Emergency Medicine1471-227X2022-01-0122111110.1186/s12873-021-00561-wIncidence of emergency neurosurgical TBI procedures: a population-based studyCathrine Tverdal0Mads Aarhus1Pål Rønning2Ola Skaansar3Karoline Skogen4Nada Andelic5Eirik Helseth6Department of Neurosurgery, Oslo University HospitalDepartment of Neurosurgery, Oslo University HospitalDepartment of Neurosurgery, Oslo University HospitalDepartment of Neurosurgery, Oslo University HospitalDepartment of Neuroradiology, Oslo University HospitalDepartment of Physical Medicine and Rehabilitation, Oslo University HospitalDepartment of Neurosurgery, Oslo University HospitalAbstract Background The rates of emergency neurosurgery in traumatic brain injury (TBI) patients vary between populations and trauma centers. In planning acute TBI treatment, knowledge about rates and incidence of emergency neurosurgery at the population level is of importance for organization and planning of specialized health care services. This study aimed to present incidence rates and patient characteristics for the most common TBI-related emergency neurosurgical procedures. Methods Oslo University Hospital is the only trauma center with neurosurgical services in Southeast Norway, which has a population of 3 million. We extracted prospectively collected registry data from the Oslo TBI Registry – Neurosurgery over a five-year period (2015–2019). Incidence was calculated in person-pears (crude) and age-adjusted for standard population. We conducted multivariate multivariable logistic regression models to assess variables associated with emergency neurosurgical procedures. Results A total of 2151 patients with pathological head CT scans were included. One or more emergency neurosurgical procedure was performed in 27% of patients. The crude incidence was 3.9/100,000 person-years. The age-adjusted incidences in the standard population for Europe and the world were 4.0/100,000 and 3.3/100,000, respectively. The most frequent emergency neurosurgical procedure was the insertion of an intracranial pressure monitor, followed by evacuation of the mass lesion. Male sex, road traffic accidents, severe injury (low Glasgow coma score) and CT characteristics such as midline shift and compressed/absent basal cisterns were significantly associated with an increased probability of emergency neurosurgery, while older age was associated with a decreased probability. Conclusions The incidence of emergency neurosurgery in the general population is low and reflects neurosurgery procedures performed in patients with severe injuries. Hence, emergency neurosurgery for TBIs should be centralized to major trauma centers.https://doi.org/10.1186/s12873-021-00561-wEmergencyNeurosurgeryTraumatic brain injuryTrauma centerIncidence |
| spellingShingle | Cathrine Tverdal Mads Aarhus Pål Rønning Ola Skaansar Karoline Skogen Nada Andelic Eirik Helseth Incidence of emergency neurosurgical TBI procedures: a population-based study BMC Emergency Medicine Emergency Neurosurgery Traumatic brain injury Trauma center Incidence |
| title | Incidence of emergency neurosurgical TBI procedures: a population-based study |
| title_full | Incidence of emergency neurosurgical TBI procedures: a population-based study |
| title_fullStr | Incidence of emergency neurosurgical TBI procedures: a population-based study |
| title_full_unstemmed | Incidence of emergency neurosurgical TBI procedures: a population-based study |
| title_short | Incidence of emergency neurosurgical TBI procedures: a population-based study |
| title_sort | incidence of emergency neurosurgical tbi procedures a population based study |
| topic | Emergency Neurosurgery Traumatic brain injury Trauma center Incidence |
| url | https://doi.org/10.1186/s12873-021-00561-w |
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