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. 2021 May 15;38(10):1411-1440.
doi: 10.1089/neu.2015.4126. Epub 2018 Dec 19.

Epidemiology of Traumatic Brain Injury in Europe: A Living Systematic Review

Alexandra Brazinova  1 , Veronika Rehorcikova  1 , Mark S Taylor  1 , Veronika Buckova  1 , Marek Majdan  1 , Marek Psota  1 , Wouter Peeters  2 , Valery Feigin  3 , Alice Theadom  3 , Lubomir Holkovic  1 , Anneliese Synnot  4   5
Affiliations

Epidemiology of Traumatic Brain Injury in Europe: A Living Systematic Review

Alexandra Brazinova et al. J Neurotrauma. .

Abstract

This systematic review provides a comprehensive, up-to-date summary of traumatic brain injury (TBI) epidemiology in Europe, describing incidence, mortality, age, and sex distribution, plus severity, mechanism of injury, and time trends. PubMed, CINAHL, EMBASE, and Web of Science were searched in January 2015 for observational, descriptive, English language studies reporting incidence, mortality, or case fatality of TBI in Europe. There were no limitations according to date, age, or TBI severity. Methodological quality was assessed using the Methodological Evaluation of Observational Research checklist. Data were presented narratively. Sixty-six studies were included in the review. Country-level data were provided in 22 studies, regional population or treatment center catchment area data were reported by 44 studies. Crude incidence rates varied widely. For all ages and TBI severities, crude incidence rates ranged from 47.3 per 100,000, to 694 per 100,000 population per year (country-level studies) and 83.3 per 100,000, to 849 per 100,000 population per year (regional-level studies). Crude mortality rates ranged from 9 to 28.10 per 100,000 population per year (country-level studies), and 3.3 to 24.4 per 100,000 population per year (regional-level studies.) The most common mechanisms of injury were traffic accidents and falls. Over time, the contribution of traffic accidents to total TBI events may be reducing. Case ascertainment and definitions of TBI are variable. Improved standardization would enable more accurate comparisons.

Keywords: epidemiology; living systematic review; traumatic brain injury.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart of the study selection process.
FIG. 2.
FIG. 2.
Traumatic brain injury incidence and mortality rates (crude) per 100,000 population per year in country-level studies.
FIG. 3.
FIG. 3.
Traumatic brain injury incidence and mortality (crude) rates per 100,000 population per year in regional-level studies.
FIG. 4.
FIG. 4.
Traumatic brain injury (TBI) incidence rates (crude) per 100,000 population per year in country-level studies. Studies reporting on all ages and all TBI severity were used. The size of the boxes depicts the weight (relative to other studies in the analysis) that the study has in relation to the summary measure of the meta-analysis; larger boxes depict higher weight. (a), 1998 data; (b), average for 5-year period (1991–1995); (c), 2001–2005 data; (d), 2009 data; (e), average for 2009–2011; (f), average for 2010–2012.
FIG. 5.
FIG. 5.
Traumatic brain injury (TBI) incidence rates (crude) per 100,000 population per year in regional-level studies. Studies reporting on all ages and all TBI severity were used. The size of the boxes depicts the weight (relative to other studies in the analysis) that the study has in relation to the summary measure of the meta-analysis; larger boxes depict higher weight. *ref. no. 80; (g), 1996 data.
FIG. 6.
FIG. 6.
Funnel plot of traumatic brain injury incidence in regional-level studies.
FIG. 7.
FIG. 7.
The most common mechanisms of injury in country-level studies.
FIG. 8.
FIG. 8.
The most common mechanisms of injury in regional-level studies.
See this image and copyright information in PMC

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