The incidence and outcome after relevant traumatic brain injury: An epidemiological study in an urban center of one million inhabitants in western Germany over 10 years

Valid epidemiological data on the incidence and outcome of traumatic brain injury (TBI) show great variability. A 10-year study on the incidence, severity and outcome of relevant TBI was conducted in an urban area of one million inhabitants in western Germany, the city of Cologne. A total of 130,000 prehospital emergencies carried out at the city of Cologne emergency medical service between 1st January 1990 and 31st December, 1999 were screened for TBI. Inclusion criteria were a GCS (Glasgow Coma Scale) 8 and/or AIShead(Abbreviated injury scale for the head) 2 with confirmed TBI via appropriate diagnostic procedures. The annual incidence of relevant TBI was 7.3/100,000. The overall mortality rate was 45.8%, pre-hospital deaths totaled 182 (28%), 116 patients (17.8%) died in hospital. Of the surviving patients 214 out of 352 (60.8%) were sufficiently rehabilitated at discharge (GOS=1), but 138 patients (39.2%) survived with persisting deficits. GOS was correlated to initial GCS and AISheadvalues. The incidence of TBI was lower compared to the figures in the literature but the overall mortality was high, especially in the pre- and early in-hospital periods.

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