Increased incidence and mortality of civilian penetrating traumatic brain injury in Sweden: a single centre registry-based study.

Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
29 Nov 2023
Historique:
received: 28 08 2023
accepted: 26 11 2023
medline: 2 12 2023
pubmed: 2 12 2023
entrez: 1 12 2023
Statut: aheadofprint

Résumé

Penetrating trauma to the head and neck (HN) has increased during the past decade in Sweden. This aim of this study was to characterize these injuries and to evaluate the outcome in patients treated at a tertiary trauma centre. Swedish trauma registry (SweTrau) data was extracted on patients with HN injuries admitted to Karolinska University Hospital, Stockholm, between 2011 and 2019. Outcome information was extracted from hospital records, with primary endpoints focusing of physiological outcome measures and secondary endpoints on surgical and radiological outcomes. Of 1436 penetrating trauma patients, 329 patients with penetrating HN injuries were identified. 20% (n=66) suffered a gunshot wound (GSW), 73% (n=240) a stab wound (SW), and 7% (n=23) other trauma mechanisms (OTM). The median age for GSW, SW and OTM were 25, 33, and 21, respectively. Assault was primary intent, GSW (81.8%, n=54) and SW (65.8%, n=158). Patients suffering GSWs had severer injuries, worse admission GCS-M and higher intubation rate at the injury site. Most GSW patients underwent major surgery (59.1%) as an initial procedure and more likely had intracranial haemorrhage (ICH) (21.2%). The 30-day mortality: 45.5% (n=30) for GSWs, 5.4% (n=13) for SWs and 0% (n=0) for OTMs. There was a yearly increase in incidence and mortality for GSW and SW. Between 2011 and 2019, there was an increasing yearly trend of incidence and mortality from penetrating HN trauma in Stockholm, Sweden. GSW patients suffered more severe injuries, ICHs, and underwent more surgical interventions compared to SW and OTM.

Sections du résumé

BACKGROUND BACKGROUND
Penetrating trauma to the head and neck (HN) has increased during the past decade in Sweden. This aim of this study was to characterize these injuries and to evaluate the outcome in patients treated at a tertiary trauma centre.
METHODS METHODS
Swedish trauma registry (SweTrau) data was extracted on patients with HN injuries admitted to Karolinska University Hospital, Stockholm, between 2011 and 2019. Outcome information was extracted from hospital records, with primary endpoints focusing of physiological outcome measures and secondary endpoints on surgical and radiological outcomes.
RESULTS RESULTS
Of 1436 penetrating trauma patients, 329 patients with penetrating HN injuries were identified. 20% (n=66) suffered a gunshot wound (GSW), 73% (n=240) a stab wound (SW), and 7% (n=23) other trauma mechanisms (OTM). The median age for GSW, SW and OTM were 25, 33, and 21, respectively. Assault was primary intent, GSW (81.8%, n=54) and SW (65.8%, n=158). Patients suffering GSWs had severer injuries, worse admission GCS-M and higher intubation rate at the injury site. Most GSW patients underwent major surgery (59.1%) as an initial procedure and more likely had intracranial haemorrhage (ICH) (21.2%). The 30-day mortality: 45.5% (n=30) for GSWs, 5.4% (n=13) for SWs and 0% (n=0) for OTMs. There was a yearly increase in incidence and mortality for GSW and SW.
CONCLUSION CONCLUSIONS
Between 2011 and 2019, there was an increasing yearly trend of incidence and mortality from penetrating HN trauma in Stockholm, Sweden. GSW patients suffered more severe injuries, ICHs, and underwent more surgical interventions compared to SW and OTM.

Identifiants

DOI: 10.1016/j.wneu.2023.11.129 PMID: 38040331
pubmed: 38040331
pii: S1878-8750(23)01693-5
doi: 10.1016/j.wneu.2023.11.129
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.

Auteurs

Robert D Lilford (RD)

Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Iftakher Hossain (I)

Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; Neurocentre, Department of Neurosurgery, Turku University Hospital, Turku, Finland; Department of Clinical Neurosciences, Neurosurgery Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, United Kingdom; Department of medical sciences, section for Neurosurgery, Uppsala University, Uppsala, Sweden.

Martin Dahlberg (M)

Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Carl-Magnus Wahlgren (CM)

Department of Molecular Medicine and Surgery, Centre for Trauma Research, Karolinska Institute and Department of Vascular Surgery, Karolinska University Hospital, Stockholm, Sweden.

Bo-Michael Bellander (BM)

Department of Neurosurgery and Department of Clinical Neuroscience, Karolinska Uni. Hospital and Karolinska Institutet, Stockholm, Sweden.

Amir Rostami (A)

Department of Social Work and Criminology, University of Gävle, Sweden; Institute for Future Studies, Stockholm, Sweden.

Mattias Günther (M)

Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.

Jiri Bartek (J)

Department of Neurosurgery and Department of Clinical Neuroscience, Karolinska Uni. Hospital and Karolinska Institutet, Stockholm, Sweden; Department of Neurosurgery, Rigshospitalet, Copenhagen, Denmark.

Elham Rostami (E)

Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of medical sciences, section for Neurosurgery, Uppsala University, Uppsala, Sweden. Electronic address: Elham.Rostami@ki.se.

Classifications MeSH