Affiliations: II. Department of Surgery, University of Cologne | Institute of Medical Statistics, Informatics and
Epidemiology, University of Cologne | Biochem. and Exptl. Division, II. Dept. of Surgery,
University of Cologne | Neurosurgical Clinic, Cologne-Merheim | Department of General Neurosurgery, University of
Cologne
Note: [] Correspondence to: B. Bouillon, II. Department of Surgery,
University of Cologne, Ostmerheimerstrasse 200, D-51109 Cologne, Germany; Tel.:
+49- 221-89070; Fax: +49-221-893864
Abstract: Epidemiological data on the incidence, the prehospital and hospital
care and the outcome of traumatic brain injury in Germany are scarce. It is
therefore difficult to estimate the importance of this injury with respect to
magnitude as well as effectiveness and efficiency of therapeutic concepts. We
therefore planned a study that was supposed to provide population based
epidemiological data in the field of severe brain trauma from the site of the
accident until discharge from hospital. All 90.000 prehospital emergencies that
were cared for by emergency physicians in Cologne from January 1990 until
December 1996 were screened for identification of severe brain trauma. Their
clinical course was reviewed using standard records and patients were included
if they had their accident within the city of Cologne and fullfilled the final
inclusion criteria of GCS ≤ 8 or AISHead ≥3. 650 eligible
patients were identified of whom 530 had complete datasets (follow-up 80 %).
Univariate statistical analysis was performed for all relevant variables. The
main study endpoints were incidence and outcome of severe brain trauma. The
annual incidence of severe brain trauma in Cologne (1 mio. inhabitants) was 93.
The average age was 39 years and 71 % of the patients were male. The average
prehospital GCS was 6.8, the average prehospital Trauma Score was 8.3 points.
49 % of the study population suffered from multiple injuries. The overall
mortality rate was 46,6 %. 60 % of deaths occurred within the prehospital
setting. The incidence of severe brain trauma in Cologne in this study was
significantly lower compared to what could be expected from the litera-ture.
The overall mortality was high, especially the high prehospital death rate is
striking.
Keywords: brain trauma, head injury, incidence, epidemiology, outcome
