Location of traumatic brain injury-related deaths: epidemiological analysis of 11 European countries

ABSTRACTBackground: Understanding the factors related to traumatic brain injury (TBI)-related mortality is important in obtaining a complete picture of the predictors and burden of injury-related deaths.Objective: To analyze deaths due to TBI occurring inside versus outside hospitals.Methods: Data were obtained by requests to the representatives of national statistical offices and health administration institutions for one reported calendar year (2014 or the nearest available year).Results: A total of 4513 cases of TBI-related deaths were identified. Of these, 2045 (45%) occurred outside and 2468 (55%) in hospitals. The pooled out-of-hospital age-adjusted mortality rate was 5.5 (95% CI = 4.8–6.3), and in-hospital age-adjusted rate was 6.6 (95% CI = 5.2–7.9) per 100 000 people. Outside (25%) or inside (53%) hospitals, the most common cause of TBI-related deaths was falls. The age group of 15–24 years and traffic-related, suicide-related, and violence-related mechanisms were the most significant factors ass...