REVIEWARTICLE- BRAIN INJURY Epidemiology of traumatic brain injury in Europe

Background Traumatic brain injury (TBI) is a critical public health and socio-economic problem throughout the world, making epidemiological monitoring of incidence, prevalence and outcome of TBI necessary. We aimed to describe the epidemiology of traumatic brain injury in Europe and to eval-uate the methodology of incidence studies. Method We performed a systematic review andmeta-analyses of articles describing the epidemiology of TBI in European countries. A search was conducted in the PubMed electronic database using the terms: epidemiology, incidence, brain injur*, head injur * and Europe. Only articles published in English and reporting on data collected in Europe between 1990 and 2014 were included. Results In total, 28 epidemiological studies on TBI from 16 European countries were identified in the literature. A great variation was found in case definitions and case ascertainment between studies. Falls and road traffic accidents (RTA) were the two most frequent causes of TBI, with falls being reported more frequently than RTA. In most of the studies a peak TBI incidence was seen in the oldest age groups. In the meta-anal-ysis, an overall incidence rate of 262 per 100,000 for admitted TBI was derived. Conclusions Interpretation of published epidemiologic stud-ies is confounded by differences in inclusion criteria and case ascertainment. Nevertheless, changes in epidemiological pat-terns are found: falls are now the most common cause of TBI, most notably in elderly patients. Improvement of the quality of standardised data collection for TBI is mandatory for reli-able monitoring of epidemiological trends and to inform ap-propriate targeting of prevention campaigns