A1 Refereed original research article in a scientific journal
Increased Incidence and Mortality of Civilian Penetrating Traumatic Brain Injury in Sweden: A Single-Center Registry-Based Study
Authors: Lilford Robert D., Hossain Iftakher, Dahlberg Martin, Wahlgren Carl-Magnus, Bellander Bo-Michael, Rostami Amir, Günther Mattias, Bartek Jiri, Rostami Elham
Publisher: Elsevier
Publication year: 2024
Journal: World Neurosurgery
Journal name in source: World Neurosurgery
Volume: 182
First page : e493
Last page: e505
ISSN: 1878-8750
eISSN: 1878-8769
DOI: https://doi.org/10.1016/j.wneu.2023.11.129(external)
Web address : https://doi.org/10.1016/j.wneu.2023.11.129(external)
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/381269391(external)
Background Penetrating trauma to the head and neck has increased during the past decade in Sweden. The aim of this study was to characterize these injuries and evaluate the outcomes for patients treated at a tertiary trauma center. Methods Swedish trauma registry data were extracted on patients with head and neck injuries admitted to Karolinska University Hospital (Stockholm, Sweden) between 2011 and 2019. Outcome information was extracted from hospital records, with the primary endpoints focusing on the physiological outcome measures and the secondary endpoints on the surgical and radiological outcomes. Results Of 1436 patients with penetrating trauma, 329 with penetrating head and neck injuries were identified. Of the 329 patients, 66 (20%) had suffered a gunshot wound (GSW), 240 (73%) a stab wound (SW), and 23 (7%) an injury from other trauma mechanisms (OTMs). The median age for the corresponding 3 groups of patients was 25, 33, and 21 years, respectively. Assault was the primary intent, with 54 patients experiencing GSWs (81.8%) and 158 SWs (65.8%). Patients with GSWs had more severe injuries, worse admission Glasgow coma scale, motor, scores, and a higher intubation rate at the injury site. Most GSW patients underwent major surgery (59.1%) as the initial procedure and were more likely to have intracranial hemorrhage (21.2%). The 30-day mortality was 45.5% (n = 30) for GSWs, 5.4% (n = 13) for SWs, and 0% (n = 0) for OTMs. There was an annual increase in the incidence and mortality for GSWs and SWs. Conclusions Between 2011 and 2019, an increasing annual trend was found in the incidence and mortality from penetrating head and neck trauma in Stockholm, Sweden. GSW patients experienced more severe injuries and intracranial hemorrhage and underwent more surgical interventions compared with patients with SWs and OTMs.
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