The world’s leading cause of traumatic brain injury is traffic accidents, although they vary by country because there are high rates of falls from height among older adults in rich countries. This is according to the first global study of brain injuries, carried out by researchers at Oregon Health and Science University (United States) and published in the journal ‘Nature Medicine’.
Every year, tens of millions of people around the world suffer head injuries, with almost five million deaths. The study relied on the collaboration of medical students to collect data from more than 2000 patients from 100 hospitals in 29 countries between 2019 and 2022.
«You can’t solve a global brain injury crisis in operating rooms alone,» according to Ahmed Raslan, chief of neurosurgery at Oregon Health & Science University School of Medicine, adding, «This study demonstrates the importance of improving the systems around us.»
Paradoxically, the research found lower rates of head trauma in less developed countries than in more industrialized ones.
This could be related to difficulty accessing medical care, especially in rural areas, where seriously injured people might not survive long enough to reach a hospital. «If in rich countries it takes two hours to get to a hospital, in some low-income countries it can take five days,» Raslan said.
PREVENT FROM THE START
Previous research looked at the efficacy of various clinical and surgical approaches to treating traumatic brain injuries. While surgical and medical teams continue to improve care for these patients, this new study is one of the first to define injury patterns, care practices, and outcomes across countries, based on their Human Development Index, which considers indicators such as income, education, and gross domestic product.
The study suggests the importance of improving infrastructure, such as roads, and encouraging helmetwearing, said Joseph Nugent, a neurosurgeon-in-residence at Oregon Health & Science University.
«Skilled neurosurgeons can accomplish a lot, but my mentors at the fire department and public health taught me that the best way to optimize trauma outcomes is to focus efforts on preventing injury early on,» Nugent explains.
Strategies to reduce traumatic brain injuries vary from country to country, according to the researchers. For example, falls at ground level are the most common cause of traumatic injuries treated at Oregon Health & Science University Hospital.
«Prevention strategies may be different in other countries where young people account for the majority of injuries in traffic accidents. The gaps are not the same in all countries, and policymakers must design solutions tailored to their own needs,» Nugent said.
