The Epidemiology of Head Trauma in Aquitaine (France), 1986: A Community-Based Study of Hospital Admissions and Deaths

Abstract

Tiret L (Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 258, Hōpital Broussais, 96 rue Didot, 75674 Paris Cédex 14, France), Hausherr E, Thicoipe M, Garros B, Maurette P, Castel J P and Hatton F. The epidemiology of head trauma in Aquitaine (France), 1986: A community-based study of hospital admissions and deaths. International Journal of Epidemiology 1990, 19: 133–140. This paper reports the findings of a study of head trauma conducted over a one-year period within a defined region with a population of 2.7 million (Aquitaine, France). It includes cases resulting in death prior to hospitalization or requiring hospitalization. During the one-year period, 391 deaths and 8549 hospital admissions due to head trauma occurred, yielding an annual estimate of 8940 head-injured people. The immediate case-fatality rate was 4.4%. Among non-fatal cases, 80% were mild, 11% moderate and 9% severe. The overall annual incidence was 281/100 000 in both sexes (384 and 185/100 000 in males and females respectively). The annual death rate was 22/100 000 (33 and 12, respectively). Patterns of incidence by age and sex were in general agreement with earlier studies. The main causes of head trauma were traffic accidents (60%) and falls (33%). One-third of hospitalized patients had no injury other than the head trauma. The most frequently associated injuries were those involving extremities, whereas the most severe were those involving the abdomen. The Injury Severity Score (ISS) ranged from 4 to 66, with a mean of 9 and a median of 5. At the eighth day following injury, 25% of hospital-treated patients were still hospitalized and 2% had died. The outcome correlated well with the ISS.