Years of life lost due to traumatic brain injury in Europe: A cross-sectional analysis of 16 countries

• Published in: PLoS medicine 2017-07, Vol.14 (7), p.e1002331-e1002331
• Main Authors: Majdan, Marek, Plancikova, Dominika, Maas, Andrew, Polinder, Suzanne, Feigin, Valery, Theadom, Alice, Rusnak, Martin, Brazinova, Alexandra, Haagsma, Juanita
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Brain; Brain injuries; Brain Injuries, Traumatic - epidemiology; Brain Injuries, Traumatic - etiology; Child; Child, Preschool; Classification; Coding; Complications and side effects; Crashes; Cross-Sectional Studies; Data processing; Death; Demographics; Demography; Epidemiology; Europe; Europe - epidemiology; Extrapolation; Fatalities; Female; Females; Health sciences; Humans; Incidence; Infant; Infant, Newborn; Injury analysis; Life Expectancy; Male; Males; Medicine and Health Sciences; Metadata; Middle Aged; Mortality; Neural coding; Neurosciences; People and Places; Population; Population studies; Public health; Resource allocation; Risk factors; Sex; Social work; Studies; Traffic; Traffic information; Traumatic brain injury; Young Adult
• ISSN: 1549-1676; 1549-1277; 1549-1676
• DOI: 10.1371/journal.pmed.1002331

Traumatic brain injuries (TBIs) are a major public health, medical, and societal challenge globally. They present a substantial burden to victims, their families, and the society as a whole. Although indicators such as incidence or death rates provide insight into the occurrence and outcome of TBIs in various populations, they fail to quantify the full extent of their public health and societal impact. Measures such as years of life lost (YLLs), which quantifies the number of years of life lost because the person dies prematurely due to a disease or injury, should be employed to better quantify the population impact. The aim of this study was to provide an in-depth analysis of the burden of deaths due to TBI by calculating TBI-specific YLLs in 16 European countries, analyzing their main causes and demographic patterns, using data extracted from death certificates under unified guidelines and collected in a standardized manner. A population-wide, cross-sectional epidemiological study was conducted in 16 European countries to estimate TBI YLLs for the year 2013. The data used for all analyses in this study were acquired from the statistical office of the European Union (Eurostat). A specifically tailored dataset of micro-level data was provided that listed the external cause of death (International Classification of Diseases-10th Revision [ICD-10] codes V01-Y98), the specific nature of injury (ICD-10 codes S00-T98), the age at death, and sex for each death. Overall number of TBI YLLs, crude and age-standardized TBI YLL rates, and TBI YLLs per case were calculated stratified for country, sex, and age. Pooled analyses were performed in order to estimate summary age-standardized rates of TBI YLLs. In order to evaluate the relative importance of TBI in the context of all injuries, proportions of TBI YLLs out of overall injury YLLs were calculated. The total number of TBI YLLs was estimated by extrapolating the pooled crude rate of TBI YLLs in the 16 analyzed countries to the total population of the 28 member states of the EU (EU-28). We found that a total of 17,049 TBI deaths occurred in 2013 in the 16 analyzed countries. These translated into a total of 374,636 YLLs. The pooled age-standardized rate of YLLs per 100,000 people per year was 259.1 (95% CI: 205.8 to 312.3) overall, 427.5 (95% CI: 290.0 to 564.9) in males, and 105.4 (95% CI: 89.1 to 121.6) in females. Males contributed substantially more to TBI YLLs than females (282,870 YLLs, 76% of all TBI YLLs),