Причины травм головы и смертность от них кардинально различаются в странах с разным уровнем развития

HealthDay News — Causes of traumatic brain injury (TBI) and outcomes vary worldwide, according to a study published online Aug. 19 in Nature Medicine. Joseph G. Nugent, M.D., M.P.H., from the Oregon Health & Science University in Portland, and colleagues conducted a prospective cohort study involving 2,165 patients with TBI from 100 hospitals in 29 countries between 2019 and 2022 to examine disparities across Human Development Index (HDI) tiers. The researchers identified disparities, with the median age ranging from 32 to 63 years for high- and very high-HDI tiers, respectively. The predominant cause of TBI was traffic injuries in low-HDI (65.8 percent) and falls in very high-HDI (66 percent) tiers. The percentage of patients arriving via private vehicles varied from 69.3 to 13 percent for the low- and very high-HDI tiers, respectively. The adjusted mortality odds were highest in the high-HDI tier versus the very high-HDI tier in logistic regression with inverse probability weighting (odds ratio, 3.13); no significant elevation was seen for low- or medium-HDI tiers. There was no dose-response relationship between mortality and HDI. Drivers of outcome disparities included inequities in injury mechanisms, patient demographics, and prehospital access. “We could reduce a lot of mortality from traumatic brain injuries in Oregon if we could make sure that frail people don’t fall,” senior author Ahmed M. Raslan, M.D., also from the Oregon Health & Science University, said in a statement. “Prevention strategies may differ in other countries where young people in motor vehicle accidents account for the largest share of injuries. The gaps are not the same in every country, and policymakers need to design solutions based on their own needs.” Abstract/Full Text