1. Incidence, course and risk factors of head injury: a retrospective cohort study.
- Author
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Gerritsen H, Samim M, Peters H, Schers H, and van de Laar FA
- Subjects
- Accidents, Traffic, Adolescent, Adult, Aged, Aged, 80 and over, Alcoholic Intoxication, Anticoagulants, Bicycling, Child, Child, Preschool, Craniocerebral Trauma etiology, Female, Humans, Incidence, Infant, Male, Middle Aged, Netherlands epidemiology, Retrospective Studies, Risk Factors, Young Adult, Craniocerebral Trauma epidemiology
- Abstract
Objectives: To assess the incidence of head injury and predictors of complication across the care continuum., Design: Retrospective cohort study using data from a research network. We calculated the incidence of overall head injury in a longitudinal cohort covering 1-year interval (31 369 patient-years), and the incidence of complicated head injury in a longitudinal cohort covering 10 years interval (220 352 patient-ears). Incidence rates were calculated per 1000 patient-years with 95% CI using the Mid-P exact test. We calculated ORs to assess potential risk factors for a complicated head injury., Setting: A practice-based research network covering a population of >30 000 patients., Participants: All patients listed in practices within the research network during the years 2005-2014., Main Outcome Measures: Incidence of (complicated) head injury and predictors for clinical complications., Results: The incidence of overall head injury was 22.1 per 1000 person-years and the incidence of a complicated course following head injury was 0.16 per 1000 person-years. The following determinants were risk factors for a complicated course: high energy trauma, bicycle accident, traffic accident in general, use of anticoagulants, alcohol intoxication, age above 60 years and low Glasgow Coma Scale at initial presentation. A complicated course was very unlikely when the patients' first encounter with a healthcare professional was in primary care (OR 0.03, 95% CI 0.01 to 0.07)., Conclusions: Complication after head injury are rarely seen in general practice. Patients who do experience complications are often easily identifiable as requiring specialist care. A more reserved referral policy for general practice may be desirable, suggesting that current guidelines are too defensive., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)
- Published
- 2018
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