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This study was primarily aimed at establishing the incidence and impact of hypotension in patients with blunt traumatic brain injury based on National Trauma Registry Database. A retrospective cohort study using the National Trauma Registry was conducted. Patients with TBI following blunt mechanisms of injury were examined, comparing those with and without hypotension (SBP < 90 mm Hg) on arrival. During the period from 1998 to 2017, the registry included 437.354 blunt trauma patients. Of them, 7818 patients were hemodynamically unstable (SBP < 90 mm Hg) on admission. 513 met the inclusion criteria. Significant percentages of patients with high grade injures (ISS≥16) and low admission's GCS 3-12 (46% vs 16.4%), were found in the group of hypotensive TBI patients (p<0.0001). 323 (62.9%) patients had head AIS score 3-4 and only 190 (37.1%) patients AIS 5-6 (p<0.0001). Mortality in the hypotensive TBI group was 32.3%, whereas 6.1% patients died in the TBI hemodynamically stable group (p<0.0001) TBI patients presenting with hypotension represent an appreciable portion blunt trauma patients. Prompt brain CT, expedient efforts at optimal resuscitation and possibly early inotropic and vasopressors agents use may have an impact on final outcome in these patients. [ABSTRACT FROM AUTHOR]

Objective: The effects of televised trauma on the emotional well-being of television viewers has received some scientific attention in recent years, suggesting that the general public is placed at risk of developing distress and possibly posttraumatic psychopathology as a result of secondary exposure via mass media. At the break of a recent war in Gaza, we assessed the psychological effects of the extensive news broadcasting. Method: An omnibus survey was performed two weeks into Operation Protective Edge with a sample of 500 participants representing the adult (> 18) Jewish population of Israel. Results: The results suggest that a vast majority (87.2%) of the population tuned in to the newscasts and the majority (76.7%) of viewers increased their news consumption compared to normal. Increased frequency of viewing newscasts was associated with reported anxiety reflected in uncontrolled fear, physiological hyperarousal, sleeping difficulties, and fearful thoughts. A regression model revealed that viewers watching the constant newscasts more than usual are 1.6 times more likely to report at least one anxiety symptom compared to those watching at the same frequency or less, standardized to gender and age. Conclusions: Increased viewing patterns of televised traumatic content, as well as negative perception of such broadcasts, are associated with the report of anxiety symptoms or psychopathology. The public health implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Background: Recent studies noted the limited applicability of Glasgow Coma Scale (GCS) for elderly patients with Traumatic Brain Injury (TBI). However, the dichotomic distinction between "elderly" and "non-elderly" does not cover the full span of influence of age on GCS presentation. Objective: To analyze the influence of age on GCS scores of patients with isolated TBI. Methods: A retrospective study of 18,534 patients hospitalized due to isolated TBI recorded in the Israeli National Trauma Registry in 1997-2017. The GCS scores were compared between four age-groups: 20-44, 45-64, 65-74 and 75+ years old. Additional factors included patient's sex, Abbreviated Injury Scores (AIS) and injury circumstances. Results: GCS scores increased continuously with age at all AIS levels. The trend was significant even after adjustment for patient's sex and injury circumstances. The angle of the trend was different in various injury circumstances, with GCS scores of victims of Road Traffic Accidents sharply increasing after age of 44 and that of the patients hospitalized after falling from own height surging after age of 64. Conclusions: Screening procedures for patients with TBI should give a greater weight to the actual age of adults, as well as to the circumstances of their injury. [ABSTRACT FROM AUTHOR]

Objective: To compare demographic, injury and hospitalization characteristics and mortality between Isolated and Non-Isolated traumatic brain injury. Methods: A retrospective study based on the Israeli National Trauma Registry of patients hospitalized for traumatic brain injury (TBI) between 2008 and 2016. Isolated TBI was defined as no other anatomic region was having concomitant injury with AIS ≥2. X2 test and multivariate logistic regression analysis were used for data analysis. Results: Of the 23566-study population, 40.4% were admitted for isolated TBI. Isolated TBI was significantly more frequent in elderly aged ≥65 years, female, Jews, and injuries sustained at home or in residential institution. The Non-isolated TBI was greater in road traffic injuries, particularly among pedestrians and motor cyclists, and in violence injuries. The Non-isolated TBI group had greater injury severity and hospital resource utilization. In-hospital mortality was higher in the patients with Non-isolated TBI [OR: 1.56(95% CI: 1.33–1.83)], particularly in patients with GCS 13–15; elderly aged 65+ years; and patients with concomitant injuries to abdomen, spine or external body regions. Conclusion: In a patient with TBI, concomitant injuries with AIS ≥2 matter, and awareness of the identified factors has relevance for guiding injury prevention efforts and indeed for potentially improving care and outcome. [ABSTRACT FROM AUTHOR]

Objective.To examine whether characteristics and circumstances of injuries are related to ethnicity. Design.The study was based on the Israeli National Trauma Registry data for patients hospitalized between 2008 and 2011. Data included demographics, injury, hospital resource utilization characteristics and outcome at discharge. Univariate analysis followed by logistic regression models were undertaken to examine the relationship between injury and ethnicity. Results.The study included 116,946 subjects; 1% were Ethiopian Born Israelis (EBI), 11% Israelis born in the Former Soviet Union (FSUBI) and 88% the remaining Israelis (RI). EBI were injured more on street or at work place and had higher rates of penetrating and severe injuries. However, FSUBI were mostly injured at home, and had higher rates of fall injuries and hip fracture. Adjusted analysis showed that EBI and FSUBI were more likely to be hospitalized because of violence-related injuries compared with RI but less likely because of road traffic injuries. Undergoing surgery and referral for rehabilitation were greater among FSUBI, while admission to intensive care unit was greater among EBI. Conclusion.Targeted intervention programmes need to be developed for immigrants of different countries of origin in accordance with the identified characteristics. [ABSTRACT FROM PUBLISHER]

Aim: To assess the incidence and injury characteristics of hospitalized trauma patients diagnosed with TBI. Methods: A retrospective study of all injured hospitalized patients recorded in the National Trauma Registry at 19 trauma centres in Israel between 2002–2011. Incidence and injury characteristics were examined among children, adults and seniors. Results: The annual incidence rate of hospitalized TBI for the Israeli population in 2011 was 31.8/100 000. Age-specific incidence was highest among seniors with a dramatic decrease in TBI-related mortality rate among them. Adults, in comparison to children and seniors, had higher rates of severe TBI, severe and critical injuries, more admission to the intensive care unit, underwent surgery, were hospitalization for more than 2 weeks and were discharged to rehabilitation. After adjusting for age, gender, ethnicity, mechanism of injury and injury severity score, TBI-related in-hospital mortality was higher among seniors and adults compared to children. Conclusion: Seniors are at high risk for TBI-related in-hospital mortality, although adults had more severe and critical injuries and utilized more hospital resources. However, seniors showed the most significant reduction in mortality rate during the study period. Appropriate intervention programmes should be designed and implemented, targeted to reduce TBI among high risk groups. [ABSTRACT FROM AUTHOR]

Objective.To examine the differences and characteristics of road traffic injuries (RTIs) among Jewish and Arab children, ages 0–17 years, in Israel. Design.A retrospective study based on data from the Israeli National Trauma Registry between 2001 and 2010. This study relates specifically to traffic-related hospitalizations among children ages 0–17 years. Data include demographic, injury, and hospitalization characteristics. Descriptive statistics and adjusted logistic regression were used to examine the differences of RTIs between the two ethnic groups. Results.A total of 18,884 children were included, of which Arab children comprised 38.2% of the total and 44.1% of the severely injured. Among Arab children 41.8% were pedestrians compared to 33.4% among Jewish children (p<0.0001). Arab children were younger, had more severe injuries and more traumatic brain injury (TBI) compared to Jewish children. Adjusted logistic regression analysis shows that the probability of an Arab child, relative to a Jewish child, to undergo surgical procedures was 1.2 (p<0.0001), to be hospitalized in intensive care units (ICUs) was 0.8 (p=0.003), and to be transferred to rehabilitation was 0.5 (p<0.0001). There was no significant difference in inpatient mortality between the two ethnic groups. Conclusions.Arab children in Israel are more likely to be hospitalized due to road accidents in comparison to Jewish children. Intervention programs should focus on Arab children and their unique characteristics. [ABSTRACT FROM PUBLISHER]

Background. In Israel, nearly 10,000 children are hospitalized due to injury every year. Objectives. To define injury patterns in subgroups of the pediatric population, in order to focus prevention programs on vulnerable groups. Methods. A retrospective study of Israel's National Trauma Registry (ITR) data on patients aged 0–17 years hospitalized between 1 January 1998 and 31 December 2002 due to trauma. Data includes patient demographic details, information on the injury, hospital resource utilization, length of stay and outcome. Descriptive statistics were used to characterize injury patterns and bivariate and multivariate analysis was used to compare injury severity and cause between population groups. Results. A total of 32,009 children were included. Falls were the cause of injury for 51% of the population, 6% of falls sustaining severe injuries (ISS 16+). Road traffic accidents (RTA) injured 23%, of which 14% were severe injuries. Burns (7%) accounted for long hospitalizations—nearly 20% stayed for over 14 days. Crude data showed that the proportion of severe injuries and inpatient death rate among non-Jewish children was double that of Jewish children (12% vs 6% and 1% vs 0.5%, respectively (χ2, p<0.0001)). When looking at children from low socio-economic status (SES) townships, the difference in proportion of severe injuries between Jewish and non-Jewish children is reduced, yet it remains higher in non-Jewish than among Jewish children (7% vs 5%) (χ2, p=0.0001). These results were verified by multivariate logistic regression analysis adjusting for SES, age, gender and external injury cause. Non-Jewish children had a significantly higher rate of burns (10% vs 6%), falls from heights above 2.5 meters (16% vs 6% of all falls) and pedestrian injuries (51% vs 37% of all injured in RTA). When SES is taken into account, the only outstanding injury among non-Jewish children is fall from height: 13%, n=376 among non-Jewish children vs 8%, n=85 among Jewish children, living in townships with low SES cluster (1–4) (χ2, p<0.0001). Conclusions. The findings of this study show that there is variability in external cause of injury and severity by age and ethnic group. Falls were most frequent among young children and burns among non-Jews. Non-Jewish children in SES clusters 1–4 are at high risk for falls from height, suggesting intervention and prevention activities should be directed in this direction. [ABSTRACT FROM AUTHOR]