Blood transfusion and traumatic brain injury

Abstract

Traumatic brain injury (TBI) is an acquired sudden injury secondary to blunt or penetrating mechanisms to the brain that disrupts its normal functioning. TBI can cause serious physical, cognitive, and psychosocial disabilities for the patient and cost for families and the health care system; the Center for Disease Control and Prevention (CDC) estimated that in 2010, 2.5 million suffered from TBI and accounted for 87% of visits to the emergency department, 11% of hospitalizations and 2% of deaths. Estimates show that 3.2-5.3 million persons have a TBI-related disability in the United States [1]. TBI is such complex health public issue that the US government has created the constitutional tools to be confronted. The Traumatic Brain Injury Act of 2008 authorized research and public health activities associated to TBI [2]. Studies performed in the United States before 2006 showed an incidence of TBI around 140/100,000 persons [3]. In 2003, Rutland-Brown et al. reported a mortality of 17.5/100,000 per year secondary to TBI [4]. During the period 1997-2007 approximately 580,000 persons died due to TBI in the United States [5]. All age groups are affected. TBI is a major cause of disability and death especially in the young adult population [6]. Mortality is higher in patients older than 65 years, in whom TBI is mostly related to falls [7, 8]. Men are more frequently affected than women. The majority of deaths are caused by motor vehicle accidents, suicides and falls [5]. TBI can occur as an isolated injury or associated with trauma to other areas of the body. It is classified as mild, moderate and severe depending on the mechanism of injury, clinical signs and symptoms. The clinical assessment of TBI patients includes the Glasgow Coma Score and radiographic data. The scale assigns values 1-5 according to clinical responses including eye opening, motor response and verbal response. Scores 13-15 points correlate to mild, 9-12 points moderate and <8 points severe brain injury [9].