Mortality and Outcome of Severe Traumatic Brain Injury in a Swiss Level One Trauma Center

Abstract

The present report describes the demography and outcome of severe traumatic brain injury (TBI) in, Bern University Hospital, a Swiss level one trauma center. The primary outcome was death after one year; the secondary outcome was patient status two weeks post-injury. The included study patients were aged ≥ 16 with severe TBI, admitted to the tertiary trauma center with an intracranial lesion AIS ≥ 4 based on Computer Tomography (CT) findings. 178 patients, predominantly males (75.8%), with a mean age of 54 ± 23.3 years, were included. The main causes of the accidents were falls (52.6%), followed by road traffic accidents (RTA, 35.8%). The mean injury severity score (ISS) was 28.5 ± 13; the mean GCS at the site of the accident was 10 ± 4.4. 35.4% of the patients underwent neurosurgical intervention. The mean Glasgow Coma scale (GCS) at day 14 was 13.8 ± 2.6. 47 (26.4%) patients died, 39 (82.9%) of them within the first 14 days. The characteristics and outcome of patients with severe TBI at Bern university hospital were similar to those found in other centers in industrialized countries. In general, mortality was highest in the first few days, and the surviving patients had a favorable neurological outcome. Younger patients were more likely to die in the first days post-injury, and the survivors had a good neurological outcome. Patients aged over 60 were more likely to have less severe TBI and predominantly died later.