Traumatic brain injury in Portugal: progress in incidence and mortality

Traumatic Brain Injury Cases' Mortality Predictors, Association, and Outcomes in the Emergency Department at a Tertiary Healthcare Center in Saudi Arabia

Aim Incidence of traumatic brain injury (TBI) in Saudi Arabia has been estimated to be 116 per 1,00,000 population as incidence of TBI continues to rise in our region. We aim to study the demographics, mortality predictors, and factors influencing the outcome of TBI cases in a tertiary care center in Jeddah, Saudi Arabia.

Materials and Methods We retrospectively collected data from all consecutive patients treated at the Emergency Department of King Abdulaziz Medical City including all acute TBI adult cases (>18 years) from 2016 to 2019. Logistic regression models were used to identify significant predictors of mortality. A total of 423 individuals with TBI were enrolled in the study. Nearly, half of them were in age group of 18 to 29 (40.77). Most patients were males (76.83%).

Results Injuries were most commonly mild-to-moderate TBI (73.83%). Road traffic accident was the most common mechanism of injury (49.7%) followed by fall (39.5%). Most common mode of transportation was private cars (47.57%). Most patient required less than or equal to24hours of admission (61.23%). A total of 30 (7%) died in the hospital all of which were male with no death cases reported among females.

Conclusion In conclusion, this study reports a mortality rate related to TBI that is among the lowest in the region. Injuries were male predominant with more balanced male to female ratio. Patients who were delivered to the hospital via private cars had an improved survival. These finding should be interpreted in the context of retrospective noncontrolled study design, and further future studies are encouraged to consolidate these findings.

Communication skills training pilot programme after traumatic brain injury: short and medium-term benefits

Objective: The study aimed to evaluate whether a pilot communication rehabilitation programme improves different communicative modalities in people who have sustained a moderate to severe TBI immediately following the training and at 3 months follow up.Methods: We have recruited 12 participants who had moderate-to-severe TBI. Subjects were randomly divided into two groups, EG and CG. We have assessed the groups before and after treatment and we have performed a follow-up three months later, through of the ABaCo. The EG followed a very structured programme. In the CG, a programme to stimulate communication through free conversation was carried out. Each programme consisted of 24 group sessions, of 1h30 min, twice a week, for 12 weeks.Results: Improvements were observed in both groups, although more evident in the EG. Both groups had better results in extralinguistic production. In the EG, there was still an improvement in the paralinguistic production and extralinguistic comprehension, after ending the training. These improvements persisted 3 months after ending the programme.Conclusion: The results demonstrated the effectiveness of the intervention of a structured pragmatic rehabilitation programme. However, the existence of a communication group based solely on conversation can also have positive results and should be implemented whenever a more specific intervention is not possible. In future research, it will be important to increase the sample size and involve caregivers in person and regularly in the EG programme.