Elderly pedestrian neurotrauma: A descriptive study from a premier neurotrauma center in India

Older adult pedestrian trauma: A systematic review, meta-analysis, and GRADE assessment of injury health outcomes from an aggregate study sample of 1 million pedestrians

This systematic review sought to assess older adult pedestrian injury severity, injury by anatomical location and incidence proportions, including comparisons to younger age groups when available and provide an analysis of the quality of the existing evidence. A structured search was conducted in PubMed, Embase, Scopus, CINAHL, PsycInfo, AMED, Web of Science, LILACS and TRID. STROBE was used to assess the reporting quality of the included studies. Random-effect model meta-analysis served to obtain pooled relative risk, incidence proportions and standardized mean differences for different outcomes due to pedestrian crashes comparing older and younger pedestrians, while meta-analyses could not be conducted for pedestrian falls. We screened 7460 records of which 60 studies (1,012,041 pedestrians) were included in the review. Injured pedestrians 60+ compared to those <60 were found to have a higher relative risk of severe injury (pooled relative risk RR 1.6, 95 % CI: 1.4-2.0 p < 0.001), critical care admission (pooled RR 1.5, 95 %CI: 1.3-1.8 p < 0.001), and fatality (pooled RR of 3.7, 95 % CI: 3.0-4.5 p < 0.001). Pedestrians 60+ also had higher incidence rates of pedestrian falls causing higher injury severity. GRADE was used to evaluate evidence quality, with the results suggesting that the overall quality of the evidence supporting these findings was low. Further research is needed to understand health risks associated with older pedestrian trauma and to develop effective risk management strategies.

Global Incidence and Mortality Patterns of Pedestrian Road Traffic Injuries by Sociodemographic Index, with Forecasting: Findings from the Global Burden of Diseases, Injuries, and Risk Factors 2017 Study

(1) Background: Pedestrian injuries (PIs) represent a significant proportion of road traffic injuries. Our aim was to investigate the incidence and mortality of PIs in different age groups and sociodemographic index (SDI) categories between 1990 and 2017. (2) Method: Estimates of age-standardized incidence and mortality along with trends of PIs by SDI levels were obtained from the Global Burden of Disease from 1990 to 2017. We also forecasted the trends across all the SDI categories until 2040 using the Statistical Package for the Social Sciences (SPSS Statistics for Windows, version 23.0, Chicago, IL, USA) time series expert modeler. (3) Results: Globally, the incidence of PIs increased by 3.31% (−9.94 to 16.56) in 2017 compared to 1990. Men have higher incidence of PIs than women. Forecasted incidence was 132.02 (127.37 to 136.66) per 100,000 population in 2020, 101.52 (65.99 to 137.05) in 2030, and reduced further to 71.02 (10.62 to 152.65) by 2040. Globally across all SDI categories, there was a decreasing trend in mortality due to PIs with the global estimated percentage reduction of 37.12% (−45.19 to −29.04). (4) Conclusions: The results show that PIs are still a burden for all SDI categories despite some variation. Although incidence and mortality are expected to decrease globally, some SDI categories and specific vulnerable age groups may require particular attention. Further studies addressing incidence and mortality patterns in vulnerable SDI categories are needed.

Traumatic brain injury: Does gender influence outcomes?

Background:

Traumatic brain injury (TBI) is a major public health problem. Both genders are affected, but little is known about female TBI. The present study exclusively explores epidemiological, clinical, imaging, and death aspects of female TBI, and how it differs from males.

Methods:

It is a retrospective study. Data were documented from a tertiary institute during January 2010 to March 2010. All variables were documented on standard proforma. The data were analyzed using R statistics software. Age group was categorized into pediatric (<18 years), middle (19–60 years) and elderly (>61 years). Significance was tested using Chi-square test at the significance level of P < 0.05.

Results:

Data of 1627 TBI patients were recorded. Of the total, female TBIs contributed nearly 20%. Compared to males, female patients reported higher percentages in manifesting symptoms (84.3% vs. 82.6%), injuries due to fall (32.1% vs. 24.4%), and surgical interventions (11.6% vs. 10.4%). Female patients were significantly higher in mild head injury group (76.8% vs. 69.5%, P - 0.016) and mortality (3.4% vs. 1.6%, P - 0.048). Number of patients and deaths was more among females than males in pediatric and elderly age group. Severities of injuries were more among female patients than male patients in middle and elder age groups.

Conclusion:

The study results observe that female TBI group differ significantly in the severity of injury and mortality.