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Int. J. Environ. Res. Public Health 2018, 15(11), 2457; https://doi.org/10.3390/ijerph15112457

An Epidemiological Analysis of Head Injuries in Taiwan

1
Department of Surgery, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan 70403, Taiwan
2
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan
3
Department of Public Health, College of Public Health, China Medical University, Taichung 40402, Taiwan
4
Department of Neurosurgery, Taipei City Hospital, Taipei 10065, Taiwan
5
Department of Emergency Medicine, Taipei City Hospital, Taipei 10065, Taiwan
*
Author to whom correspondence should be addressed.
Received: 30 September 2018 / Revised: 25 October 2018 / Accepted: 1 November 2018 / Published: 4 November 2018
(This article belongs to the Special Issue IJERPH: 15th Anniversary)
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Abstract

Traumatic head injuries occur frequently in Taiwan, having catastrophic consequences for the victims, their families, and society as a whole. However, little is known about the risk factors at the population level in Taiwan. The primary aim of this study was to obtain more information on these variables and their relationships. Another aim was to analyze the effects of independent variables such as sex, age, residency, pre-existing conditions, mechanisms of injury, associated injuries, and severity on the probability of in-hospital death. Using the 2007–2008 total admissions claim dataset from Taiwan’s National Health Insurance system, total admissions due to acute head injury were selected for further analysis. The obtained data included patient demographics and trauma hospitalization rate. A total of 99,391 patients were admitted with head injury, 48,792 of which had moderate-to-severe head injury. There were 4935 cases recorded as in-hospital mortality and the standardized in-hospital mortality rate was 10.7 deaths per 100,000 person-years. The mortality rate increased with age. After adjustments, male sex, age older than 54 years, living in a rural area, lower monthly income, a Charlson comorbidity index greater than one, being a pedestrian hit by a motor vehicle, fall from a height, and having significant chest, abdominal, or lower extremity injury increased the risk of death during admission. This population-based analysis provides information about the incidence rate and death rate for admissions in Taiwan due to acute head injury and the factors that affect in-hospital mortality. Our results that highlight the risk factors for adverse outcome can help us prevent or improve rural area trauma care of head injury patients in the future. View Full-Text
Keywords: head injury; incidence; national health insurance; population-based study; mortality; traumatic brain injury head injury; incidence; national health insurance; population-based study; mortality; traumatic brain injury
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Hsu, I.-L.; Li, C.-Y.; Chu, D.-C.; Chien, L.-C. An Epidemiological Analysis of Head Injuries in Taiwan. Int. J. Environ. Res. Public Health 2018, 15, 2457.

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