Related Experiment Video
Updated: Jul 31, 2025
Assessing Changes in Synaptic Plasticity Using an Awake Closed-Head Injury Model of Mild Traumatic Brain Injury
Published on: January 20, 2023
Causes of fatal traumatic brain injury in Finland
Jussi P Posti1, Kristiina Cajanus2, Aleksi Tornio2
11Neurocenter, Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku.
Objective:
The phenotype of patients who suffer fatal traumatic brain injury (TBI) is poorly characterized. The authors examined the external causes, contributing diseases, and preinjury medication in adult patients with fatal TBI in a nationwide Finnish cohort.
Methods:
Deaths caused by TBIs in Finland were examined among decedents aged ≥ 16 years during 2005-2020 from the national Cause of Death Registry. Usage of prescription medications prior to TBI was studied using medication purchase data from the Social Insurance Institution of Finland.
Results:
The cohort consisted of 71,488,347 person-years, 821,259 total deaths, and 14,630 TBI-related deaths during 2005-2020, of which 67% (n = 9792) occurred in men. Women were older than men among those who suffered TBI-related death (mean age 77.2 ± 17.1 vs 64.5 ± 19.5 years, p < 0.0001). The overall crude incidence rate of fatal TBIs was 20.5/100,000 person-years (28.1/100,000 in men and 13.2/100,000 in women). TBI was the cause of death in 1.8% of all deaths in the Finnish population during the study years, but in patients aged 16-19 years, TBIs caused more than 17% of all deaths. The most common external cause of fatal TBI was a fall (70%), followed by poisoning or toxic effects (20%) and violence or self-harm (15%) overall. In men, the order of the most common causes of fatal TBI was similar to overall results (64%, 25%, and 19%, respectively), while in women, the most common cause was a fall (82%), followed by complications in healthcare (10%) and poisoning or toxic effects (9%). Cardiovascular diseases, psychiatric diseases, and infections were the most common diseases contributing to death. Blood pressure (lowering) medications were the most common type of medications used before fatal TBI. CNS medications were the second most common medication group. In the context of fatal TBI in Europe, Finland remains at the upper end of fatal TBI incidence.
Conclusions:
TBI is a common cause of death in young adults, whereas the incidence of fatal TBI becomes increasingly higher with age in Finland. Cardiovascular diseases and psychiatric conditions were the most common diseases related to death, with opposite age trends. Healthcare facility complications were an alarmingly common cause of death in women with fatal TBI.
Insights
Fatal traumatic brain injury (TBI) is more common in men and increases with age. Falls are the leading cause, with cardiovascular diseases and psychiatric conditions often contributing to death, especially in older adults.
Area of Science:
- Neurology
- Public Health
- Epidemiology
Background:
- Traumatic brain injury (TBI) is a significant cause of mortality, yet the specific characteristics of fatal TBI cases are not well-understood.
- Understanding the external causes, comorbidities, and pre-injury medication use in fatal TBI is crucial for public health interventions.
Purpose of the Study:
- To characterize the phenotype of patients experiencing fatal traumatic brain injury (TBI) in a nationwide Finnish cohort.
- To investigate the external causes, contributing diseases, and pre-injury medication patterns associated with fatal TBI.
Main Methods:
- Analysis of a nationwide Finnish cohort from 2005-2020, including death registry data and medication purchase records.
- Inclusion of decedents aged 16 years and older, examining 14,630 TBI-related deaths.
Main Results:
- Fatal TBI incidence was 20.5 per 100,000 person-years, higher in men (28.1) than women (13.2).
- Falls were the primary external cause (70%), followed by poisoning (20%) and violence (15%). Women aged 77.2 years died from TBI more often than men (64.5 years).
- Cardiovascular diseases, psychiatric conditions, and infections were common contributing diseases. Blood pressure-lowering medications were frequently used prior to fatal TBI.
Conclusions:
- Fatal TBI incidence increases with age in Finland, disproportionately affecting young adults. Cardiovascular and psychiatric conditions are key comorbidities.
- Falls are the leading cause of fatal TBI, with significant gender differences in contributing factors and age at death.
- Healthcare-associated complications represent an alarming cause of death in women with fatal TBI, highlighting a critical area for improved patient safety.
