Multicenter Study Examining Temporal Trends in Traumatic Intracranial Hemorrhage Over Six Years Using Joinpoint...

Area of Science:

• Trauma Surgery and Critical Care
• Neuroscience and Neurology
• Geriatric Medicine and Epidemiology

Background:

• The aging US population is shifting the landscape of traumatic injuries.
• Limited research exists on evolving patterns of traumatic intracranial hemorrhage (tICH).
• Understanding these trends is crucial for adapting trauma care strategies.

Purpose of the Study:

• To analyze temporal changes in the incidence, demographics, severity, management, and outcomes of tICH.
• To investigate trends in patient comorbidities and injury mechanisms over a six-year period.
• To identify shifts in patient disposition, such as mortality and hospice care.

Main Methods:

• Retrospective analysis of 67,514 trauma admissions across six US Level I trauma centers (July 2016-June 2022).
• Identification of tICH cases using ICD-10 diagnosis codes.
• Joinpoint regression analysis to assess biannual percent changes (BPC) and linear trends over time.

Main Results:

• The proportion of tICH admissions increased by 2.6% biannually until July 2019, then stabilized.
• Geriatric patients (≥65 years) and fall-related injuries showed significant biannual increases.
• Hypertension, functional dependence, and chronic anticoagulant use rose among comorbidities; in-hospital mortality declined, but hospice discharges increased significantly.

Conclusions:

• Traumatic intracranial hemorrhage admissions are increasing, driven by an aging population with more comorbidities and falls.
• Traumatic brain injury severity and neurosurgical management rates have remained consistent.
• A notable shift towards hospice care suggests an escalating need for palliative services in trauma management.