Epidemiology of Traumatic Brain Injury over the World: A Systematic Review

Review Article

Austin Neurol & Neurosci. 2016; 1(2): 1007.

Epidemiology of Traumatic Brain Injury over the World: A Systematic Review

Min Li, Zilong Zhao, Gongjie Yu and Jianning Zhang*

Department of Neurosurgery, Tianjin Neurological Institute, Tianjin Medical University General Hospital, PR China

*Corresponding author: Jianning Zhang, Department of Neurosurgery, Tianjin Neurological Institute, Tianjin General Hospital, PR China

Received: May 31, 2016; Accepted: June 28, 2016; Published: July 01, 2016


We identified 60 reports from 29 countries with data on Traumatic brain injury (TBI) epidemiology in the published literature. Men were at higher risk of TBI than women. The average age at the time of TBI ranged from 27 to 59.67 years while the median age ranged from 29 to 45 years. The incidence of TBI in Sweden, Italy and Norway was decreased while the incidence of TBI in Spain and Taiwan was increased. The countries with the incidence of TBI from high to low were New Zealand, United States, Spain, Sweden, South Africa, Austria, France, Italy, Germany, Canada, Norway, Australia, Portugal, Finland, China, Iran, Switzerland and Belgium. The overall mild: moderate: severe ratio was 55: 27.7: 17.3 based on Glasgow Coma Scale (GCS). In patients with moderate and severe TBI, death was the most common outcome. In TBI patients with all severities, good recovery was the major clinical outcome. Motor vehicle collision (MVC) was the leading cause of TBI in China, Pakistan, Japan, Australia, France, Spain, Austria, England, Croatia, Slovakia, Bosnia, Macedonia, Netherland and Italy, whereas fall was the leading cause in The United States, Canada, New Zealand, Sweden, Scotland, Norway and Finland. The MVC-related TBIs were the most common causes in developing countries, whereas the fall-related TBIs were the most common causes in developed countries. The percentage of MVC-related TBIs were the highest in Asia. Europe had the highest percentage of fall-related TBIs and work-related TBIs. North America, followed by Oceania, had the highest percentage of sport-related TBIs.

Keywords: Head injury; Traumatic brain injury; Epidemiology; Incidence; Injury prevention


TBI is one of the most devastating types of injury, and it results in varying degrees of paralysis, loss of consciousness, amnesia and even death. Head trauma accounts for the majority of trauma deaths [1]. The effects of TBI are not limited to an individual’s health; it also creates a financial burden for families and societies. There was a widespread agreement that the fundamental aim of managing TBI is to avoid brain injury. Studying the epidemiology of TBI is challenging for a number of reasons, including various inclusion criteria and different methods for classifying TBI severity. Advances in understanding the mechanisms of TBI have yielded to effective prevention. Numerous articles on TBI epidemiology have come out of Europe and North America due to their TBI registries or databases [1-3]. Although most Asian countries do not have TBI registries, the number of studies from Asian countries has increased in recent years [4-7].

The knowledge of the epidemiology of TBI worldwide was required; however, a systematic review on TBI epidemiology worldwide has not been performed or published. The aim of this review was to compile epidemiological characteristics of TBI in order to improve the effectiveness of TBI prevention.


Search strategy: Pub Med, EBSCO, MEDLINE, EMBASE, and Google Scholar™ databases were searched for TBI articles published from January 1980 through May 2014 with the following key indexing and MeSH terms: “head injury”, “traumatic brain injury”, “epidemiology”, and “incidence”. These terms were linked using combinations of “epidemiology” or “incidence” plus “head injury” or “traumatic brain injury”. No language restrictions were used. References from the retrieved reports were reviewed to find additional relevant articles that may have been omitted from the database search (Figure 1).