1. Violence-Related Traumatic Brain Injury
Teemu Luoto
MD, PhD, A/Prof
Dep. of Neurosurgery
Violence-Related Traumatic Brain Injury

2. Disclosures No interest to disclose
PESG and IBIA staff have no interest to disclose
This continuing education activity is managed and accredited by Professional Education Services Group in cooperation with IBIA. PESG, IBIA, and all accrediting organization do not support or endorse any product or service mentioned in this activity.

3. Objectives
A substantial number of traumatic brain injuries (TBI) are caused by violence- related incidents
The purpose of this study was to
determine the unique characteristics of violence-related TBIs
with an emphasis on possible preventable risk factors

4. Methods – 1/2
Methods
All consecutive patients who underwent head CT due to an acute head injury were included
N = 3,023
The Emergency Department of Tampere University Hospital
Aug Jul 2012
Tampere

5. Methods – 2/2 Methods Data collection consisted of
Socio-demographics,
Injury-related data, and
clinical information from the emergency department
Patients with a violence-related TBI were identified
n = 222 (7 %)
A additional detailed retrospective data collection was performed on these patients
Statistical comparison:
Violence-related TBI VS. Other TBI
n=222
n=2801 %

6. Independent risk factors in adjusted logistic regression
Results – 1/3
Methods
Results
Methods
Violence-related TBI
Other
TBI
p-value OR
Age (mean)
35.4
56.5
<0.0001
Male
78.4
54.7
3.0
Prior circulatory system disease
8.1
41.9
0.1
Prior psychiatric disorders
43.7
24.4
2.4
Chronic alcohol abuse
34.2
17.2
2.5
Regular substance abuse
18.5
9.2
Alcohol intox
59.5
21.7
5.3
Narcotics intox
2.7
0.7
0.001
4.1
Acute trauma lesion on head CT
13.1
19.6
0.017
0.6
Violence-related TBI
Other
TBI
p-value OR
Age (mean)
35.4
56.5
<0.0001
Male
78.4
54.7
3.0
Prior circulatory system disease
8.1
41.9
0.1
Prior psychiatric disorders
43.7
24.4
2.4
Chronic alcohol abuse
34.2
17.2
2.5
Regular substance abuse
18.5
9.2
Alcohol intox
59.5
21.7
5.3
Narcotics intox
2.7
0.7
0.001
4.1
Acute trauma lesion on head CT
13.1
19.6
0.017
0.6
Violence-Related TBI
Other
TBI
p-value OR
Age (mean)
35.4
56.5
<0.0001
Male
78.4
54.7
3.0
Prior circulatory system disease
8.1
41.9
0.1
Prior psychiatric disorders
43.7
24.4
2.4
Chronic alcohol abuse
34.2
17.2
2.5
Regular substance abuse
18.5
9.2
Alcohol intox
59.5
21.7
5.3
Narcotics intox
2.7
0.7
0.001
4.1
Acute trauma lesion on head CT
13.1
19.6
0.017
0.6
Independent risk factors in adjusted logistic regression

7. No statistically significant difference between groups
Results – 2/3
Methods
Methods
Results
Violence-Related TBI vs. Other TBI:
TBI severity (mild/mod/sev)
Loss of consciousness
Post-traumatic amnesia
Disorientation
Need of neurosurgery
No statistically significant difference between groups

8. Municipalities and suburbs Municipalities and suburbs
Results – 3/3
Results
Methods
Methods
Detailed Characteristics of Violence-Related TBI:
62%
62% ?
Unknown assaulter
73% ?
Unknown assaulter
73%
Municipalities and suburbs
64%
Municipalities and suburbs
64%
10pm – 4am
53%
10pm – 4am
53%
Streets 31%
Homes 16%
Restaurants/bars 13%
Streets 31%
Homes 16%
Restaurants/bars 13%

9. Conclusions Methods Methods Results Conclusions
Young adult males with premorbid mental health history (incl. chronic alcohol abuse) are most prone to sustain a TBI due to a violence-related incident
These incidents are often related to alcohol intoxication, and occur on nighttime streets
Violence was not associated with more severe TBIs than other mechanisms of injury
Preventive measures should be focused on alcohol consumption 1 2 3 4

10. Collaborators Methods Methods Results Conclusions
Tuomas Mäntykoski, MD
University of Tampere, Tampere, Finland
Juuli Renko, BM
Grant L. Iverson, PhD, professor
Harvard Medical School, Boston, MA, USA
Juha Öhman, MD, PhD, professor
Tampere University Hospital, Tampere, Finland