What are the leading causes of hospitalized traumatic brain injuries according to age? Results of the French home and leisure injuries study in 2016

Introduction Traumatic brain injury (TBI) is most often an acute event similar to other injuries. However, consequences of TBI can be very serious and affect all aspects of lives, including mental abilities and the personality of the victim. The impact on a person and his or her family can be devastating. The number of people suffering from TBI is difficult to assess accurately but can be approximate by the French medicalized information system program (“Programme de medicalisation des systems d’information” - PMSI): 130,000 patients are hospitalized for TBI each year in France. However, this database does not provide the causes of TBI yet, which is crucial for prevention purposes. The main objective of this work is to describe the causes of TBI induced by home and leisure injury (HLI) available in the “Enquete permanente sur les accidents de la vie courante” (EPAC) study. Methods The French HLI permanent survey, EPAC, started in France in 1986 in a dozen of hospital emergency departments (ED). All patients admitted in ED for HLI are included. After consenting, patients are included and detailed information is collected: where, when, how, who, what product is involved as well as the chronology of the injury and the care given. In this study, TBI was defined as: a brain commotion, a head contusion, a skull fracture or other brain injuries. All patients recorded in 2016, responding to TBI criteria and hospitalized at least one day were selected. The individual causes of TBI described in the free text were analyzed and recoded. Since causes of TBI are very different according to age, they were described separately for:  Results In 2016, among the 119,260 patients victim of HLI, recorded in EPAC database, 2918 were hospitalized following their TBI (2.4%). They were more frequent among toddlers (7.3%) and elderly (8.6%) and less frequent among teenagers (0.7%) or young adults (0.8%). Among toddlers ( Conclusions TBI is a frequent reason of admission in ED, more particularly for young children and elderly. This study allows describing the causes of TBI, for which patients need hospitalization. Those causes are very different according to the age and need to be further explored to help building targeted prevention campaigns, more particularly for 65 years and over since causes are various and sometimes not well known.