Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Eric Peter Thelin, Karolinska University Hospital
- Second opponent: Senior Consultant Øystein Tveiten, Haukeland University Hospital
- Third member and chair of the evaluation committee: Professor Tina Gaarder, University of Oslo
Chair of the Defence
Professor Mona Skjelland, University of Oslo
Principal Supervisor
Senior Consultant, PhD Mads Aarhus, Oslo University Hospital
Summary
Traumatic brain injury (TBI) is a major health and socioeconomic issue across the globe. Internationally, the most common causes are road traffic accidents, falls and violence. In developed countries, the epidemiology of TBI has changed as the rate of elderly patients injured in a fall is increasing.
The aims of the thesis were to describe patient characteristics and types of injury, to present rates and incidence of emergency neurosurgical procedures, and to assess proportion of patients discharged directly to specialized rehabilitation and factors related to that.
We extracted data from Oslo TBI Registry – Neurosurgery, a medical quality registry managed by the Department of Neurosurgery, Oslo University Hospital (OUH). This registry includes patients admitted to OUH with abnormal traumatic intracranial findings on CT and/or MRI.
In the five-year period (2015-2019), 2153 individuals were registered and included in this study. The archetypical TBI patient admitted to OUH with abnormal neuroimaging was 50–79 years old, male, often with significant comorbidities and injured in a fall from own height. The studies showed that pre-hospital management, triage to a Level 1 hospital and the acute management at OUH is well organized and prioritized. The low incidence of emergency neurosurgery in the general population (4 per 100 000 person-years) is an argument for the centralization of advanced trauma care in Norway, considering the maintenance of expertise and adequate resources. TBI has a substantial impact on the demand for acute hospitals beds, and many are treated without surgery. The proportion of patients with moderate–severe TBI discharged directly to rehabilitation increased during the study period, from 22% (2015) to 35% (2019). However, the results show the need for further strengthening of the specialized rehabilitation services, and increased focus on early rehabilitation for elderly patients with traumatic brain injury.
Additional information
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