Incidence, Demographics, and Outcome of Traumatic Brain Injury in The Middle East: A Systematic Review

Background Traumatic brain injury (TBI) is a serious global public health challenge. We aimed to assess the pattern of TBI in the Middle East, as reported in the last decade. Methods Literature searches were conducted on PubMed, MEDLINE, and Google scholar electronic databases. The search terms used in different combinations were epidemiology, incidence, case fatality, mortality, intracranial injury, brain injury, head injury, and the country names. Additional searches were conducted using reference lists of studies and review articles for selection of relevant articles. The search yielded 1082 articles; of which 701 duplicates and 346 articles were excluded. Thirty-five original studies met the inclusion criteria. Data were extracted using standardized Excel form and pilot tested. Median with interquartile range (IQR) was used to estimate the incidence rate and mortality of TBI. Results In the Middle East region, the median TBI incidence rate per capita was 45 (IQR, 38.5–367) per 100,000. The overall median emergency department–based TBI mortality, which included all age groups and all injury severities, was 10% (IQR, 7.75–15.75). We estimated the overall median mortality for head trauma studies based on emergency department admissions as 6% (IQR, 3–18) among all age groups and all injury severities. The overall TBI-related median mortality in the intensive care unit–based studies was 25% (IQR, 15.5–47). Conclusions The epidemiology of TBI in the Middle East remains understudied. The use of a globally recognized definition of TBI will contribute greatly to improve its reporting, analysis, and interpretation and to establish appropriate injury prevention programs.