The epidemiology, management, and outcomes of traumatic brain injury in man-made and natural disasters: A systematic review

Background: Acute management up to the post-hospital rehabilitation are all crucial in disaster-related traumatic brain injury. We perform a systematic review of literatures reporting the epidemiology, management, and outcomes of traumatic brain injury (TBI) in man-made and natural disasters.Methods: Literature search was performed in accordance to the PRISMA guidelines for studies with data regarding the epidemiology, prevention, management, and rehabilitation of TBI in single-event disasters, both natural and man-made. A summary of all the included studies is displayed through tabulation, along with the extractable quantitative data.Results: A total of 275 studies were identified. Further screening excluded 243 studies, and 22 studies were screened for full article eligibility screening, resulting in a total of six studies included in the systematic review. Four (66.67%) studies reported of natural disasters, while two (33.3%) other reported man-made disasters. The total reported TBI cases in all six studies was 5,461 cases. In studies reporting of the number of patients based on the severity of TBI, most had mild TBI (42.62%). Eleven (7.59%) fatalities were reported, mostly with severe TBIs. In the study reporting the number of patients who underwent rehabilitation, only 685 (13.16%) underwent rehabilitation after experiencing disaster-related TBI. The need for immediate approach and management of TBI is not an uncommon occurrence in events of disasters, as the reviewed studies have displayed. Earlier plans for rehabilitation services to the patients is a core function of trauma care system necessary for a better long-term outcome disaster-related TBIs.Conclusion: Disaster-related TBI is a multifaceted problem with debilitating consequences to the victim, families, and the community as a whole with, not just medical, but potential economic, societal, and quality of life burdens. It is important for healthcare workers and non-professionals to understand the magnitude of TBI in disasters.