NEW DELHI: In glaring evidence of how two-wheeler crashes have a high share in traumatic brain injury (TBIs) in India, a study at Christian Medical College in Vellore has revealed that over 70% of injuries were due to such accidents and less than 1% of patients were wearing a helmet at the time of crash.
The results of the study – based on patients admitted to the hospital and carried out over six and a half years from March 2013 to Sept 2019 – was published recently. The report gains significance considering that 77,539 two-wheeler occupants died in road crashes, which was nearly 45% of all road fatalities in 2023 in India. There has been an increase both in the number and share of two-wheeler occupants getting killed in road crashes in the past decade.
During the study, researchers identified 3,172 patients, of which 84% were males, who were admitted with TBI. Two-wheeler road traffic crashes caused 2,259 (71%) injuries and only 13 (0.6%) of these patients were wearing a helmet, as per the study. Around one-third of patients reported alcohol consumption.
The study paper – prepared by researchers from Cambridge University, CMC’s neurological sciences department, National and Kapodistrian University of Athens – mentioned that the lesser causes of injury included falls (307), pedestrian-vehicle accidents (278) and four-wheeler road traffic accidents (163). The median time from injury to arrival at the emergency department was three hours and 1,093 patients were transferred from a referring hospital. While 1,162 (37%) patients experienced a mild injury, around 33% had moderate injuries and the remaining around 30% (968) had severe injuries.
While there were 174 (5%) inpatient deaths, the overall mortality was 540 (17%) in three to nine months. Among the inpatient mortalities, 82 died within two days of admission, 108 within four days, and 147 within eight days. Only around 4% patients had health insurance, and 31% patients were unable to cover their hospital expenses. The average hospital expenditure was Rs 35,850 and the average patient expenditure was Rs 28,900.
The report, in its conclusion, said, “In a high-volume tertiary care centre in India, we described a predominantly young male TBI population with a high contribution of two-wheeler road traffic accidents and significant post-discharge mortality. We also identified clinical features associated with inpatient mortality and found that existing prognostic models performed poorly when predicting which patients died after leaving hospital.”
It added that a large proportion of TBI cases in low and middle income countries (LMICs) can be prevented or made less severe through public health policies, particularly those addressing road safety and access to pre-hospital care.