Epidemiology & Importance

Severe and moderate TBI constitutes a major health and socio-economic problem throughout the world (Ghajar 2000). In well-developed countries it is the leading cause of death and disability among young adults and the incidence in the elderly population is increasing (Kannus et al 2001; Luukinen et al 1999). The incidence of TBI requiring hospitalization, or causing death is approximately 100 per 100.000 inhabitants each year. In the US an estimated 1.6 million persons sustain TBI each year with 52,000 deaths and 18,000 patients suffering from permanent neurologic impairment (Sosin et al 1996; Bruns and Hauser 2003). At least 5 million Americans currently live with disabilities resulting from TBI (Thurmann 1999). In the US, the direct and indirect costs of TBI are estimated at $ 60 billion (Thurmann 2001).

In lesser-developed countries the incidence of injury is high and rapidly increasing. The WHO has projected that by the year 2020, road traffic accidents, a major cause of TBI, will rank third as a leading cause of the global burden of disease and injury, second only to ischemic heart disease and unipolar major depression (Finfer and Cohen 2001).

There is therefore a strong ethical imperative to enhance TBI prevention, to improve treatment and to optimize chances of demonstrating efficacy with emerging treatment modalities.

The IMPACT project is focused on advancing knowledge of prognosis, trial design and treatment in TBI.