Frontiers in neurology · 2026
Neurotrauma admission disparities in Scotland: a 6-year analysis of socioeconomic and demographic trends.
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Demetriades Andreas K, Peul Wilco
Аннотация
BACKGROUND: Neurotrauma, encompassing traumatic brain injury (TBI) and spinal trauma, remains a significant global cause of mortality and morbidity. Socioeconomic deprivation is associated with higher injury incidence and poorer outcomes, though gradients vary across healthcare systems. This study examines neurotrauma admission disparities across socioeconomic and demographic groups in Scotland over a 6-year period.
METHODS: A national population-based analysis of neurotrauma admissions in Scotland from 2014 to 2020 was conducted using data from Public Health Scotland. Admissions were categorized by sex, age group, injury severity (minor, moderate, major), and socioeconomic status using the Scottish Index of Multiple Deprivation (SIMD), where Quintile 1 represents the most deprived and Quintile 5 the least deprived areas. Year-on-year incidence trends, demographic patterns, and length of stay (LOS) were analyzed.
RESULTS: Total neurotrauma admissions increased from 1,098 in 2014 to 2,428 in 2020. A consistent socioeconomic gradient was observed across all injury severities: the most deprived group (SIMD 1) accounted for the highest proportion of admissions annually, while the least deprived (SIMD 5) had the lowest. Males demonstrated higher admission numbers than females across all severity levels. Age-related patterns revealed patients aged <16 years had the highest proportion of head injuries (73.0%), whereas those aged 16-44 and 45-54 had higher proportions of spinal injuries (48.9 and 48.4% respectively). Longer hospital stays were associated with greater deprivation, even after adjusting for age and injury severity.
CONCLUSIONS: Substantial and persistent socioeconomic gradients exist in neurotrauma admissions across Scotland, with the most deprived communities bearing the greatest burden. These disparities persist despite universal healthcare coverage, suggesting deprivation influences injury exposure, resilience, and recovery pathways. Findings support targeted prevention strategies for high-risk groups and resource allocation informed by area-based deprivation indices to address neurotrauma as both a clinical and public health challenge.
METHODS: A national population-based analysis of neurotrauma admissions in Scotland from 2014 to 2020 was conducted using data from Public Health Scotland. Admissions were categorized by sex, age group, injury severity (minor, moderate, major), and socioeconomic status using the Scottish Index of Multiple Deprivation (SIMD), where Quintile 1 represents the most deprived and Quintile 5 the least deprived areas. Year-on-year incidence trends, demographic patterns, and length of stay (LOS) were analyzed.
RESULTS: Total neurotrauma admissions increased from 1,098 in 2014 to 2,428 in 2020. A consistent socioeconomic gradient was observed across all injury severities: the most deprived group (SIMD 1) accounted for the highest proportion of admissions annually, while the least deprived (SIMD 5) had the lowest. Males demonstrated higher admission numbers than females across all severity levels. Age-related patterns revealed patients aged <16 years had the highest proportion of head injuries (73.0%), whereas those aged 16-44 and 45-54 had higher proportions of spinal injuries (48.9 and 48.4% respectively). Longer hospital stays were associated with greater deprivation, even after adjusting for age and injury severity.
CONCLUSIONS: Substantial and persistent socioeconomic gradients exist in neurotrauma admissions across Scotland, with the most deprived communities bearing the greatest burden. These disparities persist despite universal healthcare coverage, suggesting deprivation influences injury exposure, resilience, and recovery pathways. Findings support targeted prevention strategies for high-risk groups and resource allocation informed by area-based deprivation indices to address neurotrauma as both a clinical and public health challenge.