Traumatic Brain Injuries in the U.S.--Medical Legal Implications
Published: Friday, 02 April 2010 12:59
Traumatic brain injuries (TBIs) have increased 21% since 2004, whereas the population has grown only 6.3%, according to new data from the Centers for Disease Control and Prevention (CDC). In particular, TBIs are increasing among children as more become active in sports and among the elderly as that demographic grows.
The new report is an update of the CDC's landmark 2004 report on the impact of TBI in the United States. Researchers led by Mark Faul, PhD, a behavioral scientist in the CDC's Injury Center Division of Injury Response, analyzed data from 2002 to 2006 and found that 1.7 million deaths, hospitalizations, and emergency department visits related to traumatic brain injury (TBI) occur in the United States each year.
An interesting finding from this report is that TBI was a contributing factor in 30.5% of all injury-related deaths.
The study showed that there were 52,000 deaths and 275,000 hospitalizations annually during the study period. Almost 1.4 million, or 80%, of the people who sustained a TBI were treated and released from an emergency department.
Children, Adolescents, Elderly Most at Risk
According to the new report, called "Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Death," the groups at highest risk for TBI are children from birth to 4 years of age, adolescents aged 15 to 19 years, and adults 65 years and older. Falls were the leading cause of TBI (35.2%), and rates were highest for children from birth to 4 years and for adults 75 years and older.
The data show a 62% increase in fall-related TBIs seen in emergency departments among children 14 years and younger from 2002 to 2006. However, there was no increase in deaths, and there was a decrease in hospitalizations.
Although it is difficult to determine the exact cause of the increase in TBIs among American children aged 14 and younger, the large increase in emergency department visits for children from birth to age 14 from 2002 through 2006 may explain the increase. In addition, public awareness that TBI is a treatable injury may be an important factor as well. We also think that since more children are participating in organized sports, more sports-related injuries occur in this age group than we have seen before.
The increasing numbers of persons 65 years and older is also driving a portion of the TBI increase. CDC has been monitoring the increase in falls among this population in recent years. The study found that increases in senior falls are probably due to people living longer, increase in sedentary lifestyle that contributes to a lack of agility, and an increase in the use of prescription medication.
Dr. Faul referred clinicians to the CDC's evidence-based recommendations on the Injury Center Website (http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html) to help older adults and caregivers reduce the potential for falls through exercise, health checks, and home safety evaluation.
Traffic accidents were the second leading cause of TBI among all age groups (17.3%) and caused the largest percentage of TBI-related deaths (31.8%). In every age group, TBI rates are higher for males than for females.
This report not only presents TBI numbers, it helps to show the impact of this injury nationwide. These data can help to impact the lives of millions of Americans as they serve as building blocks that guide TBI prevention strategies. They also help to identify research and education priorities and support the need for services among individuals at risk or living with a TBI.
The current report shows an increase in TBI in the United States. Falls are the leading cause of TBI. Even though hospitalizations for TBI have increased, TBI-related death remains stable. This suggests improved treatment strategies for the treatment of TBI; but specific research is needed to verify this.
To download a free copy of the report, go to http://www.cdc.gov/traumaticbraininjury/tbi_ed.html.
Faul M, Xy L, Wald MM, Coronado VG. Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations and Deaths 2002-2006. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.