CDC releases analysis of TBI statistics
80,000 Americans permanently disabled annually
One American sustains a brain injury every 15 seconds. A staggering 80,000 of those, or nine people every hour, experience the onset of long-term disability following hospitalizations for traumatic brain injury (TBI), according to recently released statistics from the Centers for Disease Control and Prevention (CDC) in Atlanta.
This marks the first time national TBI incidence data have been analyzed for their impact on the health care system and society and released to the public, notes Richard J. Waxweiler, PhD, director of the division of acute care, rehabilitation research and disability prevention at the National Center for Injury Prevention and Control at the CDC.
Using data from a national database for 1995-1996, the findings presented at a recent press conference in Atlanta include:
• A million Americans are treated and released from hospital emergency departments for TBI each year.
• 230,000 people are hospitalized each year for TBI and survive.
• 50,000 people die each year from TBI.
• 5.3 million Americans, or 2% of the total population of the United States, are living today with disability resulting from a previous hospitalization for TBI.
• The risk of TBI is highest for adolescents and young adults.
• The risk of TBI is twice as great for males as females.
• The leading causes of TBI are motor vehicle crashes, violence, and falls.
— Falls are the leading cause of TBI in adults over age 65.
— Transportation injuries are the leading cause of TBI in people 5 to 64.
Young males at greatest risk
A panel of medical experts convened by the Washington, DC-based American Medical Rehabilitation Providers Association found in a recent analysis of TBI studies that the annual incidence of TBI in the United States is estimated to be 102.8 per 100,000 people. However, in males between 15 and 24, the rate jumps to 248.3 per 100,000, and it’s also high (243.4 per 100,000) in men over 75. The incidence in females for the 15 to 24 age group is 101.6; for the over-75 age group, it’s 154.9.
The panel also concluded that about 75% of TBIs that require hospitalization are not fatal, and the medical costs of TBI treatment are about $48 billion per year. TBI length of stay (LOS) for inpatient rehabilitation ranged from 40 to 165 days from 1988 to 1992. One study said the average TBI LOS was 61 days, with an average charge of $64,648, excluding physician fees. Total charges averaged $154,256.
In more recent studies, however, the average LOS and charges were lower, ranging from 19 to 27 days and costing $24,000 to $38,000.
The panel considered the effectiveness of rehabilitation services, asking five questions related to inpatient rehabilitation of TBI patients. (See summary of TBI panel’s findings, p. 103.)
TBI patients and their families desperately need information about the potential long-term consequences of brain injury and where to turn for help, says Allan Bergman, chief executive officer of the Brain Injury Association in Alexandria, VA.
"This is truly a silent epidemic. Few physicians and fewer Americans are aware of how many lives are touched by TBI," he says, "and physicians don’t do a good job educating patients about TBI. Patients are released without adequate evaluation and follow-up. They’re given a head injury checklist, and most are never seen again. Years later, these individuals may end up with cognitive impairments, learning disabilities, or in the criminal justice system, and no one ever makes the connection between their current problems and their past TBI." (See p. 102 for a list of possible impairments caused by TBI.)
Bergman says he hopes the new data will draw the attention of physicians and community members to the importance of accurate diagnosis and treatment. "How many coaches have watched a young athlete take a blow to the head, dusted him off, and sent him right back out on the field?"
The CDC plans to release a pamphlet, "Facts About Brain Injury," in upcoming months, says Waxweiler. In the meantime, the data and the pamphlet are available on the CDC’s Web site: www.cdc.gov.
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