Epidemiology of traumatic brain injury in Pennsylvania, 2000-2006

Background: Traumatic brain injury (TBI) imposes a major health burden in the United States, accounting for 1.1 million emergency department visits, 235,000 hospitalizations, and 50,000 deaths per year.

Purpose: To describe TBI hospitalizations in Pennsylvania.

Methods: Data came from acute care hospitals reporting discharge data to the Pennsylvania Health Care Cost Containment Council from 2000-2006. Persons hospitalized due to TBI were included, but those who died before admission, were treated and released from emergency departments, or were treated at rehabilitation hospitals were not in the database. Variables analyzed include age, gender, mechanism of injury, mortality, and length of stay.

Results: Among 114,915 TBI discharges in Pennsylvania 60.6% occurred among males and 77% among whites. The overall fatality rate was 5.5 %. Hospitalizations were most common in those 75+ years old (24.8%). The most common injury mechanism was falls (41.3%), followed by motor vehicle related (37.1%) and struck by or against (7.4%). Firearms-related head injuries were eleven times more common in African-Americans with TBI than whites (p<.01). Nearly 8% of all TBIs were coded as intentional. Males were three times more likely than females (p<.01) to suffer an assault-related TBI, while African-Americans were more than 11 times more likely than whites to sustain an assault-related TBI (p<.01).

Conclusions: These findings suggest there are ages, gender, and racial disparities among those hospitalized in Pennsylvania with TBI. Preventive measures should focus on those at highest risk of TBI.