Trends in Traumatic Brain Injury in the US and the public health response: 1995-2009

Problem: Traumatic Brain Injury (TBI) is a public health problem in the United States. In 2009, approximately 3.5 million patients with a TBI listed as primary or secondary diagnosis were hospitalized and discharged alive (N = 300,667) or were treated and released from emergency departments (EDs; N = 2,077,350), outpatient departments (ODs; N = 83,857), and office-based physicians (OB-P; N = 1,079,338). In addition, 52,695 died with one or more TBI-related diagnoses. Methods: Federal TBI-related laws that have guided CDC since 1996 were reviewed. Trends in TBI were obtained by analyzing data from nationally representative surveys conducted by the National Center for Health Statistics (NCHS). Findings: CDC has developed and is implementing a strategy to reduce the burden of TBI in the United States. Currently, 20 states have TBI surveillance and prevention systems. From 1995-2009, the TBI rates per 100,000 population increased in EDs (434.1 vs. 686.0) and OB-Ps (234.6 vs. 352.3); and decreased in ODs (42.6 vs. 28.1) and in TBI-related deaths (19.9 vs. 16.6). TBI Hospitalizations decreased from 95.5 in 1995 to 77.9 in 2000 and increased to 95.7 in 2009. Conclusions: The rates of TBI have increased since 1995 for ED and PO visits. To reduce of the burden and mitigate the impact of TBI in the United States, an improved state- and territory-specific TBI surveillance system that accurately measures burden and includes information on the acute and long-term outcomes of TBI is needed. National Safety Council and Elsevier Ltd. All rights reserved.