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Health - Oklahoma Cooperative Extension Service

Health Topics

Acute Care

Disabilities related to injury are serious public health problems because of their impact on quality of life and their economic impact on our health care system. The National Center for Injury Prevention and Control, through the Division of Acute Care, Rehabilitation Research, and Disability Prevention, coordinates a national public health approach to reducing the impact of injuries by improving trauma care and rehabilitation systems. The program includes the prevention of injury-related disabilities and their secondary conditions.

Traumatic Brain Injury: 1995-1996

Incidence of traumatic brain injury (TBI). Using national data for 1995-1996, the CDC estimates that TBIs have this impact in the United States each year:

1 million people are treated and released from hospital emergency departments1 230,000 people are hospitalized and survive2 50,000 people die3

TBI incidence rate, risk factors, and causes. Using preliminary hospitalization and mortality data collected from 12 states (Alaska, Arizona, Sacramento County [California], Colorado, Louisiana, Maryland, Missouri, New York, Oklahoma, Rhode Island, South Carolina, and Utah) during 1995-1996, CDC finds the following:4

The average TBI incidence rate (combined hospitalization and mortality rate) is 95 per 100,000 population. Twenty-two percent of people who have a TBI die from their injuries. The risk of having a TBI is especially high among adolescents, young adults, and people older than 75 years of age.  For persons of all ages, the risk of TBI among males is twice the risk among females.  The leading causes of TBI are motor vehicle crashes, violence, and falls. Nearly two-thirds of firearm-related TBIs are classified as suicidal in intent.  The leading causes of TBI vary by age: falls are the leading cause of TBI among persons aged 65 years and older, whereas transportation leads among persons aged 5 to 64 years.  The outcome of these injuries varies greatly depending on the cause: 91% of firearm-related TBIs resulted in death, but only 11% of fall-related TBIs are fatal.

Incidence and prevalence of TBI-related disability. Based on national TBI incidence data and preliminary data from the Colorado Traumatic Brain Injury Registry that describe TBI-related disability in 1996-1997, CDC estimates the following:5

Each year 80,000 Americans survive a hospitalization for traumatic brain injury but are discharged with TBI-related disabilities.  5.3 million Americans are living today with a TBI-related disability.

Note: The preliminary estimates described above are derived from provisional data that are subject to change, pending receipt of additional data. Therefore, the information contained in this outline should not be published without approval from the Centers for Disease Control and Prevention.

Acute Care in the United States

  • Emergency department visits for injuries per year total 33 million.
  • The most common causes of injuries seen in emergency departments are from traffic crashes, falls, and violence.
  • Only one fourth of the U.S. population lives in an area served by a trauma care system.
  • Studies of conventional trauma care show that as many as 35% of trauma patient deaths could have been prevented if optimal acute care had been available.
  • Up to 25% of injuries treated in emergency departments are alcohol related.

Disability and Rehabilitation in the United States

  • An estimated 34 to 43 million people in the United States have chronic disabilities.
  • Traumatic brain injuries incurred each year number 1.5 million.
  • Traumatic spinal cord injuries incurred each year number 10,000.
  • Traffic crashes, violence, and falls are the leading causes of traumatic brain and spinal cord injuries, which are the two most severe disabling injury conditions.
  • Traumatic brain injury is the leading cause of death and injury-related disability among children and young adults.
  • For every death caused by lack of access to a trauma care system, three persons are severely disabled and 75 are temporarily disabled.
  • Rehabilitation services are not available consistently throughout the United States, nor are they financially accessible by all.

Cost of Traumatic Brain and Spinal Cord Injury

  • Traumatic brain injuries cost more than $37 billion annually.
  • Spinal cord injuries cost more than $6.2 billion annually.

Current Activities of the Division

  • Funding for the Development of a National Toll-Free Poison Control Number
  • Disability prevention and rehabilitation activities on the incidence and impact of TBI
  • Evaluation and surveillance of emergency medical services
  • Promotion for standard for emergency department data systems
  • Development of guidelines for surveillance of injuries to the central nervous system (primarily traumatic brain and spinal cord injuries)
  • Development of alcohol-focused clinical prevention services
  • Research on the prevention of secondary conditions such as pressure sores
  • Multistate surveillance system for traumatic brain and spinal cord injuries.

Funding of the West Virginia Injury Control Training and Demonstration Center Prevention Works

Two proven ways to reduce the toll of injury are regionalized trauma care systems and clinical prevention services:

After regionalized trauma care was introduced in San Diego, California, in 1984, the number of preventable deaths from trauma declined from 22% to less than 2% and has remained at that level.  In Orange County, California, the introduction of a trauma care system lowered preventable deaths by 50%.  Brief clinical prevention services reduce alcohol consumption for 20% of patients with mild to moderate drinking problems.