The epidemiology of severe traumatic brain injury among persons 65 years of age and older in Oklahoma, 1992–2003

Abstract

PRIMARY OBJECTIVE: To describe the epidemiology of traumatic brain injury (TBI) among persons 65 years of age and older in Oklahoma from 1992-2003. RESEARCH DESIGN: Descriptive epidemiology of data collected through active statewide surveillance on TBI inpatient hospitalizations and fatalities. METHODS AND PROCEDURES: Data collected from hospital medical records and the Office of the Chief Medical Examiner. TBI was defined by ICD-9-CM codes for skull fracture 800.0-801.9, 803.0-804.9, concussion or other intracranial injury 850.0-854.1 and head injury, unspecified 959.01; all cases included a description of TBI. MAIN OUTCOME AND RESULTS: TBI rates increased 79% for the study population; however, case-fatality rates decreased from 32% in 1992 to 18% in 2003. The TBI rate increase was observed among all elderly age groups, both genders and all races. Unintentional injuries nearly doubled while both assault and self-inflicted injuries decreased. Fall-related TBI increased by 126%, while MVC-related TBI increased by 17%. Survivors were hospitalized for an average of 6.8 days and over half required post-acute care. CONCLUSIONS: The increased TBI rate and decreased case-fatality rate among elderly persons means potentially more persons living with TBI disability. TBI prevention efforts among the elderly must be expanded, especially for fall-related TBI.