The Costs and Causes of Traumatic Brain Injury

The Costs and Causes of Traumatic Brain Injury


EVERY 15 SECONDS, ONE PERSON IN THE U.S SUSTAINS A BRAIN INJURY

DEFINITION
Traumatic brain injury (TBI): is an insult to the brain, not of degenerative or congenital nature caused by an external physical force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning. It can also result in the disturbance of behavioral or emotional functioning
Acquired brain injury (ABI): injury to the brain which is not hereditary, congenital or degenerative

A patient with mild traumatic brain injury : is a person who has had a traumatically induced physiological disruption of brain function, as manifested by a least one of the following
Any period of loss of consciousness
Any loss of memory for events immediately before or after the accident
Any alteration in mental state at the time of the accident (e.g., feeling dazed, disoriented, or confused); and
Focal neurological deficit(s) that may or may not be transient; but where the severity of the injury does not exceed the following
post-traumatic amnesia (PTA) not greater than 24 hours. - after 30 minutes, an initial Glasgow Coma Scale (GCS) of 13-15; and - loss of consciousness of approximately 30 minutes or less


II. When Does a Brain Injury Occur
A brain injury may occur at any time. There is no age, gender or sect that escapes it. Brain injury targets those in the best of health. Brain injury happens indiscriminately. The ramifications of a brain injury can be devastating for the individual and their family. This is why correct evaluations and rehabilitation programs are the most important first steps



SCOPE
An estimated 5.3 million Americans little more than 2% of the US population currently live with disabilities resulting from brain injury
It is estimated that one million people are treated for traumatic brain injury and released from hospital emergency rooms every year
Each year, 80,000 Americans experience the onset of long-term disability following traumatic brain injury
More than 50,000 people die every year as a result of traumatic brain injury
Vehicle crashes are the leading cause of brain injury. They account for 50% of all traumatic brain injuries
Falls are the second leading cause, and the leading cause of brain injury in the elderly. The risk of traumatic brain injury is highest among adolescents, young adults and those older than 75
After one brain injury, the risk for a second injury is three times greater; after the second injury, the risk for a third injury is eight times greater




THE COSTS
The cost of traumatic brain injury in the United States is estimated to be $48.3 billion annually. Hospitalization accounts for $31.7 billion, and fatal brain injuries cost the nation $16.6 billion each year


THE CONSEQUENCES
Brain injury can affect a person cognitively, physically and emotionally.
Cognitive consequences can include: Short term memory loss; long term memory loss Slowed ability to process information trouble concentrating or paying attention for periods of time difficulty keeping up with a conversation; other communication difficulties such as word finding problems spatial disorientation organizational problems and impaired judgment unable to do more than one thing at a time
Physical consequences can include: Seizures of all types muscle spasticity double vision or low vision, even blindness Loss of smell or taste speech impairments such as slow or slurred speech; headaches or migraines fatigue, increased need for sleep; balance problems
Emotional consequences can include: a lack of initiating activities, or once started, difficulty in completing tasks without reminders increased anxiety depression and mood swings denial of deficits impulsive behavior more easily agitated egocentric behaviors; difficulty seeing how behaviors can affect others



References



Guerrero JL, Leadbetter S, Thurman DJ, Whiteneck G and Sniezek JE. A method for estimating the prevalence of disability from traumatic brain injury, in press



Data from the National Hospital Ambulatory Medical Care Survey, 1995-1996, of the National Center for Health Statistics. Described in Guerrero JL, Thurman DL and Sniezek JE. Emergency department visits associated with traumatic brain injury. United States, 1995-1996, in press



Guerrero JL, Leadbetter S, Thurman DJ, Whiteneck G and Sniezek JE. A method for estimating the prevalence of disability from traumatic brain injury, in press



Unpublished data from Multiple Cause of Death Public Use Data from the National Center for Health Statistics, 1996


Krause J, Sorenson S. Epidemiology. In J Silver, S Yudofsky, R Hales (eds.). Neuropsychiatry of Traumatic Brain Injury. Washington, DC: American Psychiatric Press, Inc., 1994




Analysis by the CDC National Center for Injury Prevention and Control, using data obtained from state health departments in Alaska, Arizona, California, Colorado, Louisiana, Maryland, Missouri, New York, Oklahoma, Rhode Island, South Carolina and Utah


Annegers JF, Garbow JD, Kurtland LT et al. The Incidence, Causes and Secular Trends of Head Trauma in Olstead County, Minnesota 1935- 1974. Neurology. 1980; 30:912-919


Lewin ICF. The Cost of Disorders of the Brain Washington, DC: The National Foundation for the Brain, 1992. Special Report CDC Report Shows Prevalence of Brain Injury April 14, 1999 ATLANTA (CNN) An estimated 5.3 million Americans, a little more than 2 percent of the U.S. population, currently live with disabilities from traumatic brain injuries, according a to a new report by the Centers for Disease Control and Prevention



Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. (J Head Trauma Rehabil 1993:8(3):86-87)