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Complete Health Indicator Report of Traumatic Brain Injury (TBI)

Definition

The rate of traumatic brain injuries (TBIs) resulting in emergency department visit, hospitalization, or death per 100,000 population. These cases may include a TBI alone or in combination with other injuries or conditions. ICD-9-CM Hospital Codes for TBI Morbidity: 800.0-801.9 Fracture of the vault or base of the skull; 803.0-804.9 Other and unqualified and multiple fractures of the skull; 850.0-854.1 Intracranial injury, including concussion, contusion, laceration, and hemorrhage; 950.1-950.3 Injury to the optic chiasm, optic pathways, and visual cortex; 959.01 Head injury, unspecified; 995.55 Shaken Infant Syndrome. ICD-10 Death Codes for TBI Mortality: S01.0-S01.9 Open wound of the head; S02.0, S02.1, S02.3, S02.7-S02.9 Fracture of skull and facial bones; S04.0 Injury to optic nerve and pathways; S06.0-S06.9 Intracranial injury; S07.0, S07.1, S07.8, S07.9 Crushing injury of head; S09.7-S09.9 Other and unspecified injuries of head; T01.0 Open wounds involving head with neck; T02.0 Fractures involving head with neck; T04.0 Crushing injuries involving head with neck; T06.0 Injuries of brain and cranial nerve with injuries of nerves and spinal cord at neck level; T90.1, T90.2, T90.4, T90.5, T90.8, T90.0 Sequelae of injuries of head.

Numerator

The number of traumatic brain injuries (TBIs) which meet the case definition mentioned in the data notes explaining ICD-9 and ICD-10 codes.

Denominator

The total number of persons in the population of Utah.

Data Interpretation Issues

Traumatic brain injury (TBI) is defined as an occurrence of injury or death resulting from trauma to the head. With regard to injury, the occurrence must be documented in a medical record with one or more of the following: observed or self-reported loss of consciousness or decreased level of consciousness; amnesia; skull fracture; changes in motor function, sensory function, reflexes, or speech; seizures; or hemorrhages, bruising, or other trauma of the brain. With death, the injury has been listed on the death certificate, autopsy report, or medical examiner's report as a sequence that caused death. Clinical definitions of TBI exclude several conditions including: lacerations or contusions of the face, eye, or scalp without other criteria; fractures of facial bones without other criteria; birth trauma; primary anoxic, inflammatory, toxic, or metabolic encephalopathies which are not complications of head trauma; brain infarction (ischemic stoke); intracranial hemorrhage (hemorrhagic stroke) without associated trauma; airway obstruction (e.g., near-drowning, throat swelling, choking, strangulation, or crush injuries of the chest); seizure disorders (Grand mal, etc.); intracranial surgery; and neoplasms.

Why Is This Important?

Traumatic brain injury is a leading cause of death and disability in Utah, costing more than $118 million in hospitalization charges in 2014. During 2014, 25,213 people in Utah sustained a TBI. Among those injured, 584 died (19.8 per 100,000 population) where TBI was reported as a cause of death on the death certificate alone or in combination with other injuries or conditions; another 2,415 (82.0 per 100,000) were hospitalized, and an additional 22,214 (754.4 per 100,000) were treated and released from emergency departments with a TBI alone or in combination with other injuries or conditions. An unknown number of individuals sustained injuries that were treated in other settings or went untreated.

Healthy People Objective IVP-2:

Reduce fatal and nonfatal traumatic brain injuries
U.S. Target: Not applicable, see subobjectives in this category

Other Objectives

{{style color:#003366 Healthy People 2020 Objective IVP-2.1:}}[[br]] Reduce fatal traumatic brain injuries[[br]] '''U.S. Target:''' 15.7 deaths per 100,000 population {{style color:#003366 Healthy People 2020 Objective IVP-2.2:}}[[br]] Reduce hospitalizations for nonfatal traumatic brain injuries[[br]] '''U.S. Target:''' 77.0 hospitalizations per 100,000 population[[br]] '''Utah Target:''' 77.0 hospitalizations per 100,000 population {{style color:#003366 Healthy People 2020 Objective IVP-2.3:}}[[br]] Reduce emergency department (ED) visits for nonfatal traumatic brain injuries[[br]] '''U.S. Target:''' 365.3 ED visits per 100,000 population

How Are We Doing?

The age-adjusted rate of traumatic brain injury (TBI) in Utah in 2014 was 867.0 per 100,000 population. This rate was higher than the previous year's rate of 834.7 per 100,000 population. From 2010 to 2014, age-adjusted rates of TBI for both sexes have increased. Males have significantly higher rates of TBI compared to females.

How Do We Compare With the U.S.?

In Utah the rate of TBI deaths for ages 5-19 is higher than the national rate for those ages. The TBI death rate for the 0-4 age group in Utah is slightly lower than the national rate for the same age group. The national rates are reported in the 2013 MMWR article entitled, ''QuickStats: Rate of Traumatic Brain Injury (TBI)-Related Deaths Among Persons Aged 0-19 Years, by Age Group - National Vital Statistics System, United States 1999-2010'' (MMWR Morb Mortal Wkly Rep. 2013 Mar 22;62(11):215).

What Is Being Done?

The Utah Department of Health Violence and Injury Prevention Program (VIPP) receives funding from the U.S. Centers for Disease Control and Prevention to conduct TBI surveillance for the state of Utah. This is done through review of hospital discharge data, vital statistics data, and hospital records abstractions. These data are used to develop interventions and policies targeting those at highest risk (such as young people for motor vehicle incidents and the elderly for fall incidents). In 2010, the VIPP was awarded a $1 million grant from the U.S. Department of Health and Human Services, Health Resources and Services Administration Maternal and Child Health Bureau. The four-year grant was awarded to develop statewide capabilities to address family and person-directed resources for individuals with TBIs and their families. The goals of the grant are to: 1) foster improvement in the TBI service delivery system, 2) assure access to coordinated community services and supports for young children (ages birth-4 years) who have a TBI, and 3) assure access to coordinated community services for service members and veterans of Operation Iraqi Freedom and Operation Enduring Freedom who have a TBI. The grant is not for primary services but instead is aimed at developing a more informed system of service agencies and professionals ready to help individuals with a TBI and their families. The Traumatic Brain Injury (TBI) Fund was established in 2008 by the Utah Legislature as a restricted special revenue fund. The fund consists of gifts, grants, donations, and any other funding from private sources. Individuals with a TBI may receive help with resource facilitation or neuropsychological testing through the TBI Fund. The TBI Fund is designed to be a payor of last resort, meaning individuals have no other financial means available to obtain these services. More information on the TBI Fund can be found at [http://www.health.utah.gov/vipp/topics/traumatic-brain-injury/tbi-fund.html]. The Traumatic Spinal Cord and Brain Injury Rehabilitation Fund was established during the 2012 Utah Legislative Session (Section 26-54) as a restricted special revenue fund that consists of gifts, grants, donations, or any other conveyance of money that may be made to the fund from private sources; portion ($20) of the impound fee as designated in Section 41-6a-1406; and amounts as appropriated by the legislature. The Legislature appropriated an initial allocation of $200,000 for State Fiscal Year 2013. The SCI/TBI Rehabilitation Fund provides individuals with spinal cord or traumatic brain injuries with physical, occupational, and speech therapy; and equipment necessary for daily living activities. More information on the SCI/TBI Rehabilitation Fund can be found at [http://www.health.utah.gov/vipp/topics/traumatic-brain-injury/sci-fund.html].

Health Program Information

The Violence and Injury Prevention Program (VIPP) is a trusted and comprehensive resource for data related to violence and injury. Through education, this information helps promote partnerships and programs to prevent injuries and improve public health. VIPP goals are to a) focus prevention efforts on reducing intentional and unintentional injury, b) conduct education aimed at increasing awareness and changing behaviors that contribute to the occurrence of injury, c) strengthen local health department capacity to conduct local injury prevention programs, d) promote legislation, policy changes, and enforcement that will reduce injury hazards and increase safe behaviors, e) collaborate with private and public partners, and f) improve the Utah Department of Health capacity to collect mortality and morbidity data from multiple sources and conduct injury epidemiology for use in prevention planning, implementation, and evaluation.


Related Indicators

Related Relevant Population Characteristics Indicators:




Graphical Data Views

TBI Incidence Rates by Sex, Utah, 2010-2014

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confidence limits

On average, from 2010-2014 Utah males had a significantly higher rate of TBI than females.
UT M, UT F, US M, US FYearAge-adjusted Rate per 100,000Lower LimitUpper LimitNumer- atorDenom- inator
Record Count: 10
Utah Males2010834.0818.6849.611,8361,393,737
Utah Males2011878.1862.4894.012,6271,414,293
Utah Males2012896.2880.6912.213,0981,435,312
Utah Males2013850.3835.1856.612,6271,459,282
Utah Males2014907.9892.2923.813,4021,480,607
Utah Females2010707.5693.3721.99,6411,380,609
Utah Females2011725.5711.2740.010,0531,401,031
Utah Females2012782.2767.4797.110,9731,419,882
Utah Females2013703.4689.5717.410,0531,443,505
Utah Females2014820.1805.2835.211,7901,463,891

Data Notes

ICD-9-CM codes for TBI Morbidity: 800.0-801.9, 803.0-804.9, 850.0-854.1, 950.1-950.3, 959.01, 995.55; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   [[br]] [[br]] Rates are calculated using both sampled and non-sampled TBI hospitalization, death, and ED visit cases. [[br]] [[br]] Rates have been age-adjusted to the 2000 U.S. population.

Data Sources

  • Utah Department of Health, Violence & Injury Prevention Program, TBI database
  • Emergency Department Encounter Database, Bureau of Emergency Medical Services, Utah Department of Health
  • Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health
  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2015


TBI Incidence Rates by Age Group and Sex, Utah, 2014

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confidence limits

Males have significantly higher rates of TBI compared to females in all age groups.
Males vs. FemalesAge GroupRate per 100,000 PopulationLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 12
Male0-171,981.11,940.72,021.69,208464,784
Male18-441,324.01,294.61,353.47,809589,809
Male45-541,119.01,066.21,171.91,723153,973
Male55-641,184.61,126.81,242.51,609135,822
Male65-741,698.41,609.51,787.31,40282,547
Male75+4,430.64,252.54,608.72,37853,672
Female0-171,236.41,203.51,269.25,440439,990
Female18-44683.4662.0704.93,906571,524
Female45-54516.6480.5552.6789152,731
Female55-64518.4480.8556.0730140,811
Female65-74654.8601.9707.758989,951
Female75+1,631.71,536.31,727.11,12468,884

Data Notes

ICD-9-CM codes for TBI Morbidity: 800.0-801.9, 803.0-804.9, 850.0-854.1, 950.1-950.3, 959.01, 995.55; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   [[br]] [[br]] Rates are calculated using both sampled and non-sampled TBI hospitalization, death, and ED visit cases.

Data Sources

  • Utah Department of Health, Violence & Injury Prevention Program, TBI database
  • Emergency Department Encounter Database, Bureau of Emergency Medical Services, Utah Department of Health
  • Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health
  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population Estimates: National Center for Health Statistics (NCHS) through a collaborative agreement with the U.S. Census Bureau, IBIS Version 2015


TBI Hospitalizations and Deaths Etiology, Utah, 2013

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confidence limits

More than half (52.2%) of TBI hospitalizations and deaths are the result of falls. Motor vehicle traffic crashes and recreational activity are also leading causes of TBI hospitalizations and deaths in Utah.
EtiologyPercentage of CasesLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 13
Falls52.2%48.4%55.9%370709
Motor Vehicle Crashes11.3%9.0%13.8%80709
Recreational Activity7.6%5.8%9.8%54709
Assault4.7%3.2%6.5%33709
Bicycle Crashes6.5%4.8%8.6%46709
OHV/ATV5.2%3.7%7.1%37709
Horse/rodeo3.0%1.8%4.5%21709
Motorcycle Crashes3.8%2.5%5.5%27709
Pedestrian5.2%3.7%7.1%37709
Suicide/suicide Attempts1.0%0.4%2.0%7709
Team Sports2.5%1.5%4.0%18709
Snow Sports3.4%2.1%5.0%24709
Skateboard/rollerblade2.7%1.6%4.2%19709

Data Notes

ICD-9-CM codes for TBI Morbidity: 800.0-801.9, 803.0-804.9, 850.0-854.1, 950.1-950.3, 959.01, 995.55; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   '' ''[[br]][[br]] Bicycle crashes include traffic- and non-traffic-related crashes. [[br]] [[br]] Cases of TBI with unknown etiology are not included in this chart. [[br]] [[br]] Causes of TBI as displayed in this chart are not mutually exclusive; that is, a single TBI could be sustained through a combination of these causes, in which case it would be counted in multiple categories. [[br]] [[br]] Numbers represent TBI-related deaths and hospitalizations and are extrapolated from the number of cases in a representative sample from the VIPP TBI database. The 2013 TBI hospitalization and death sample is the most recent one available.

Data Sources

  • Utah Department of Health, Violence & Injury Prevention Program, TBI database
  • Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health
  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health


TBI Incidence Rates by Utah Small Area, 2014

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confidence limits

In Utah in 2014, there were 23 Small Areas with TBI rates significantly higher than the state rate. Five from the Weber-Morgan LHD, one from Davis County LHD, 11 from Salt Lake County LHD, one from Utah County LHD, and the Tooele County LHD, Summit County LHD, and TriCounty LHD Small Areas.
Utah Small AreasAge-adjusted Rate per 100,000 PopulationLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 64
Brigham City879.2765.91,004.622224,441
Box Elder Co (Other)666.5570.4774.118027,059
Logan885.5812.9962.861776,504
Cache Co (Oth)/Rich Co (All)737.6656.0826.632344,127
Ben Lomond1,145.71,058.51,238.266458,907
Morgan Co (All)/Weber Co (E)761.4681.8847.734545,441
Ogden (Downtown)1,338.51,220.21,465.149837,762
South Ogden1,081.2977.11,193.339836,683
Roy/Hooper1,035.4941.41,136.246545,802
Riverdale1,079.5958.61,211.429326,504
Clearfield/Hill AFB1,006.5922.81,095.766270,644
Layton880.4811.9953.166879,528
Syracuse/Kaysville763.9689.5844.345762,301
Farmington/Centerville622.5542.8710.523237,720
Woods Cross/North Salt Lake747.2652.3851.925432,866
Bountiful793.1716.1876.139946,632
SLC (Rose Park)904.4803.71,014.231735,478
SLC (Avenues)677.9563.3809.013722,537
SLC (Foothill/U of U)619.9522.1730.714524,309
Magna1,057.3925.31,202.827427,627
SLC (Glendale)1,256.51,130.01,393.238631,559
West Valley (West)946.9874.11,024.073482,233
West Valley (East) V21,060.7969.21,158.454052,455
SLC (Downtown)908.6820.41,003.843152,695
South Salt Lake1,110.1984.21,247.629226,874
Millcreek930.0852.81,012.354158,039
Holladay1,097.71,003.71,198.252847,164
Cottonwood721.3642.5807.131743,022
Kearns V21,257.91,133.51,392.345840,169
Taylorsville (E)/Murray (W)1,064.2958.91,177.938237,128
Taylorsville (West)817.0723.6919.130139,257
Murray1,329.41,208.01,459.744633,517
Midvale1,082.5967.51,207.332931,241
West Jordan (NE) V21,000.1879.71,132.428731,268
West Jordan (SE)1,033.0917.31,159.234937,240
West Jordan (W)/Copperton858.0719.11,015.832446,647
South Jordan819.3741.2903.345759,793
Sandy (Center)993.7910.71,082.353755,264
Sandy (NE)879.2757.81,014.519823,382
Sandy (SE)782.1678.9896.522430,178
Riverton/Draper782.0724.7842.6924123,721
Tooele Co971.9891.71,057.459361,623
Lehi/Cedar Valley706.3636.8781.3671107,663
American Fork/Alpine757.5681.7839.541556,572
Pleasant Grove/Lindon798.5717.7885.941756,146
Orem (North)945.5835.81,065.631237,622
Orem (West)849.4745.5963.726733,146
Orem (East)721.1612.1843.915922,127
Provo (North)/BYU551.4480.1630.425052,889
Provo (South)824.4734.6922.145366,924
Springville/Spanish Fork881.4815.9950.977390,616
Utah Co (South)1,076.9962.91,200.637837,805
Summit Co1,119.01,003.41,244.339239,129
Wasatch Co604.8512.9708.516527,782
TriCounty LHD1,020.8938.81,108.060058,408
Juab/Millard/Sanpete Co860.9782.3945.445051,369
Sevier/Piute/Wayne Co850.7740.5972.622325,049
Carbon/Emery Co858.8758.3968.827131,256
Grand/San Juan Co724.0620.1840.317724,698
St George634.9581.4692.055181,875
Washington Co (Other)588.1532.3648.243070,002
Cedar City649.5573.5732.727943,322
Southwest LHD (Other)602.4504.1714.314122,678
State867.0856.1878.025,2132,944,498

Data Notes

ICD-9-CM codes for TBI Morbidity: 800.0-801.9, 803.0-804.9, 850.0-854.1, 950.1-950.3, 959.01, 995.55; ICD-10 codes for TBI Mortality: S01.0-S01.9, S02.0, S02.1, S02.3, S02.7-S02.9, S04.0, S06.0-S06.9, S07.0, S07.1, S07.8, S07.9, S09.7-S09.9, T01.0, T02.0, T04.0, T06.0, T90.1, T90.2, T90.4, T90.5, T90.8, T90.0. These cases may include a TBI alone or in combination with other injuries or conditions.   [[br]] [[br]] Rates age-adjusted to the 2000 U.S. standard population. [[br]] [[br]] Statistical significance is determined by whether a region's confidence bounds overlap with the state's rate. [[br]] [[br]] A description of the Utah Small Areas may be found on IBIS at the following URL: [http://ibis.health.utah.gov/resource/Help.html].

Data Sources

  • Utah Department of Health, Violence & Injury Prevention Program, TBI database
  • Emergency Department Encounter Database, Bureau of Emergency Medical Services, Utah Department of Health
  • Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health
  • Utah Death Certificate Database, Office of Vital Records and Statistics, Utah Department of Health
  • Population estimates produced by the UDOH Center for Health Data and Informatics. Linear interpolation of U.S. Census Bureau and ESRI ZIP Code data provided annual population estimates for ZIP Code areas by sex and age groups, IBIS Version 2015

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 01/06/2017, Published on 01/25/2017
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Fri, 20 October 2017 11:51:20 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Thu, 12 Oct 2017 16:48:10 MDT