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Complete Health Indicator Report of Traumatic Brain Injury (TBI)

Definition

TBI Hospitalizations Rate: The rate of TBIs resulting in non-fatal hospitalizations per 100,000 population. For all definitions, these cases may include a TBI alone or in combination with other injuries or conditions. ICD-10-CM Hospital Codes for TBI Morbidity: S02.0, S02.1 Fracture of skull; S02.8, S02.91 Fracture of other specified skull and facial bones, unspecified fracture; S04.02, S04.03, S04.04 Injury of optic tract and pathways, injuries of visual cortex; S06 Intracranial injury; S07.1 Crushing injury of skull; T74.4 Shaken infant syndrome.

Numerator

TBI Hospitalization Rate: The number of TBIs resulting in hospitalization which meet the case definition mentioned in the data notes explaining ICD-10-CM codes. TBI Hospitalizations and Deaths Percentage: The number of TBIs with a cause or set of causes as defined through medical record review, as part of the TBI Injury Surveillance Database sample.

Denominator

TBI Hospitalization Rate: The total number of persons in the population of Utah.

Data Interpretation Issues

Due to the transition to the ICD-10-CM coding system, data is available beginning in 2016. 2015 data is available from sampled traumatic brain injury (TBI) hospitalization and death cases, provided by the Violence and Injury Prevention Program, Traumatic Brain Injury Surveillance Program; this data was used to report etiology. 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 2019, 423 per 100,000 Utahns were hospitalized due to a TBI. Of sampled 2016-2017 TBI cases, more than half (52.8%) of TBI hospitalizations and deaths are the result of a fall. Motor vehicle traffic crashes (13.4%) are the second leading cause of TBI hospitalizations and deaths in Utah.

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 hospitalization rate of traumatic brain injury (TBI) in Utah in 2019 was 423.0 per 100,000 population. This rate was higher than the previous year's rate of 417.5 per 100,000 population. From 2016 to 2019, age-adjusted rates of TBI for both sexes have decreased. In 2018 and 2019, rates of TBI hospitalizations were comparable between males and 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 2018 VIPP was a warded a grant from the U.S. Department of Health & Human Services (HHS) Administration of Community Living (ACL). The purpose of the three year grant is to program is to create and strengthen a system of services and supports that maximizes the independence, well-being, and health of persons with TBI across the lifespan, their families, and their caregivers by: 1) supporting and maintaining the Utah Brain Injury Council (TBI Advisory Board), 2) creating a TBI State Registry, 3) enhancing the TBI workforce through professional training, 4) providing information about TBI to families and referrals to appropriate services, and 5) improving local and national coordination and collaboration around TBI services and supports. With a previous grant, TBI was added to the Medical Home Portal to provide additional information about TBI diagnosis and treatment of young children (birth through age 4) for physicians, health care professionals, educators, families, and patients ([https://www.medicalhomeportal.org/]). 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. The 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 Hospitalizations Age-adjusted Rates by Sex, Utah, 2016-2019

::chart - missing::
confidence limits

Between 2016 and 2019, TBI hospitalization rates have remained fairly consistent. Male age-adjusted rates are higher than female age-adjusted rates for all years. Caution should be noted, as 2016 was the first year that ICD-10-CM was used for hospital coding.
UT M, UT F, US M, US FYearAge-adjusted Rate per 100,000Lower LimitUpper LimitNumer- atorDenom- inator
Record Count: 8
Utah Males201690.885.696.01,2521,531,131
Utah Males201790.385.295.41,2721,561,796
Utah Males201892.887.797.91,3281,588,240
Utah Males201990.085.995.91,3411,614,917
Utah Females201653.149.357.07581,510,737
Utah Females201755.451.559.37991,539,246
Utah Females201851.247.654.97641,565,310
Utah Females201954.150.357.88221,591,041

Data Notes

ICD-10-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 TBI hospitalizations. [[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, 2019

::chart - missing::
confidence limits

Males have significantly higher rates of TBI-related hospitalizations compared to males in all most age groups. Rates of TBI-related hospitalizations per 100,000 population were highest among older adults aged 85+, with rates significantly increasing for older adults aged 65+.
Males vs. FemalesAge GroupRate per 100,000 PopulationLower LimitUpper LimitNumer- atorDenom- inator
Record Count: 26
MaleLess than 1 year120.681.4172.23024,869
Male1-4 years34.223.947.635102,191
Male5-9 years33.124.144.544132,868
Male10-14 years44.233.856.861137,940
Male15-17 years75.060.891.597129,312
Male18-19 years64.852.079.888135,806
Male20-24 years53.144.363.2128240,955
Male25-34 years58.649.069.4132225,425
Male35-44 years78.765.893.4131166,434
Male45-54 years105.789.8123.5157148,584
Male55-64 years170.1146.1196.9179105,244
Male65-74 years315.9268.3369.615649,382
Male75+ years647.5528.5785.310315,907
FemaleLess than 1 year97.161.5145.62323,697
Female1-4 years17.510.228.01797,046
Female5-9 years26.218.036.733126,108
Female10-14 years28.520.039.237130,045
Female15-17 years34.525.046.543124,535
Female18-19 years16.310.124.921128,846
Female20-24 years17.812.724.141230,851
Female25-34 years20.615.127.645218,028
Female35-44 years34.626.144.956161,996
Female45-54 years53.742.866.683154,550
Female55-64 years108.690.3129.4124114,222
Female65-74 years302.8259.9350.917758,450
Female75+ years538.2447.0642.612222,667

Data Notes

ICD-10-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 TBI-related hospitalizations.

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


Percentage of TBI Hospitalizations and Deaths by Etiology, Utah, 2016-2017

::chart - missing::
confidence limits

Of sampled TBI cases, more than half (52.8%) of TBI hospitalizations and deaths are the result of falls. Motor vehicle traffic crashes (13.4%) are the second leading cause of TBI hospitalizations and deaths in Utah.
EtiologyPercentage of CasesLower LimitUpper LimitNoteNumer- atorDenom- inator
Record Count: 15
Falls52.8%50.2%55.4%7441,409
Motor Vehicle Crashes13.4%11.6%15.2%1891,409
OHV/ATV5.3%4.1%6.4%741,409
Pedestrian3.5%2.6%4.5%501,409
Bicycle Crashes5.3%4.2%6.5%751,409
Motorcycle Crashes3.9%2.9%4.9%551,409
Recreational Activity2.3%1.5%3.0%321,409
Skateboard/rollerblade1.7%1.0%2.4%241,409
Assault4.0%3.0%5.1%571,409
Suicide/suicide Attempts1.8%1.1%2.5%261,409
Horse/rodeo1.3%0.7%2.0%191,409
Snow Sports1.6%0.9%2.2%221,409
Team Sports0.9%0.4%1.4%131,409
Other Recreational Vehicles****
Other2.4%1.6%3.2%341,409

Data Notes

ICD-10-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]] **Data have been suppressed and do not meet UDOH standards for reliability. [[br]] For more information, please go to [http://ibis.health.utah.gov/pdf/resource/DataSuppression.pdf]. Bicycle crashes include traffic- and non-traffic-related crashes. Cases of TBI with unknown etiology are not included in this chart. 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. 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 2016-2017 TBI hospitalization and death sample is the most recent one available in the TBI database.

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

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.

Page Content Updated On 10/19/2020, Published on 01/05/2021
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 Thu, 16 September 2021 13:18:17 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 5 Jan 2021 16:54:38 MST