Appendix B
Traumatic Brain Injury in Children and Youth as a Public Health Problem: An Overview
Presented by Dr. David Thurman, CDC

This section features copies of the slides from Dr. David Thurman’s presentation. The surveillance data (beginning with Slide 2) are from selected states for the information available at the time of the meeting; therefore, the data should be considered preliminary.

 

 
Slide 1 - Estimated Impact of TBI on Children Aged 0-14 Years in the United States
  • 3,000 deaths (NCHS, 1994)
  • 29,000 hospitalizations
  • 400,000 ED visits (NHAMCS, 1996)
  • Unknown number with long-term disability

 

Slide 2 - Preliminary Surveillance Findings for TBI-Related Hospitalizations & Deaths –1997


TBI Surveillance--Background

  • CDC collects data on TBI-related injuries from 15 states.
  • Clinical case definition: Injury to the head associated with decreased consciousness, amnesia, neurologic abnormalities, skull fracture, intracranial lesion or death.
  • Data case definition: ICD-9 codes 800-801, 803-804, 850-854 and (for fatalities only) 873.
  • Data sources: Vital records, hospital discharge data and medical records (for a sample of cases).
  • Data elements: Demographic, nature of injury (ICD-9 N-codes), cause of injury (ICD-9 E-codes), severity, and outcome.
  • For this presentation, unless otherwise noted, data are from Minnesota, Missouri, South Carolina and Utah

 

Slide 3 - Figure 1: Rates of TBI in Children and Youth by Age Group & Care Level, 1997

TBI death and hospitalization rates were highest among those aged 15-19 year

 

Slide 4 - Figure 2: TBI in Children and Youth: Percent with Fatal Outcomes, 1997

 

Slide 5 - Figure 3: TBI Rates in Children and Youth by Age and Race, 1997

28% of cases were of unknown race)

  • For all categories of race, the highest TBI rates were among youth, aged 15-19 years followed by children aged 0-4 years.
  • The TBI rate in black children aged 0-4 years was approximately twice as high as for the same-aged white or other race children.

 

Slide 6 - Figure 4: Rates of TBI in Children and Youth by Age Group and External Cause of Injury, 1997
  • The rate of TBI from falls decreased with increasing age.
  • The rate of TBI from transportation incidents was more than three times as high for youth aged 15-19 years as for children in the younger age groups.
  • The rate of TBI from firearm-related injuries was highest among 15-19 year-olds.
  • The rate of TBI from non-firearm assaults was highest among 0-4 year-olds.
    •

 

Slide 7 - Figure 5: TBI in Children Aged 0-4 Years: Proportion by Cause & Race, 1997

children aged 0-4 years, falls were the leading cause of TBI, followed by transportation and assaults; however, transportation-related TBIs accounted for a greater proportion among black children than among whites.

 
Slide 8 - Figure 6: TBI in Children Aged 5-14 Years: Proportion by Cause & Race, 1997

 
Slide 9 - Figure 7: TBI in Youth Aged 15-19 Years: Proportion by Cause and Race, 1997

leading cause of TBIs, but compared to those aged 5-14 years, a greater proportion were due to assaults and firearm-related injuries, particularly among blacks.

 

 
 

 

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