TBI-related Emergency Department (ED) Visits

Key Findings
  • In 2014, there were approximately 2.5 million TBI-related ED visits in the U.S., including over 812,000 among children.
  • Unintentional falls, being unintentionally struck by or against an object, and motor vehicle crashes were the most common mechanisms of injury contributing to a TBI diagnosis in the ED. These three principal mechanisms of injury accounted for 47.9%, 17.1%, and 13.2%, respectively, of all TBI-related ED visits.
  • Rates of TBI-related ED visits per 100,000 population were highest among older adults aged ≥ 75 years (1,682.0), young children aged 0-4 years (1,618.6), and individuals 15-24 years (1,010.1).

Trends in Age-adjusted Rates of TBI-related Emergency Department Visits

  • Age-adjusted rates of TBI-related ED visits increased 54% from 521.6 per 100,000 population in 2006 to 801.9 in 2014. An increase in age-adjusted rates occurred among nearly all of the major unintentional and intentional principal mechanism categories, including:
    • a 24% increase for TBI-related ED visits as a result of motor vehicle crashes (from 85.3 to 106);
    • an 80% increase for TBI-related ED visits as a result of falls (from 208.8 to 374.9);
    • a 58% increase for TBI-related ED visits as a result of being struck by or against an object (from 90.8 to 143.9);
    • a 60% increase for TBI-related ED visits ED visits as a result of intentional self-harm (from 0.5 to 0.8); and
    • an 18% increase for TBIs as a result of assault (from 57.6 to 67.8).
2006 2007 2008 2009 2010 2011 2012 2013 2014
Motor vehicle crashes 85.3 83.8 83.9 88.7 95.3 98.7 99.9 99.6 106.0
Unintentional falls†† 208.8 221.7 240.9 298.8 316.3 348.7 355.9 362.9 374.9
Unintentionally struck by or against an object 90.8 90.6 95.8 123.9 127.0 138.8 149.8 141.0 143.9
Other unintentional injury, mechanism unspecified‡‡ 40.4 42.7 43.1 49.5 50.5 53.4 55.4 54.1 53.2
Intentional self-harm 0.5 0.4 0.5 0.6 0.6 0.7 0.7 0.7 0.8
Assault 57.6 56.8 60.3 64.6 68.7 68.9 69.9 68.0 67.8
Other or no mechanism specified§§ 38.2 37.7 35.3 44.2 41.1 47.1 40.4 58.3 55.3
 Total  521.6  533.8  559.8  670.2  699.5  756.3  771.9  784.6  801.9

Source: Healthcare Cost and Utilization Project’s (HCUP) Nationwide Emergency Department Sample. Age-adjusted to the 2000 U.S. standard population. ††Includes falls of undetermined intent to maintain consistency with past data releases. ‡‡E-codes specify that the injury was unintentional but do not specify the actual mechanism of injury. §§Includes TBIs in which the intent was not determined as well as those due to legal intervention or war. Includes TBIs in which no mechanism was specified in the record. Does not include falls of undetermined intent.