Incidence of TBI likely greater than previously estimated

Though researchers are becoming increasingly aware of the long-term effects of head injury, few studies have looked at the prevalence of traumatic brain injury (TBI) in all age groups, including males and females, taking into account both mild and serious events. In a recent study published in Epidemiology, Mayo Clinic researchers applied a new, refined system for classifying injuries caused by force to the head and found that the incidence of traumatic brain injury is likely greater than has been estimated by the Centers for Disease Control and Prevention (CDC).

"Even mild traumatic brain injuries can affect sensory-motor functions, thinking and awareness, and communication," says study author Allen Brown, M.D., director of brain rehabilitation research at Mayo Clinic. "In assessing frequency, we have likely been missing a lot of cases. This is the first population-based analysis to determine prevalence along the whole spectrum of these injuries."

Researchers used the Mayo Traumatic Brain Injury Classification System, a new brain injury method that classifies head injuries along a more comprehensive scale than ever before. The categories label patients with "definite," "probable" and "possible" TBIs, providing a way to incorporate symptoms such as a brief period of unconsciousness or even an injured patient's complaint of dizziness or nausea.

Using the Rochester Epidemiology Project, a several decades-long compilation of medical records in Olmsted County, Minn., the team determined that TBIs occur in as many as 558 per 100,000 people, compared to the 341 per 100,000 estimated by the CDC. Researchers found that 60 percent of injuries fell outside the standard categorization used by the CDC, even though two-thirds of them were symptomatic. Mayo researchers found the elderly and the young were found most at risk for "definite" and "possible" injury, respectively, and men were more at risk than women. The findings reinforce ongoing efforts by the CDC to create a brain injury classification that more broadly encompasses traumatic head injury.

"With more complete assessment of frequency, we'll have better tools to develop prevention programs, optimize treatments, understand cost-effectiveness of care and predict outcomes for patients," says Dr. Brown.