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Long-Term Trends in the Epidemiology of Major Traumatic Brain Injury

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Abstract

Traumatic brain injury (TBI) is a leading cause of death and disability among adults. Falls and motor vehicle collisions (MVCs) are the most common causes of TBI hospitalizations in Canada. The purpose of this study was to determine whether, at the provincial level, there have been significant changes in the injury rate and causes of major TBI. This was a retrospective cohort study of all patients in Nova Scotia who presented with major TBI (Abbreviated Injury Scale Head score ≥ 3) between 2002 and 2018. Prospectively entered data were collected from the Nova Scotia Trauma Registry. Annual injury rates were calculated based on 100,000 population (all ages) using population estimates from Statistics Canada. Linear regression was performed to analyze annual trends of major TBI within the province. There were 5590 major TBI patients in Nova Scotia during the 16-year study period. The overall annual rate of major TBI was 37 per 100,000 population. There was a 39% increase in the rate of major TBI over the study period (r =  − 0.72, R2 = 0.51, p < 0.002). Patients had a mean age of 51 ± 25 years; 72% were male. The proportion of TBIs in males decreased significantly from 76% in 2002 to 69% in 2017 (p < 0.001). Mechanisms of injury were predominantly falls (45%) and MVCs (29%); the proportion of violent injuries was 11.5%. The rate of fall-related TBIs more than doubled between 2002 and 2017, increasing from 9.1 to 20.5 injuries per 100,000 (p < 0.001). Our findings demonstrate an increasing incidence of major TBI over a 16-year period with a greater than two-fold increase in the rate of fall-related TBI. These results are important for targeting TBI prevention efforts in reducing falls, especially in older adults.

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Availability of data and material

Data used in this research was made available by the Nova Scotia Department of Health and Wellness.

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Acknowledgements

We would like to acknowledge the support provided by Beth Sealy and Karen Ssebazza, Registry Coordinators of the NSTR. We also want to thank Jennifer Heatley for her support during the course of this study.

Funding

This project was funded by a grant from the Nova Scotia Department of Health and Wellness. Any opinions expressed by the authors do not necessarily reflect the opinion of the Nova Scotia Department of Health and Wellness or of Trauma Nova Scotia.

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Author notes

  1. Deceased—Ginette Thibault-Halman.

Authors and Affiliations

  1. Division of Neurosurgery, Dalhousie University, QEII Health Sciences Centre, Halifax, Canada

    Nelofar Kureshi, Ginette Thibault-Halman, Lynne Fenerty & David B. Clarke

  2. Trauma Nova Scotia, Nova Scotia Health, Halifax, Canada

    Mete Erdogan & Robert S. Green

  3. Departments of Critical Care Medicine and Emergency Medicine, Dalhousie University, Halifax, Canada

    Robert S. Green

  4. Brain Repair Centre, Dalhousie University, Halifax, Canada

    David B. Clarke

Authors
  1. Nelofar Kureshi
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  2. Mete Erdogan
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  3. Ginette Thibault-Halman
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  4. Lynne Fenerty
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  5. Robert S. Green
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  6. David B. Clarke
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Contributions

NK and ME participated in the study design, data collection, data analysis, interpretation, writing, and critical revision. GTH participated in the study design, data collection, data analysis. LF participated in the study design, data collection, writing, and critical revision. DBC and RSG participated in the study design, interpretation, and critical revision.

Corresponding author

Correspondence to David B. Clarke.

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Conflict of interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical Approval

This study was approved by the Nova Scotia Health Research Ethics Board.

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Kureshi, N., Erdogan, M., Thibault-Halman, G. et al. Long-Term Trends in the Epidemiology of Major Traumatic Brain Injury. J Community Health 46, 1197–1203 (2021). https://doi.org/10.1007/s10900-021-01005-z

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  • DOI: https://doi.org/10.1007/s10900-021-01005-z

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