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CSTE Annual Conference ▪ June 14, 2011 Ericka Welsh, PhD Nebraska Injury Prevention and Control Program.

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Presentation on theme: "CSTE Annual Conference ▪ June 14, 2011 Ericka Welsh, PhD Nebraska Injury Prevention and Control Program."— Presentation transcript:

1 CSTE Annual Conference ▪ June 14, 2011 Ericka Welsh, PhD Nebraska Injury Prevention and Control Program

2  Traumatic brain injury (TBI) is caused by a bump, blow or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.  Each year, about 1.7 million Americans sustain a TBI; about 52,000 die as a result.  Currently, about 5.3 million Americans are living with a TBI-related disability, and 85,000 persons each year will sustain a TBI that results in a permanent disability.

3  Created to inform public health practitioners, policymakers, and the general public about the burden of TBI in Nebraska in order to design and implement effective preventive measures against TBI.

4  Describe the burden of TBI-related deaths, hospitalizations, and emergency department (ED) visits in Nebraska ◦ Frequencies and age-adjusted rates ◦ 5-year trends ◦ Age-specific rates ◦ Leading causes, by gender ◦ Median hospital charge and expected primary payer  Highlight current initiatives in Nebraska to prevent and control TBI

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6  Nebraska death certificates ◦ Provided by the NDHHS Office of Vital Statistics ◦ Multiple cause-of-death ◦ Classify injuries by external cause of death

7  Hospital discharge data (HDD) ◦ Data collected via 2004 Uniform Billing form (UB- 04) ◦ Provided by Nebraska acute care hospitals to the Nebraska Hospital Association (NHA) ◦ E-code data, a subset of HDD containing injury related records, is provided to the Nebraska DHHS by the NHA

8  TBI-related deaths and hospitalizations CDC State Injury Indicators: Instructions for Preparing 2005 Data (2007)

9 Deaths with ANY of the following International Classification of Diseases (ICD)-10 codes in ANY field of the multiple cause of death file:

10 Hospital discharges with ANY of the following ICD-9-CM diagnostic codes in ANY of the diagnostic fields of the injury hospital discharge (E-code) subset:

11  All results are based on deaths and hospital discharges of Nebraska residents. Nebraska residents who died or were treated at hospitals out of state are not included.  Frequencies and rates reflect numbers of discharge records, rather than numbers of patients discharged.  Five-year averages are used to provide more stable rates by reducing the effects of fluctuations from year to year.

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13 30,265 ED visits 4,750 hospitalizations 1,610 deaths ??? Other medical care ??? No medical care AA rate= 17.4 per 100,000 pop. AA rate=50.9 per 100,000 pop. AA rate=337 per 100,000 pop.

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18  Increasing trends similar for data  From 2000 to 2009: ◦ 115% increase for TBI-related ED visits ◦ 40% increase for TBI-related hospitalizations

19  From 2005 to 2008 :  ~12% increase for injury-related ED visits w/out TBI, but ~52% increase for injury-related ED visits w/ TBI  Greater relative increases among certain causes: MVT, falls, struck by/against, and not specified  Greatest relative increase within “unspecified head injury” category

20 Case definitions

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26 Among TBI-related deaths due to firearm injuries, 82% were suicide, 15% were homicide, and the remaining 3% were unintentional or undetermined intent.

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28 Percent of TBI-related ED visits that were sports-related: 3.5% among females, 11.5% among males.

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30  From 2004 to 2008, the median hospital charge for TBI-related hospitalizations was $17,152.

31  From 2004 to 2008, the median hospital charge for TBI-related ED visits was $1,664.

32  From : ◦ Rates for TBI-related death remained relatively stable, while TBI-related hospitalizations and ED visits increased.  Increased coding of “unspecified head injury” ◦ TBI-related death and hospitalization rates were highest among older adults; TBI-related ED visits were highest among infants, young children, adolescents, and older adults.

33  From : ◦ The leading causes of TBI-related deaths were motor vehicle crashes, falls, and firearms (esp. for males). ◦ The leading causes of TBI-related hospitalization and ED visits were falls, motor vehicle crashes, and stuck/by against injuries. ◦ For males, slightly more than 1 in 10 TBI-related ED visits are sports-related

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35  NE-BIA director is a member of the Injury Community Planning Group  DHHS working closely with NE-BIA to promote newly passed Nebraska Concussion Awareness Act

36  Signed into law April 14, 2011  Prohibits youth who suffer concussions in school- sponsored athletics and in programs run by cities, businesses and nonprofit groups from playing or practicing until cleared by a healthcare professional  Requires that coaches receive training on the warning signs of concussion  Workgroup formed to decide how to best promote to coaches and healthcare professionals

37  Motor vehicle crashes ◦ Distracted driving among teen drivers  Older adult falls ◦ Tai Chi: Moving for Better Balance

38  Data support ◦ Jennifer Marcum, DrPH ◦ Alan Xu ◦ Ming Qu, PhD  Program support ◦ Peg Ogea-Ginsburg ◦ Jason Kerkman, MPH  Data providers

39  Contact information: Ericka Welsh, PhD (402)  Website:


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