The epidemiology of severe traumatic brain injury among persons 65 years of age and older in Oklahoma, 1992-2003

Primary objective: To describe the epidemiology of traumatic brain injury ( TBI) among persons 65 years of age and older in Oklahoma from 1992 - 2003. Research design: Descriptive epidemiology of data collected through active statewide surveillance on TBI inpatient hospitalizations and fatalities. Methods and procedures: Data collected from hospital medical records and the Office of the Chief Medical Examiner. TBI was defined by ICD- 9- CM codes for skull fracture 800.0 - 801.9, 803.0 - 804.9, concussion or other intracranial injury 850.0 - 854.1 and head injury, unspecified 959.01; all cases included a description of TBI. Main outcome and results: TBI rates increased 79% for the study population; however, case- fatality rates decreased from 32% in 1992 to 18% in 2003. The TBI rate increase was observed among all elderly age groups, both genders and all races. Unintentional injuries nearly doubled while both assault and self- inflicted injuries decreased. Fall- related TBI increased by 126%, while MVC- related TBI increased by 17%. Survivors were hospitalized for an average of 6.8 days and over half required post- acute care. Conclusions: The increased TBI rate and decreased case- fatality rate among elderly persons means potentially more persons living with TBI disability. TBI prevention efforts among the elderly must be expanded, especially for fall- related TBI.