TRENDS IN DEATH ASSOCIATED WITH TRAUMATIC BRAIN INJURY, 1979 THROUGH 1992 - SUCCESS AND FAILURE

Objective.-To report updated national trends in traumatic brain injury deaths from 1979 through 1992. Design.-Retrospective analysis of Multiple Cause-of-Death Public Use Data Tapes from the National Center for Health Statistics. All deaths associated with traumatic brain injury were identified, the underlying causes of death were categorized, and the annual rates were calculated per 100 000 US residents. Patients.-Residents of the United States who died with traumatic brain injury from 1979 through 1992. Results.-An average of 52 000 US residents die each year with traumatic brain injuries. The brain injury-associated death rate declined 22% from 24.6 per 100 000 US residents in 1979 to 19.3 per 100 000 US residents in 1992. Firearm-related rates increased 13% from 1984 through 1992, undermining a 25% decline in motor vehicle-related rates for the same period. Firearms surpassed motor vehicles as the largest single cause of death associated with traumatic brain injury in 1990. Conclusions.-These data highlight the success of efforts to prevent traumatic brain injury due to motor vehicles and failure to prevent such injuries due to firearms. The increasing importance of penetrating injury has important implications for research, treatment, and prevention of traumatic brain injury in the United States.