Langlois Jean A, Kegler Scott R, Butler Jacqui A, Gotsch Karen E, Johnson Renee L, Reichard Audrey A, Webb Kevin W, Coronado Victor G, Selassie Anbesaw W, Thurman David J
National Center for Injury Prevention and Control, CDC, USA.
MMWR Surveill Summ. 2003 Jun 27;52(4):1-20.
PROBLEM/CONDITION: Previous studies indicate that each year in the United States, approximately 1.5 million Americans sustain a traumatic brain injury (TBI). Of those injured, approximately one quarter million are hospitalized. Approximately one third of adults hospitalized with TBI still need help with daily activities 1 year after their discharge.
This report summarizes surveillance data for TBI in the United States for January-December 1997.
Data are from 14 states that participated in an ongoing CDC-funded TBI surveillance system. State health departments used CDC guidelines to identify TBI cases from hospital discharge data or from other statewide injury data systems. Supplementary information was abstracted from medical records.
The overall age-adjusted TBI-related live hospital discharge rate was 69.7/100,000 population. Rates were highest for American Indians and Alaska Natives (75.3/100,000) and Blacks (74.4/100,000). The age-adjusted rate for males was approximately twice as high as for females (91.9 versus 47.7/100,000 respectively). For both sexes, the rates were highest among those aged 15-19 years and >/= 65 years. Motor-vehicle crashes, falls, and assaults were the leading causes of injury for TBI-related discharges (27.9, 22.5, and 7.3/100,000 respectively). TBI-related discharge rates for falls were highest among those aged >/= 65 years (82.3/100,000). Black males and American Indian/Alaska Native males had the highest rates of TBI attributable to assault (31.3 and 29.5 per 100,000, respectively), approximately 4 times the rate for white males. An estimated 46% of injured motor-vehicle occupants, 53% of motorcyclists, and 41% of pedal cyclists reportedly were not using personal protective equipment (PPE) (e.g., seat belts or helmets) at the time of their TBI. With regard to outcome assessed before discharge from the hospital, approximately 17% of persons hospitalized with TBI had moderate to severe disability.
Data in this report, the most extensive to date from a multistate population-based TBI surveillance system, indicate the importance of TBI as a public health problem. Population-based information regarding TBI hospitalizations can be useful in assessing the effect of prevention efforts and planning for the service needs of persons with TBI.
问题/状况：以往研究表明，在美国，每年约有150万美国人遭受创伤性脑损伤（TBI）。在这些伤者中，约有25万人住院治疗。在因TBI住院的成年人中，约三分之一在出院1年后仍需要日常生活方面的帮助。
本报告总结了1997年1月至12月美国TBI的监测数据。
数据来自参与疾病控制与预防中心（CDC）资助的持续TBI监测系统的14个州。州卫生部门使用CDC指南，从医院出院数据或其他全州范围的伤害数据系统中识别TBI病例。补充信息从医疗记录中提取。
经年龄调整后的与TBI相关的住院患者实际出院率为每10万人69.7例。美国印第安人和阿拉斯加原住民（每10万人75.3例）以及黑人（每10万人74.4例）的比率最高。经年龄调整后的男性比率约为女性的两倍（分别为每10万人91.9例和47.7例）。对于男女两性，15 - 19岁和≥65岁人群中的比率最高。机动车碰撞、跌倒和袭击是与TBI相关出院病例的主要致伤原因（分别为每10万人27.9例、22.5例和7.3例）。≥65岁人群中因跌倒导致的与TBI相关的出院率最高（每10万人82.3例）。黑人男性和美国印第安/阿拉斯加原住民男性因袭击导致的TBI比率最高（分别为每10万人31.3例和29.5例），约为白人男性比率的4倍。据报告，在发生TBI时，估计46%的机动车驾乘人员、53%的摩托车手和41%的骑自行车者未使用个人防护装备（PPE）（如安全带或头盔）。关于出院前评估的结果，约17%因TBI住院的人有中度至重度残疾。
本报告中的数据是来自多州基于人群的TBI监测系统的迄今最广泛的数据，表明TBI作为一个公共卫生问题的重要性。关于TBI住院情况的基于人群的信息有助于评估预防措施的效果以及规划TBI患者的服务需求。
