Division of Injury Response, National Center for Injury Prevention and Control, CDC, Atlanta, Georgia 30341, USA.
MMWR Surveill Summ. 2011 May 6;60(5):1-32.
PROBLEM/CONDITION: Traumatic brain injury (TBI) is a leading cause of death and disability in the United States. Approximately 53,000 persons die from TBI-related injuries annually. During 1989-1998, TBI-related death rates decreased 11.4%, from 21.9 to 19.4 per 100,000 population. This report describes the epidemiology and annual rates of TBI-related deaths during 1997-2007.
January 1, 1997-December 31, 2007.
Data were analyzed from the CDC multiple-cause-of-death public-use data files, which contain death certificate data from all 50 states and the District of Columbia.
During 1997-2007, an annual average of 53,014 deaths (18.4 per 100,000 population; range: 17.8-19.3) among U.S. residents were associated with TBIs. During this period, death rates decreased 8.2%, from 19.3 to 17.8 per 100,000 population (p = 0.001). TBI-related death rates decreased significantly among persons aged 0-44 years and increased significantly among those aged ≥75 years. The rate of TBI deaths was three times higher among males (28.8 per 100,000 population) than among females (9.1). Among males, rates were highest among non-Hispanic American Indian/Alaska Natives (41.3 per 100,000 population) and lowest among Hispanics (22.7). Firearm- (34.8%), motor-vehicle- (31.4%), and fall-related TBIs (16.7%) were the leading causes of TBI-related death. Firearm-related death rates were highest among persons aged 15-34 years (8.5 per 100,000 population) and ≥75 years (10.5). Motor vehicle-related death rates were highest among those aged 15-24 years (11.9 per 100,000 population). Fall-related death rates were highest among adults aged ≥75 years (29.8 per 100,000 population). Overall, the rates for all causes except falls decreased.
Although the overall rate of TBI-related deaths decreased during 1997-2007, TBI remains a public health problem; approximately 580,000 persons died with TBI-related diagnoses during this reporting period in the United States. Rates of TBI-related deaths were higher among young and older adults and certain minority populations. The leading external causes of this condition were incidents related to firearms, motor vehicle traffic, and falls.
Accurate, timely, and comprehensive surveillance data are necessary to better understand and prevent TBI-related deaths in the United States. CDC multiple-cause-of-death public-use data files can be used to monitor the incidence of TBI-related deaths and assist public health practitioners and partners in the development, implementation, and evaluation of programs and policies to reduce and prevent TBI-related deaths in the United States. Rates of TBI-related deaths are higher in certain population groups and are primarily related to specific external causes. Better enforcement of existing seat belt laws, implementation and increased coverage of more stringent helmet laws, and the implementation of existing evidence-based fall-related prevention interventions are examples of interventions that can reduce the incidence of TBI in the United States.
问题/状况：创伤性脑损伤（TBI）是美国导致死亡和残疾的主要原因。每年约有 5.3 万人死于与 TBI 相关的伤害。在 1989-1998 年期间，TBI 相关死亡率下降了 11.4%，从每 10 万人 21.9 例降至 19.4 例。本报告描述了 1997-2007 年期间与 TBI 相关的死亡的流行病学和年发生率。
1997 年 1 月 1 日-2007 年 12 月 31 日。
数据来自 CDC 多原因死亡公共使用数据文件，其中包含来自所有 50 个州和哥伦比亚特区的死亡证明数据。
在 1997-2007 年期间，美国居民中每年有 53,014 人（每 10 万人中有 18.4 人，范围为 17.8-19.3）与 TBI 相关的死亡。在此期间，死亡率下降了 8.2%，从每 100,000 人 19.3 例降至 17.8 例（p = 0.001）。0-44 岁人群和≥75 岁人群的 TBI 相关死亡率显著下降。男性（每 100,000 人中有 28.8 人）的 TBI 死亡率是女性（每 100,000 人中有 9.1 人）的三倍。在男性中，死亡率最高的是非西班牙裔美洲印第安人/阿拉斯加原住民（每 100,000 人中有 41.3 人），最低的是西班牙裔（每 100,000 人中有 22.7 人）。与枪支（34.8%）、机动车（31.4%）和跌倒相关的 TBI 是 TBI 相关死亡的主要原因。与枪支有关的死亡率在 15-34 岁（每 100,000 人中有 8.5 人）和≥75 岁（每 100,000 人中有 10.5 人）人群中最高。与机动车相关的死亡率在 15-24 岁人群中（每 100,000 人中有 11.9 人）最高。与跌倒相关的死亡率在≥75 岁的成年人中（每 100,000 人中有 29.8 人）最高。总体而言，除跌倒外，所有原因的死亡率都有所下降。
尽管 1997-2007 年期间 TBI 相关死亡的总体率有所下降，但 TBI 仍然是一个公共卫生问题；在美国，本报告期间约有 58 万人死于与 TBI 相关的诊断。TBI 相关死亡的发生率在年轻和老年成年人以及某些少数族裔人群中较高。这种情况的主要外部原因是与枪支、机动车交通和跌倒有关的事件。
准确、及时和全面的监测数据对于更好地了解和预防美国的 TBI 相关死亡至关重要。CDC 多原因死亡公共使用数据文件可用于监测 TBI 相关死亡的发生率，并帮助公共卫生从业人员和合作伙伴制定、实施和评估减少和预防美国 TBI 相关死亡的计划和政策。TBI 相关死亡的发生率在某些人群中较高，主要与特定的外部原因有关。更好地执行现有的安全带法，实施和增加更严格的头盔法的覆盖范围，以及实施现有的基于证据的跌倒预防干预措施，是可以减少美国 TBI 发生率的干预措施的例子。
