The number of traumatic brain injury (TBI)-related deaths in the US increased 22% between 2010 and 2020, with the largest rise in individuals aged 75 and older, a new study shows.
The cohort study, published online December 4 in JAMA Neurology, involved an analysis of all TBI-related deaths in the US from 1999 through 2020 from the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research platform.
Overall, the rate of TBI-related mortality remained relatively flat during the study period, increasing slightly but not significantly from 18.64 per 100,000 people in 1999 to 19.34 per 100,000 in 2020.
But the mortality rate over the last half of the study increased significantly (average annual percentage change [AAPC], 1.22; 95% CI, 0.82-1.63).
"Although the overall TBI-related mortality in the US was stable over the 22-year study period, this trend obscures a gradual increase in TBI-related mortality over the past decade," write investigators led by Andrea L. C. Schneider, MD, PhD, University of Pennsylvania, Philadelphia.
Mortality rates were consistently higher in males but were stable over time within each sex.
By race and ethnicity, TBI-related mortality rates declined over time among Asian and Pacific Islander and Hispanic individuals, were stable among Black individuals, and increased among White individuals.
Among American Indian and Alaska Native individuals, TBI-related mortality rates decreased in 1999-2018 (AAPC, -1.69; 95% CI, -2.38 to -0.99), although there was a substantial increase in 2018-2020 (AAPC, 31.03; 95% CI, 5.59-62.60). However, investigators noted that their estimates were less precise among these smaller subgroups.
Investigators also found sharp changes when examining TBI-related mortality date by age group. Deaths among people aged 25 and younger dropped 92% (AAPC, -1.92; P < .001), while mortality rose by 97% in people aged 75 and older (AAPC, 1.97; P < .001).
"This group also had the highest absolute rates of TBI-related mortality, suggesting that this may be a high-risk group for targeting prevention measures," the authors write. "Approximately 30% to 40% of TBIs occurring among older individuals are attributable to falls, which are a leading cause of mortality among this population."
The study follows earlier work by the same investigators, who reported in January that sustaining even a single head injury is linked to a significant increase in mortality risk.
The study was funded by the National Institute of Neurological Disorders and Stroke. No disclosures were reported.
Kelli Whitlock Burton is a reporter for Medscape Medical News covering neurology and psychiatry.
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