The analysis highlights the high rates of death from TBI among the elderly and men

A new analysis of US mortality data reveals the disproportionate impact of traumatic brain injuries (TBI) on older adults, men and certain racial and ethnic groups.

The study, published in the peer-reviewed journal Brain injuryprovides a comprehensive analysis of TBI-related deaths in different population groups in the US in 2021.

The findings show that suicides remain the most common cause of TBI-related deaths, followed by unintentional falls, and specific groups are disproportionately affected by these tragedies.

Men, in particular, were found to be more likely to die from TBI – more than three times the rate of women (30.5 vs. 9.4). The reasons observed were multifactorial and could reflect differences in injury severity after a fall or road traffic accident, the interaction of gender and age – with TBI outcomes in men worsening with age, while postmenopausal women fare better than men of a similar age.

While anyone is at risk of getting a TBI, some groups are more likely than others to die from one. We identified specific populations that are most affected. In addition to men, older adults are particularly at risk, with unintentional falls being the leading cause of TBI-related death. American Indians or Alaska Natives also have higher rates of these fatal injuries.”

Alexis Peterson PhD, lead author of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention

“These findings highlight the importance of tailored prevention strategies to reach groups that may be at higher risk and the role health care providers can play in reducing TBI-related deaths through early intervention and culturally sensitive care.” .

TBI remains the leading cause of injury-related deaths in the US In 2020, TBIs were associated with about a quarter of all injury-related deaths. These injuries can result from a bump, blow, or jolt to the head that disrupts normal brain function, whether unintentional (such as car accidents or accidental falls), self-inflicted harm, or associated with an assault.

Using data from the National Vital Statistics System, the new analysis found 69,473 TBI-related deaths among US residents in 2021 — an average of 190 deaths per day. The age-adjusted TBI mortality rate was 19.5 per 100,000, representing an 8.8% increase from 2020.

Through statistical modeling, the researchers examined the simultaneous effect of multiple factors, such as geographic region, gender, race and ethnicity, and age, on TBI-related mortality.

Key findings include:

• The elderly (75+) had the highest rates of TBI-related deaths, with unintentional falls being the most common cause in this age group.
• Non-Hispanic American Indians/Alaskan Natives experienced the highest rate of TBI-related mortality (31.5) compared to other racial and ethnic groups.
• There were 37,635 TBI-related deaths categorized as unintentional injuries (ie, motor vehicle accidents, unintentional falls, unintentional strikes from or against an object, other).
• 30,801 were categorized as intentional injuries (ie all suicide and homicide mechanisms).
• Children aged birth to 17 years accounted for approximately 4% of TBI-related deaths (2,977).

The authors emphasize the critical role of health care providers in preventing TBI-related deaths, particularly with higher-risk groups. “By assessing patients who may be at higher risk for TBI, especially due to falls or mental health challenges, healthcare providers can make early referrals and recommend culturally tailored interventions to prevent further injury or death,” says Dr Peterson.

Public health efforts should focus on addressing the underlying causes of TBI-related deaths, such as unintentional falls and mental health crises, to help prevent further loss of life. “TBIs remain a major public health concern, especially among the elderly, men, and certain racial and ethnic groups,” says Peterson. “CDC has proven resources that health care providers can use to not only reduce health disparities that increase risk for TBI, but also improve care for anyone affected by TBI.”

The authors note that the COVID-19 pandemic could have influenced TBI-related death trends in 2021. They also acknowledge several limitations of this analysis, including potential misclassification or underdocumentation of causes on death certificates, which may lead to inaccuracies in the estimation of TBI deaths.