The Epidemiology of Hospitalized Head Injury in British Columbia, Canada

Phillips, Leah; Voaklander, Don; Drul, Colleen; Kelly, Karen D. · 2009 · OpenAlex-citations

DOI: 10.1017/s0317167100008118

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Summary

This descriptive epidemiological study investigates the incidence, demographics, and health care utilization associated with hospitalized head injuries in British Columbia, Canada, over a ten-year period (1991/92–2000/01). Motivated by significant discrepancies in traumatic brain injury (TBI) incidence estimates globally and a lack of comprehensive Canadian data, the research aims to provide standardized incidence rates to facilitate comparisons with other provinces and inform public health policy. The study utilizes administrative data from the Canadian Institute of Health Information (CIHI) and the BC Health Insurance Registration File, covering 48,753 hospital admissions. Cases were defined using ICD-9 codes consistent with CDC and CIHI standards, with age-standardized rates calculated using the 2001 Canadian population as the reference. The analysis reveals that males comprised 68.7% of the cohort, with a risk ratio of 2.21 compared to females. The highest incidence occurred in the 1991/92 fiscal year (174.18 per 100,000), while the lowest raw number of admissions was recorded in 2000/01. Intracranial injuries were the most common diagnosis (52.4%), followed by fractured facial bones (32.0%) and fractured skulls (10.4%). Falls accounted for 31.1% of injuries, followed by motor vehicle traffic (26.1%) and intentional interpersonal violence (17.8%). Notably, admissions for concussion dropped significantly over the decade, potentially reflecting changes in coding practices rather than true incidence. Socioeconomic analysis indicated that individuals in the lowest socioeconomic quintile had the highest proportion of admissions (23.1%). Health care utilization metrics showed a mean hospital length of stay of 7.4 days, with 10% of patients requiring intensive care unit (ICU) admission, averaging 4.4 days in the ICU. Length of stay varied significantly by diagnosis and cause; fractured skulls had the longest mean stay (14.2 days), while motor vehicle traffic incidents resulted in the longest mean stay among external causes (12.2 days). The study concludes that while overall incidence appears to be decreasing, specific at-risk groups, particularly young men with lower socioeconomic status, warrant targeted attention. The findings provide a baseline for inter-provincial comparisons and highlight the need for policy discussions regarding resource allocation and prevention strategies for traumatic brain injuries.

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• incidence prevalence