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Traumatic Brain Injury Cases Likely Under-Reported

Illustration of brain (NIDA)

(National Institute of Drug Abuse)

A study by researchers at the Mayo Clinic in Rochester, Minnesota suggests that the number of cases of traumatic brain injury (TBI) is greater than current estimates offered by the Centers for Disease Control and Prevention. The team’s findings appeared late last year in the journal Epidemiology (paid subscription required).

The investigators used a new, more comprehensive method for classifying head injuries called the Mayo Traumatic Brain Injury Classification System. This scheme provides a way of incorporating symptoms such as a brief period of unconsciousness or an injured patient’s complaint of dizziness or nausea. The tool then allows for classifying the patients into “definite/probable/possible/no” groupings for TBI.

The research also took advantage of a compilation of medical records in nearby Olmstead County, Minnesota called the Rochester Epidemiology Project. This initiative aggregates medical records in the county going back several decades, and offers researchers a population-based database to gauge the occurrence of diseases or conditions in the community. The researchers took a 16 percent random sample of records from this database for the years 1987-2000 for their inquiry.

The Mayo team determined from the sample that TBIs occur in as many as 558 per 100,000 people. The researchers note that the Centers for Disease Control and Prevention uses methods that estimate the occurrence of TBI at 341 per 100,000 people.  The findings indicate that 60 percent of injuries fell outside the standard categorization used by the CDC, even though two-thirds (66%) of the cases reported symptoms, such as dizziness or nausea. The results also show the elderly and the young were most at risk for TBI, respectively, and men were more at risk than women.

“With more complete assessment of frequency, says Allen Brown Mayo Clinic’s director of brain rehabilitation research, “we’ll have better tools to develop prevention programs, optimize treatments, understand cost-effectiveness of care, and predict outcomes for patients.”

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