Trends in hospitalization associated with traumatic brain injury in a publicly insured population, 1992-2002

J Trauma. 2009 Jan;66(1):179-83. doi: 10.1097/TA.0b013e3181715d66.


Background: Traumatic brain injury (TBI) is a leading cause of death and disability in developed countries. We document trends in TBI-related hospitalizations in Ontario, Canada, between April 1992 and March 2002, focusing on relationships between inpatient hospitalization rates, age, sex, cause of injury, severity level, and in-hospital mortality.

Methods: Information on all acute hospital separations in Ontario with a diagnosis of TBI was analyzed using logistic regression.

Results: Hospitalization rates fell steeply among children and young adults but remained stable among adults aged 66 and older. The proportion of TBI hospitalizations with mild injuries decreased from 75% to 54%, whereas the proportion with moderate injuries increased from 19% to 37%. Adjusting for other risk factors, in-hospital deaths were higher for injuries because of motor vehicle crashes than those because of falls. In-hospital death rates were stable for patients with moderate or severe injuries, but increased over time among those whose injuries were classified as mild, suggesting a trend toward more serious injury within the "mild" classification.

Conclusions: Hospitalizations for TBI involve fewer mild injuries over time and are highest in the oldest segment of the population.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Injuries / economics
  • Brain Injuries / epidemiology*
  • Brain Injuries / mortality
  • Cause of Death
  • Child
  • Child, Preschool
  • Female
  • Hospital Mortality
  • Hospitalization / trends*
  • Humans
  • Infant
  • Infant, Newborn
  • Injury Severity Score
  • Logistic Models
  • Male
  • Middle Aged
  • Ontario / epidemiology
  • Registries
  • Risk Factors