Purpose: The purpose of this study was to compare and contrast the epidemiology of traumatic brain injury among urban and rural residents of Colorado.
Methods: Cases of traumatic brain injury (ICD 800, 801, 803, 804, 850-854) for 1991 and 1992 from the Colorado surveillance system of hospitalized and fatal traumatic brain injuries were used. Urban cases resided in counties designated by the U.S. Census Bureau as metropolitan statistical areas (MSA). Rural cases were divided into two groups: "rural, nonremote," if the country of residence was adjacent to an MSA county or if it had a population of 2500, and "rural, remote," if not.
Results: Average annual age-adjusted rates of hospitalized and fatal traumatic brain injury varied significantly from 97.8 per 100,000 population for the most urban group to 172.1 per 100,000 population for the residents of rural, remote counties. Similarly, total mortality ranged from 18.1 per 100,000 population among residents of the most urban counties to 33.8 among residents of rural, remote counties. Prehospital mortality ranged from 10.0 to 27.7 traumatic brain injuries per 100,000 population.
Conclusions: These results provide justification for expanding efforts to prevent traumatic brain injury to include the small, but high-risk group of residents in rural areas.