The 1995 crude mortality rate of physician diagnosed traumatic brain injury (TBI) in New Mexico is estimated to be 21 deaths per 100,000 population and the crude incidence of both hospitalized and fatal TBI is 110 cases per 100,000 population (1,856 TBI cases). This is elevated above a 1992 published figure for the national TBI fatality rate of 19 deaths per 100,000 population, and below at least one study reporting 180 medically confirmed cases of TBI per 100,000 population. The New Mexico rates are felt to be low because none of the available data sets contained complete coverage of the entire New Mexico population and some data coding practices preclude complete case ascertainment. Statewide hospital emergency department and emergency medical services data were not adequately developed for inclusion in these 1995 analyses. Economic analyses of both fatal and non-fatal TBI in New Mexico were conducted. Using a conservative human capital approach, the mortality costs of TBI in New Mexico during 1995, were approximately $162 million, and the morbidity costs were approximately $128 million. Half (49%) of these costs, $142 million, resulted from motor vehicle crashes. Traumatic brain injuries frequently occur in younger populations and represent a large cost for New Mexicans. Given the high costs and disability associated with TBI, promotion of prevention programs should include a cost comparison. The leading causes of hospitalized and fatal TBI in New Mexico were motor vehicle traffic crashes 791 (43%); non-traffic transportation, 85 (51%); falls, 240 (13%); hitting and striking, 141 (8%); and, firearms, 66 (4%). Occurrence of traumatic brain injury resulting from motor vehicle crashes was significantly associated with non-use of safety belts and being in a crash severe enough to require towing. TBI is twice as likely in towaway crashes. Overall, occupants in motor vehicle crashes were 12.4 times more likely to sustain a serious or fatal TBI if they were not using a safety belt. Safety belt effectiveness in terms of TBI or for the reduction of TBI was not associated with seating position in the vehicle, gender or age of the vehicle occupant. (A)
Samenvatting