Everyone, at any age, is at risk of suffering a head injury. In France, more than 150,000 people are victims each year. The causes are multiple: road accident, fall, assault, etc. In the United States, brain injury from impact remains a leading cause of injury-related death. American researchers examined mortality linked to these traumatic injuries. They found that certain population groups were at much greater risk of succumbing to this type of injury.
Traumatic brain injuries remain a leading cause of injury-related death in the United States. In 2020, they were responsible for about a quarter of them. Researchers from National Center for Injury Prevention and Control (National Center for Injury Prevention and Control) set out to examine the simultaneous effect of multiple factors (geographic region, sex, race, ethnicity, and age) on mortality from traumatic brain injury (TBI). They found that some people were at greater risk of death than others.
A clear disparity between men and women
Their study, published in the journal Brain Injuryprovides a comprehensive analysis of TBI-related deaths in different population groups in the United States in 2021. That year, 69,473 deaths related to head injuries were recorded – an average of 190 deaths per day. The age-adjusted TBI-related mortality rate was 19.5 per 100,000. This represents an increase of 8.8% compared to 2020.
Among the TBI-related deaths recorded, 37,635 were classified as unintentional injuries. These included motor vehicle accidents, unintentional falls, unintentional collisions with or against an object, etc. In addition, 30,801 deaths were classified as intentional injuries (suicides and homicides).
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Using multivariable mortality modeling, researchers examined the effect of several factors such as geographic region, gender, race and ethnicity, and age. “ While everyone is susceptible to head injury, some groups have more risks than others to die of head trauma. We have identified specific populations that are most affected said Alexis Peterson, first author of the study.
It appears that men are much more likely to die from head trauma than women (30.5% versus 9.4%). The reasons for this gap between the two sexes are multifactorial. According to the study authors, they could reflect differences in the severity of injuries after the incident.
The interaction of gender and age also plays a role. It turns out, in fact, that the results of head injuries in men worsen with age. Generally, women of the same age and in the same circumstances fare better.
Seniors and young children among those most at risk
Data analysis also revealed that people aged 75 and older had the highest rates of TBI-related deaths. Not surprisingly, accidental falls were the most common cause in this age group. In the United States, this group represents approximately 32% of hospitalizations and 28% of deaths linked to head injuries, specifies the CDC.
Non-Hispanic American Indians and Alaska Native people had the highest TBI-related death rate (31.5%) of all racial and ethnic groups. “ These findings highlight the importance of tailored prevention strategies to reach high-risk groups and the role health care providers can play in reducing head injury-related deaths through early intervention and culturally appropriate care. “, emphasizes Peterson.
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Children aged 17 and under represented a smaller, but still significant, proportion (4%) of TBI-related deaths recorded in 2021. Among those under 5, accidental falls are a common cause of head injuries. Added to this is shaken baby syndrome, an abuse of which several hundred children are victims each year in France. One in ten babies dies; the others suffer from serious neurological after-effects.
A Public Health France report published in 2016 specified that very young children were most at risk of developing cognitive or behavioral disorders following head trauma, whatever the cause.
Finally, note that a large proportion (nearly 45%) of TBI-related deaths in 2021 in the United States resulted from unintentional falls and suicides. This essentially means that with appropriate prevention strategies (protective equipment, muscle strengthening for seniors, psychological support, etc.), these tragedies could be avoided.
Preventive interventions adapted to each person
Depending on its severity, head trauma can cause headaches, nausea and vomiting, but also various neurological damage. Some patients experience loss of sensitivity, motor problems, aphasia, drowsiness or visual disturbances. In some cases, rehabilitation is necessary to restore motor and cognitive functions.
This American study shows that head injuries disproportionately affect certain specific groups, who are more likely to die from them. These injuries are a significant public health problem among older adults, men, and certain racial and ethnic groups. The researchers emphasize the essential role of health professionals, who should pay the greatest attention to these high-risk groups.
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To reduce mortality from head injuries, it is clear that prevention efforts must focus on the main underlying causes, namely accidental falls and mental health problems.
“ By assessing patients who may be at higher risk of LCTespecially due to falls or mental health issues, health care providers can refer patients in a timely manner and recommend culturally appropriate interventions to prevent further injury or death », Explains the specialist.
However, she and her co-authors recognize that their analysis has several limitations. In particular, they highlight that the COVID-19 pandemic may have influenced trends in TBI-related deaths in 2021. In addition, potential misclassification or incomplete documentation of causes on death certificates could have led to inaccuracies in the estimate. of the number of deaths linked to head trauma.
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