Sport Traumatic Brain Injury Prevention
Magnitude of the Problem
There are 12650 traumatic brain injuries (TBI) that require hospital treatment among Hawaii residents each year, with a generally increasing trend. However, this total includes nearly 8,300 TBI defined by diagnoses of “unspecified head injury”. If case definition is limited to more specific coding (e.g. concussion, intracranial hemorrhage, etc.) there are 4360 TBI each year, with a decreasing trend over the 2013 to 2017 period. About one-third (32%) of these more specifically-coded TBI result in hospital admission, compared to only 3% of patients with “unspecified head injury”. Residents 75 years and older have the highest rates of any type of TBI, followed by those under the age of 5, and 15 to 18 year-olds. Hospital disposition generally worsened across the age range, reaching 4% mortality among patients 75 years and older. About three-fourths (73%) of the patients are residents of Oahu; standardized rate estimates are significantly higher for Oahu residents than for any other county. Unintentional falls caused over half (57%) of all TBI, including 41% among senior-aged (65 years and older) residents. Other common causes were car/truck crashes, assaults, and motorcycle/moped crashes. Data from the Hawaii Trauma Registry describes significant associations between non-use of seat belts and helmets and incidence of TBI among patients injured in motor vehicle crashes. It is difficult to say how many of these TBI were sustained while engaged in sports, as only 28% of the hospital records contained codes on patient activities. Among this subset of records, 21% had activity codes to indicate sports, most commonly tackle football (6%), basketball (3%) and soccer (3%). Most (62%) of the TBI among 10 to 17-year-old patients with requisite activity codes were sports-related.
The EMSIPSB places a priority on having injury prevention strategies recommended by a community-driven action plan or informed by key implementing partners. Because a multitude of factors influence individual behavior, the strategies in the below table are framed across the individual, relationship, community, and policy levels.