Repairing-Shattered-Lives_Report

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Repairing-Shattered-Lives_Report

12

Part One:

Brain systems and development

Repairing Shattered Lives © Barrow Cadbury Trust

Prevalence

TBI is the most prevalent form of brain injury [24]. In a general (‘community’)

population, the number of people that are estimated to have suffered a TBI of

some form (from mild to severe) is approximately 8.5% [30]. In males, a range

of 5 – 24% of prevalence for TBI of all severities has been given across studies [31].

The yearly incidence of TBI ranges from 180–250 per 100,000 people in the

US [25] to 91 – 419 per 100,000 people (variation is across health authorities)

in England [26] A study conducted by Exeter University showed that the

incidence was 430 per 100,000, with 40 per 100,000 categorized as

moderate to severe injuries (see Table 2 for definitions of severity and

Figure 4 for age trends of attendence to an emergency department) [27].

In general terms, then, this suggests that around 80-90% of all TBIs are mild

[28]. The global effect of TBIs as a disease, with various degrees of severity,

and therefore burden, is thought to be greatly underestimated and to be likely

to increase substantially in the future [29].

Figure 4: Rates of moderate to severe head injury per 100,000 of the population,

by 5 year range, gender and area of residence, UK.

Rate per 100,000 popn

200

180

160

140

120

100

80

60

40

20

0

0-4

5-9

10-14

15-19

20-24

© original figures: An epidemiological study of head injuries in a UK population attending an emergency

department. P J Yates, W H Williams, A Harris, A Round, R Jenkins. J Neurol Neurosurg Psychiatry 2006;

77:699–701. doi: 10.1136/jnnp.2005.081901

Causes and risk factors

The main causes of TBI include road accidents, falls, sporting injury, and

assaults. Age is a major risk factor for injury, with the very young being most

at risk, particularly from falls. Adolescents and younger adults are then the

most at risk group, from road accidents, assaults etc. In the very young both

genders are at equal risk, but in teenage years and throughout most of adult

life, males are much more at risk than females [27]. Other factors that can

substantially increase risk include:

Being from a deprived socio-economic group;

Geographical location, with urban dwelling youth being more at

risk [27]; and

Use of alcohol and or other drugs, particularly in adolescence and

young adulthood [32].

Severity of injury

25-29

30-34

35-39

40-44

45-49

The severity of a TBI can be classified from ‘mild’ through to ‘severe’,

although any TBI may be sufficient for actual changes in brain integrity and

function. In essence, the level of severity indicates the level of impact that an

injury will have on an individual’s functioning. A very mild injury – typically

referred to as a ‘concussion’ (where there may be some disorientation or

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

Urban Male

Urban Female

Mixed Rural Male

Mixed Rural Female

Age Group

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