Elsevier

Annals of Epidemiology

Volume 7, Issue 3, April 1997, Pages 207-212
Annals of Epidemiology

Original report
Urban and rural traumatic brain injuries in Colorado

https://doi.org/10.1016/S1047-2797(96)00150-0Get rights and content

Abstract

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.

References (27)

  • JF Annegers et al.

    The incidence, causes, and secular trends of head trauma in Olmsted County, Minnesota, 1935–1974

    Neurology

    (1980)
  • KD Cooper et al.

    The epidemiology of head injury in the Bronx

    Neuroepidemiology

    (1983)
  • D Fife

    Head injury with and without hospital admission: comparisons of incidence and short-term disability

    Am J Public Health

    (1987)
  • D Fife et al.

    Incidence and outcome of hospital-treated head injury in Rhode Island

    Am J Public Health

    (1986)
  • TA Gennarielli et al.

    Comparison of mortality, morbidity, and severity of 59,713 head-injured patients with 114,447 patients with extracranial injuries

    J Trauma

    (1994)
  • J Jagger et al.

    Epidemiologic features of head injury in a predominantly rural population

    J Trauma

    (1984)
  • B Jennet et al.

    Epidemiology of head injury

    Br Med J

    (1981)
  • WD Kalsbeek et al.

    The national head and spinal cord survey. Major findings

    J Neurosurg

    (1980)
  • MR Klauber et al.

    The epidemiology of head injury: A prospective study of an entire community—San Diego County, California, 1978

    Am J Epidemiol

    (1981)
  • JF Kraus et al.

    The incidence of acute brain injury and serious impairment in a defined population

    Am J Epidemiol

    (1984)
  • EJ MacKenzie et al.

    Trends in hospitalized discharge rates for head injury in Maryland, 1979–1986

    Am J Public Health

    (1990)
  • L Tiret et al.

    The epidemiology of head trauma in Aquitaine (France), 1986: A community-based study of hospital admissions and deaths

    Int J Epidemiol

    (1990)
  • A Woodward et al.

    Head injuries in country and city: A study of hospital separations in South Australia

    Med J Australia

    (1984)
  • Cited by (78)

    • Geographical risk of fatal and non-fatal injuries among adults in Norway

      2021, Injury
      Citation Excerpt :

      The country covers 13 degrees northern latitude from south to north. Previous studies have shown associations between trauma outcomes and geographic location [3–10], and several groups have found higher mortality rates in rural compared to urban areas in Norway [11–13]. Kristiansen et al. reported a 33% higher trauma-related mortality rate in rural areas of Norway.

    • The relationship between geographic location and outcomes following injury: A scoping review

      2019, Injury
      Citation Excerpt :

      Of all studies reporting mortality outcomes (n = 35), ten did not adjust for any potential confounding factors [13,15,32,33,41,43–47]. A number of papers adjusted for age (n = 8) [11,12,17,39,48–51]; age and gender (n = 5) [9,14,18,52,53]; and age, gender and injury severity (n = 3) [40,54,55]. One study adjusted for age and injury severity [56].

    • The Rotterdam Scoring System Can Be Used as an Independent Factor for Predicting Traumatic Brain Injury Outcomes

      2016, World Neurosurgery
      Citation Excerpt :

      Traumatic brain injury (TBI) is among the leading causes of death in the United States.1

    • The prehospital management of traumatic brain injury

      2015, Handbook of Clinical Neurology
    View all citing articles on Scopus

    This study was funded in part by a Disability Prevention Cooperative Agreement no. U59/CCU803364 from the Centers for Disease Control and Prevention. The contents of this report do not necessarily reflect the views of the Centers for Disease Control and Prevention.

    View full text