Hospitalizations due to traumatic head injuries down 35% over a decade

New data released today by the Canadian Institute for Health Information (CIHI) show that fewer Canadians are admitted to hospitals due to traumatic head injuries than were a decade ago. In 2003-2004, 16,811 were admitted to hospitals compared to 25,665 in 1994-1995, a 35% decrease.

In the 10 years of the analysis, the largest difference was seen among children and youth (from birth to 19 years of age), where traumatic head injury admissions fell 53%-from 10,589 hospital admissions in 1994-1995 to 4,966 in 2003-2004. At the same time, deaths as a result of head injury in this age group decreased by 34%. The Canadian population for this age group remained relatively stable over the decade.

Only one age group (60 and older) showed an increase in the absolute number of admissions (4%). However, the population for this age group increased by 17% over the same period. This sector of the population also experienced a 35% increase in deaths (from 601 to 809) after admission for a head injury.

While there was a decline in the number of head injury hospitalizations overall, the number of people admitted to specialized trauma hospitals with severe head injuries, as determined by an international injury scoring system, rose by 46% between 2000-2001 (3,880 admissions) and 2003-2004 (5,660 admissions).

"While all degrees of severity can have important and long-term implications, moderate to severe traumatic head injuries can significantly impair physical, cognitive, emotional and social functioning," says Margaret Keresteci, Manager of Clinical Registries at CIHI. "When you take into account the often lifelong impacts associated with head injuries, you start to get an idea of how important the decrease in traumatic injuries is, and how vital it is to understand the factors related to the rise in admissions to specialized trauma hospitals for serious head injuries."

Impact of head injury on children, youth and seniors

The impact of traumatic head injury in Canada can be seen most prominently at both ends of the age spectrum. In 2003-2004, children and youth had the highest proportion of hospitalizations due to traumatic head injuries, representing 30% of all cases, or 4,966 admissions to hospital. Canadians aged 60 and older came a close second, making up 29% of all cases, or 4,902 admissions.

The length of stay in hospital associated with a traumatic head injury increases with age. For those 60 years of age and older, hospital stays were often lengthy, at an average of 15 days, or three times longer than stays of children and youth. Of those admitted and treated after sustaining a traumatic head injury in 2003-2004, 1,368 succumbed to their injuries (8%), double the death rate seen for traumatic injury hospitalizations overall in Canada in the same year. The majority (59%) of deaths associated with a traumatic head injury admission occurred in those 60 years of age and older.

Most head injury admissions related to falls

When looking at all Canadians, the biggest proportion of traumatic head injuries in 2003-2004 was caused by falls (45%), followed by motor vehicle incidents (36%) and assault (9%). Over the last decade, falls as a cause of traumatic head injury admission have decreased by 29% and motor vehicle incidents as a cause of traumatic head injury have also seen a significant decrease (41%).

When divided into age groups, falls accounted for the largest proportion of traumatic head injuries among children and youth (40% or 1,973 admissions) and Canadians 60 years and over (76% or 3,732 admissions) in 2003-2004. Motor vehicle incidents were the second leading cause of traumatic head injuries in both of these age groups, representing 39% (1,955) in those under the age of 20 years, and 17% (840) in those 60 years of age and over.

Among Canadians between 20 and 39 years of age, more than half of traumatic head injuries were due to motor vehicle incidents in 2003-2004 (1,867 admissions), followed by assault and homicide, which accounted for one-fifth of cases for this age group, or 722 admissions. For Canadians between the ages of 40 and 59, motor vehicles also accounted for the largest proportion of traumatic head injuries (40% or 1,308 admissions), followed closely by falls (39% or 1,290 admissions).

Cycling as a factor in head injuries

Traumatic head injuries were sustained during sports and recreational activities in 28% of children and youth admitted to hospital for traumatic injury, and 8% of adults. Cycling is one of the leading causes of sports and recreation-related head injury. Of the 4,605 cycling injury hospitalizations in 2003-2004, 18% were due to head injuries. The highest proportion of hospitalizations due to cycling-related head injuries was seen in children and youth (60%).

The number of cycling-related head-injury admissions dropped between 1994-1995 and 2003-2004, particularly among children and youth (under age 20), who experienced a 55% decrease (from 1,085 to 494), with the largest decrease experienced by those aged 5 to 9 years (64%). Adults aged 20 years and older also saw a decrease in cycling-related head-injury hospital admissions, with a 24% decline (from 422 to 321 cases) during the same time period.