traumatic brain injury in alaska: who, how and where alaska native tribal health consortium injury...
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Traumatic Brain Injury in Alaska:Who, How and Where
Alaska Native Tribal Health ConsortiumInjury Prevention Program
What is a Traumatic Brain Injury?
CDC describes it as:
“…caused by a bump, blow, or jolt to the head or a penetrating head injury that disrupts the normal function of the brain.”
How do you get a TBI?
Many different kinds of events, some that are almost everyday events, can cause a TBI:
Hitting your head when you fall or trip
Crashing your bike, snow machine or ATV
Being in a motor vehicle crash
Injure your head during sports
Being near an explosion
How does a TBI affect you?
If you or someone else gets a TBI, it can cause temporary or permanent changes in:
Thinking (remembering and reasoning)
Physical abilities (walking, coordination)
Sensation (touch, taste, smell)
Language (understanding, communication)
Emotion (depression, aggression, anxiety)
Increased Risk of TBI
Who?
The Gender GapNon-fatal TBI Hospitalizations in Alaska
2004-2008
United States* Alaska, All races
Alaska, AN/AI0
50
100
150
200
250
118 122
235
7060
111
Males
Females
Rat
e o
f T
BI H
osp
ital
izat
ion
s (i
nju
ries
per
100
,000
pe
op
le)
* US data for 2002-2006, per CDC
Age DifferencesNon-fatal TBI Hospitalizations in Alaska
2004-2008
0-9
10-1
9
20-2
9
30-3
9
40-4
9
50-5
9
60-6
9
70-7
980
+0
50
100
150
200
250
300
350
AN/AI
Non-native
AGE GROUPS
RA
TE
OF
TB
I H
OS
PIT
AL
-IZ
AT
ION
(p
er
10
0,0
00
)
Age groups and Activities
Different age groups have different activities that result in the highest numbers of TBI:
Ages (years) Activities with the most TBI
0-9 Falls
10-19 Motor vehicle, ATV/Snowmachine
20-39 Motor vehicle, Assault
40+ Falls, Motor vehicle
Increased Risk of TBI
Where?
Region of Patient ResidenceNon-fatal TBI Hospitalizations in Alaska
2004-2008*
All U.S. Rate**: 93
All Alaska Rate*: 92
Alaska Native Rate*: 174
* Crude rates, reported as TBI per 100,000 people
** All U.S. rate for 2002-2006, per CDC.
Specific places of occurrence Non-fatal TBI Hospitalizations in Alaska
2004-2008
Highway
Home
Public Place
Industrial Place
Recreation Sports
Residential Institu-tion
Other
Increased Risk of TBI
Is Alcohol a Risk Factor?
Yes
Alcohol Association by Age Non-fatal TBI Hospitalizations in Alaska
2004-2008
0-9
10-1
9
20-2
9
30-3
9
40-4
9
50-5
9
60-6
9
70-7
9
80-8
9
90+
0
10
20
30
40
50
60
Per
cent
of
TB
I ho
spit
aliz
atio
ns f
or e
ach
age
grou
p as
soci
ated
wit
h al
coho
l
Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska, 2004-2008
Cases associatedACTIVITY with alcohol
Assault 3 out of every 4
Suicide attempt and Snow machine 1 out of every 2
Pedestrian and All-terrain vehicle 2 out of every 5
Motor vehicle traffic 1 out of every 3
All other 1 out of every 5
Alcohol by Activity Non-fatal TBI Hospitalizations in Alaska
2004-2008
Per cent of cases ACTIVITY Total Cases associated with alcohol
Assault 375 72%
Snow machine 121 49%
Suicide attempt 27 48%
Pedestrian 108 41%
All-terrain vehicle 240 39%
Motor vehicle traffic 644 32%
Bicycle 132 23%
Falls 1034 18%
All other 408 18%
Increased Risk of TBI
How severe?
Time in Hospital
For TBI hospitalizations from 2004-2008, the length of time patients spent in the hospital:
Average: 5.6 days (compared to 3.9 fornon-TBI injuries)
Maximum: 305 days (10 months)
Patient destination at dischargeNon-fatal TBI Hospitalizations in Alaska
2004-2008
2082
521
162
83
71 44 29 97Home,No Assistance
Acute Care Hospital
Inpatient Rehabilitation
Skilled Nursing
Home,Rehab Outpatient
Home,Health Care
Left against medical advice (AMA)
Other or unknown
Patient’s General Condition on Discharge
Condition Frequency %
Good, Return to Previous Level of Function 861 28
Temporary Disability, Expected to Return 1111 36to Previous Level of Function
Moderate Disability with Self Care 133 4
Severe Disability, Dependent 155 5
Persistent Vegetative State 4 .1
Unknown 825 27
Risks of TBI
How much $$?
Hospitalization costs
Hospitalization costs for TBI in all Alaska averages $29,000 per injury, compared to the $20,000 average for all injury hospitalizations
Estimated total per year: $16.7 million
Highest hospitalization cost for TBI: $1,010,000
Medivac costs
These costs vary dramatically depending on the contract with the Medivac company.
These are cost ranges Alaska companies provided for actual trips taken:
Juneau to Seattle: $17,000 to $37,000
Anchorage to Seattle: $27,000 to $56,000
Nome to Seattle: $37,000 to $75,000
Anchorage to Richmond, VA: $63,000 to $124,000
Prevention
What is being done?
Snowmachine, ATV, and Motorcycle Safety
Child Motor Vehicle Safety
Gun Safes
Reducing harm from guns
Date: Resident: Assessment by:
This Home Safety Survey is designed to look for hazards in and around the house so they can be fixed before they cause problems. Home safety problems could lead to unintentional injuries from falls, burns, or poisoning. Falls can be a major problem for an elder. Falling can result in serious injury or loss of independence. This survey can be done by a CHA/P, CHR, or a family member.
YES NO
Home Entrance
Steps and walkways in good repair; no broken edges or boards or other hazard
Secure ramp installed if resident uses a wheelchair or finds stairs difficult
Exterior stairs and landing are slippery when wet
Area on roof for ice/snow to accumulate and slide onto landing, stairs, or ramp
Secure, sturdy railing on both sides that is easy to grasp with both hands
Lights that light up a wide area of the yard and walkway
Lock that does not need a key to open from inside (unless wandering is an issue)
Mat, carpeting or textured floor in entryway to prevent slipping when wet
Seat available for putting on and removing ice grippers or cleats
Living Areas
Doorways wide enough to use a walker, a wheelchair, or if carrying a load
Open pathways with no small furniture, clutter, or "stuff"
Throw rugs or mats
Thresholds between rooms/floor textures are smooth with visible color contrast
Electric phone cords running under rugs or carpeting or across open areas
Frayed electric cords
Electric outlets and switches overloaded (warm to the touch)
Lights can be turned on without walking across a dark room
Home Safety Survey
Ice cleats
Home modification
Raising awareness
ANTHC Traumatic Brain Injury Contacts
Jaylene Wheeler, Injury Prevention Coordinator(907) 729-3799 [email protected]
Hillary Strayer, Senior Injury Prevention Specialist (907) 729-3513 [email protected]
Website: http://www.anthc.org/chs/wp/injprev/
Thank you!