Prevalence of Traumatic Brain Injury (TBI) disability: a national population-based survey
Dr Claire JOURDANa, Prof Philippe AZOUVIa, Prof François GENETa, Mr Nicolas SELLYa, Prof Loic JOSSERANa, Dr Alexis SCHNITZLERa
a APHP Hôpital Raymond Poincaré
Objectives: Traumatic Brain Injury (TBI) epidemiological literature lacks information on prevalence of TBI-related disability, and on its long-term consequences on a population-based scale.
Methods: A National Disability and Health Survey was conducted in French households and institutions in 2008-2009. Participants were 33 896 adults representative of 49 million individuals. Face-to-face interviews addressed medical conditions including sequelae from TBI, impairments, activities and participation, health and use of health services. Disability levels of persons with TBI were derived from the Glasgow Outcome Scale. Weighted analyzes were computed including comparisons adjusted on age and gender between persons with or without TBI.
Results: Prevalence of self-reported TBI sequelae was 0.7%. Persons with TBI sequelae were men for 62%; median age was 50; median time since injury was 13.9 years. Their disability level was vegetative state for 0.2%, severe disability for 22%, moderate disability for 37%, good recovery for 41%. For all items included in the Brief International Classification of Functioning Core Set for TBI, they declared higher impairments than the no-TBI population, with odds ratios ranging from 1.7 (behavioural difficulties) to 8.6 (motor difficulties). Rates of cardiovascular, respiratory, musculoskeletal, digestive, urological, neurological, and psychiatric conditions were all higher in the TBI population than in the no-TBI population, with highest odds ratios for the last two domains. Use of health care services was higher in the TBI population, and women with TBI had high rates of unmet needs for health services.
Discussion: Chronic sequelae from TBI are frequent and responsible for important disability in the general population. Associations with many other conditions justify lifelong specialized care.
Keywords : Traumatic Brain Injury ; epidemiology ; prevalence ; Public Health ; Handicap