Traumatic Brain Injury in Alaska:
Who, How and Where
Alaska Native Tribal Health Consortium
Injury 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 Gap
Rate of TBI Hospitalizations
(injuries per 100,000 people)
Non-fatal TBI Hospitalizations in Alaska
2004-2008
250
235
Males
200
150
Females
118
100
122
70
111
60
50
0
United States* Alaska, All races Alaska, AN/AI
* US data for 2002-2006, per CDC
Age Differences
Non-fatal TBI Hospitalizations in Alaska
2004-2008
RATE OF TBI HOSPITALIZATION
(per 100,000)
350
AN/AI
300
Non-native
250
200
150
100
50
0
AGE GROUPS
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 Residence
Non-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
Residential
Institution
Other
Recreation
Sports
Highway
Industrial Place
Public Place
Home
Increased Risk of TBI
Is Alcohol a
Risk Factor?
Yes
Alcohol Association by Age
Non-fatal TBI Hospitalizations in Alaska
2004-2008
Percent of TBI hospitalizations for each
age group associated with alcohol
60
50
40
30
20
10
0
Alcohol by Activity
Non-fatal TBI Hospitalizations in Alaska, 2004-2008
ACTIVITY
Cases associated
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
ACTIVITY
Total Cases
Per cent of 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%
1034
18%
408
18%
Falls
All other
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 for
non-TBI injuries)
Maximum:
305 days (10 months)
Patient destination at discharge
Non-fatal TBI Hospitalizations in Alaska
2004-2008
71
44
29 97
Home,No Assistance
83
Acute Care Hospital
162
Inpatient Rehabilitation
Skilled Nursing
521
2082
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
to Previous Level of Function
1111
36
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
Reducing harm from guns
Gun
Safes
Home Safety Survey
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
Raising
awareness
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
Ice cleats
Home
modification
ANTHC Traumatic Brain
Injury Contacts
Jaylene Wheeler, Injury Prevention Coordinator
(907) 729-3799
jzwheeler@anthc.org
Hillary Strayer, Senior Injury Prevention Specialist
(907) 729-3513
hdstrayer@anthc.org
Website: http://www.anthc.org/chs/wp/injprev/
Thank you!