“Traumatic brain injury is the leading cause of death and disability in children and young adults around the world, and is involved in nearly half of all trauma deaths. Many years of productive life are lost and many people have to suffer years of disability after brain injury. In addition it engenders great economic costs for individuals, families and society”.(1)
For the purposes of this book a literature review was conducted, trends in TBI certainly are emerging, as is the noted burden on healthcare, family and societal systems in general. There is a global consensus that TBI and the sequale of TBI has become a serious problem worldwide. Due to the fact that criteria for gathering data varied, study to study and country to country and that standards of care, protocols and statistical measures are not consistent, the data cannot be uniformly compared, particularly in developing verses undeveloped nations.
Having said that the World Health Organization (WHO) has projected that “Traumatic brain injury (TBI) according to the World Health Organization, will surpass many diseases as the major cause of death and disability by the year 2020” (2) with the male to female ratio estimated at anywhere from 2:1 to 3:1.(1)
“It has been estimated that after one brain injury, the risk of a second injury is three times greater, and that after a second injury, the risk of a third is eight times greater”.(3)
TBI has an impact on greater society as a reported 53% of homeless individuals live with brain injury the vast majority 70% were injured prior to becoming homeless.(4)
An estimated 82% of the prison populations live with the effects of traumatic brain injury.(5)
TBI has been identified as the signature injury of the Iraq-Afghanistan conflict with an estimated 10-20 per cent of returning US military personnel suffering from a traumatic brain injury, in addition to the several million North Americans each year surviving TBI, more people than ever are being affected by this life altering injury.(6,7)
Considerations have been made towards traumatic brain injury as a “silent epidemic, as society is largely unaware of the magnitude of this problem” (8) p231. Within industrialized countries “the number of productive years lost because of traumatic brain injury exceed those of cancer, cerebrovascular disorders and HIV/AIDS combined”. (9)
The primary causes of TBI worldwide vary with some commonality. Road traffic accidents, falls, work place injury, violence, civil unrest and sport are amongst the leading causes. While falls from the roofs in Pakistan and falls out of unsafe bunk-beds in Hong Kong refugee camps for the Vietnamese are also common causes(1). In low and middle income countries, pedestrians, cyclists and bus passengers are at a higher risk for sustaining a TBI(1).
Costs of treating traumatic brain injury extend beyond the basic costs of hospital care and include rehabilitation, costs of care-giving, loss of productivity and early retirement costs. These costs are exponential such that “if we prevent just one serious brain injury each year, over the lifetime of the first injury prevented, we realize a support care cost savings of over $90 million dollars” (10).
The global estimated cost of TBI in 2000 was $406 billion.(11)
Without effective treatment, many of these people will lead lives of quiet desperation, isolation and depression.
(*) Cited references can be found on page xxxi and xxxii of Traumatic Brain Injury Rehabilitation: The Lefaivre Rainbow Effect