Robert Teasell MD FRCPC, Swati Mehta PhD, Heather MacKenzie MD FRCPC, Jo-Anne Aubut BA, Mark Bayley MD FRCPC, Nora Cullen MD FRCPC
incidence and Prevalence
Acquired brain injury (ABI), particularly traumatic brain injury (TBI), is one of the leading causes of death and lifelong disability in North America (Greenwald et al. 2003; Pickett et al. 2001; Thurman & Guerrero 1999). In the United States between 1.4 and 1.7 million people sustain a TBI every year (Faul et al. 2010; Zaloshnja et al. 2008), with more than 120,000 people expected to develop long-term disabilities (Zaloshnja et al. 2008). In the province of Ontario, more than 80,000 individuals sustained a TBI between 2002 and 2006 (Colantonio et al. 2010). Among low and middle income countries, the lifetime prevalence of TBI ranged from 0.3% in China to 14.6% in rural Mexico (Khan et al. 2015).
Most individuals with TBI have milder injuries, but residual deficits in these patients are not uncommon (Thornhill et al. 2000). Moreover, 10-15% of patients with TBI have more serious injuries requiring specialist care (Maas et al. 2008). The frequency of injuries of moderate severity are increasing, with the proportion of moderate TBIs being 19% in 1992 and increasing to 37% in 2002 (Colantonio et al. 2009). Unfortunately, the incidence of TBI is expected to increase due to the ongoing demographic shift of an aging population (Colantonio et al. 2009).
Much of the data pertaining to ABI is collected from a specific point of care (i.e., emergency departments, inpatient rehabilitation, and outpatient services). It should be noted that because these studies do not explore the number of patients treated in other healthcare settings, and the number of individuals who go untreated are not accounted for, the number of individuals with a brain injury is likely to be higher than these figures suggest (Langlois et al. 2006).