Of all types of injury, those to the brain are among the most likely to result in death or permanent disability. Brain injury is the leading cause of death and disability worldwide.
Gathering accurate data about acquired brain injury is problematic for the following reasons:
• Statistics are often based upon the presenting diagnosis at A&E. Often the foremost diagnosis is recorded, therefore if a patient presents with a broken leg the additional head injury may not be taken into account.
• Where data is accurate generally only traumatic injuries are recorded leaving out the injuries caused by problems such as infection ie not all categories of acquired brain injury.
• Primary Care Trusts differ in their classification systems regarding acquired brain injury.
• There is a lack of joined up care in the NHS, therefore as a patient moves through the system information is often lost or mis-recorded.
UKABIF is working with organisations across the UK to improve data collation. Accurate figures are fundamental to our ability to press for better services and therefore this is a priority for UKABIF.
*Please note that most of the figures below apply to traumatic brain injury rather that the much larger category of acquired brain injury.
Professor Alan Tennant of Leeds University carried out the most recent study in 2005 which includes all patients admitted to hospital in England with head injury during years 2001-2 and 2002-3.
229.4 per 100,000 = 112,718 cases in England, 134,854 in the UK
229.1 per 100,000
A number of other studies, listed below, indicate that between 1 million and 1.4 million people attend hospital each year after suffering a head injury – these people are not necessarily admitted.
Teasdale (1995) Almost one million patients in the UK present to hospital each year having suffered a head injury.
Powell (1996) A figure of 1 million A&E attenders with head injury for the UK as a whole each year is often quoted, but this is based on figures from the late 1970s.
Haboubi et al (2001) Approx. 1.4 million people in Britain present at A&E departments each year with a head injury.
National Clinical Guideline (2003) Each year 1.4 million people attend hospitals in England and Wales after suffering a head injury, of whom 150,000 are admitted to hospital.
The studies again show a wide variation in the figures between 60,000 from the Department of Health and 910,000 from the most recent study.
Alan Tennant – Research for NSF for Long-term Conditions (2004)
Ages 16-74 prevalence estimate:
England – 431,000
Extrapolated to UK – 515,641
‘All ages’ prevalence estimate:
England – 760,000
Extrapolated to UK – 909,250
The highest rate of injury occurs in between the ages of 15-24 years. Persons under the age of 5 or over the age of 75 are also at higher risk.
British Society of Rehabilitation Medicine (1988) Incidence is around 300 per 100,000 per annum. McLellan (1998) Head injuries requiring hospitalisation occur in the UK at the rate of about 275/100,000 population annually.
British Society of Rehabilitation Medicine (1988) Incidence is around 300 per 100,000 per annum.
McLellan (1998) Head injuries requiring hospitalisation occur in the UK at the rate of about 275/100,000 population annually.
• Road Traffic Accidents account for 50% of all traumatic brain injuries. This includes cars, trucks, motorcycles, bicycles, and pedestrians hit by vehicles.
• The leading causes of traumatic brain injuries vary by age: falls are the leading cause among persons aged 65 years and older; transportation is the leading cause among persons under the age of 65 years.
• Estimates suggest that sports related brain injury accounts for close to 300,000 injuries each year, with winter sports such as skiing and ice-skating accounting for close to 20,000 brain injuries.
• Assaults are another common cause.
• Infection, disease and stroke also cause a large number of acquired brain injuries. Estimates for encephalitis alone amount to 4,000 new cased per year.
Brain Injury can cause many kinds of physical, cognitive, and behavioural/emotional impairments as shown below. They may be either temporary or permanent. Impairments may range from subtle to severe. Brain injury may result in seizure disorders.
While some people may be physically disabled, the large majority have only ‘hidden’ disabilities, which are less easy to observe and, as a result, lead to misunderstanding.
A person with a brain injury may find it very difficult to relate to people, to carry out tasks which make him or her employable, and to remember life before their accident, and may well seem a different person to those around him or her. He/she may also lack the insight to understand the seriousness of what has happened to him or her.
The costs to the state of acquired brain injury are difficult to estimate due to the problems with the accuracy of the figures. In addition to the costs of treatment and care, the loss of earnings of patients and carers has to be taken into account. An approximation of figures is given below:
Bed rates per day:
high dependency – about £2000/day
rehabilitation – about £400/day
If we, very conservatively, assume admission for 2 days on average to an ordinary ward (at £300/day) then the cost of 130000 people (see above) admitted each year amounts to £78 million/year. Then, some will be admitted to HDU at £2000/day and some to a rehabilitation ward at £400/day and many of those for many months. As noted above about 1 million attend hospital casualty each year at further cost. These costs exclude the costs of lost employment and social security to the State. As an example, an average legal settlement for a young man with a severe head injury to provide care for life and compensate for lost earnings amounts to about £5 million. We can estimate that the total cost of brain injury in the UK is at least £1billion per annum.
This information was collated with the assistance of Headway – the brain injury association.