Head and spinal cord injury in North Carolina

Oh АоШ 1 \ О. Л <k,, STUDIES A SPECIAL REPORT SERIES BY THE N.C. DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES, DIVISION OF STATISTICS AND INFORMATION SERVICES, CENTER FOR HEALTH AND ENVIRONMENTAL STATISTICS, P.O. BOX 27687, RALEIGH, N.C. 27611-7687. No. 57 June 1991 HEAD AND SPINAL CORD INJURY IN NORTH CAROLINA by Тепа H. Ward ABSTRACT In recent years North Carolina has recognized the need to confront injury as one of the major, preventable health problems in this state. Traditionally, injuries have been regarded as unavoidable events. Injuries, however, have been found to be both predictable and preventable ( I ). Head and spinal cord injuries are particularly devastating because the severe nature of many of these injuries leads to death or permanent disability. Using the North Carolina death files, this study examines resident head and spinal cord injury mortality from 1979 to 1988. Mortality data are then compared to hospital discharge data from the Medical Database Commission. Head injury was involved in 1 1,317 deaths during this period, spinal cord injury in 493 deaths. Head injury-associated death (HIAD) is most often related to motor vehicle collisions, falls, homicide, and suicide. For both whites and nonwhites, males are at much greater risk of HIAD than females. Age groups most affected are those 1 5-24 and 75 and older. By race, rates are generally higher for non whites than whites. A comparison of the HIAD portion of this study to a national HIAD study reveals higher state rates overall but similar age-specific rates. There are also differences in the proportion of HIADs by cause, with an excess of motor-vehicle-related HIAD in North Carolina. Spinal cord injury-associated death (SCIAD) is most often related to motor vehicle collisions and falls. Again, males are at a much higher risk of SCIAD than females. Rates increase at ages 15-24, level off, then rise sharply after age 65. In general, rates are higher for nonwhites than whites, particularly nonwhite males. A comparison of 1988 mortality and hospital discharge data reveals that, for every death from head injury, another 4.4 persons were hospitalized with a head injury. The corresponding ratio for spinal cord injury was 6.0. The relationship between HIADs or SCIADS and hospitalized survivors varies by age group and sex group.