Epidemiology and Risk Factors for Intentional Traumatic Brain Injury

Abstract

Background/Objectives: Intentional injury due to violent acts is associated with significant morbidity and mortality. However, intentional traumatic brain injury (TBI) has received little attention and there is limited research on the relationship of injury intent to injury mechanism, severity, mortality, hospital disposition and demographic factors. In this study, the aim was to examine the factors associated with intentional TBI and evaluate the differences in outcomes based on injury intent. Methods: We conducted a retrospective analysis of patients with diagnosed TBI at an urban trauma center. Hospital data were obtained from the Department of Surgery’s trauma registry for the years 2017–2022. Intentional and unintentional TBI patients were compared using descriptive, univariate and multivariate methods. Results: In this study, 123 (9.28%) intentional TBIs and 1203 (90.72%) unintentional TBIs were identified. Younger age, male gender, minority status, Medicaid coverage, alcohol use and the lack of orthopedic injury were associated with intentional TBI. Patients with intentional TBI were more likely to be discharged to home and with admissions had shorter hospital lengths of stay and were less likely to be discharged to rehabilitation. Multivariate analysis found that Black race and alcohol use near the time of injury were predictive of intentional injury when adjusting for other demographic variables. Conclusions: Overall, patients with intentional TBI had less severe and more focal injury events with shorter hospital stays if admitted. Multiple demographic- and injury-related variables were associated with intentional TBI. Further study is needed to evaluate the long-term patient outcomes and re-injury after intentional TBI.