In 2007 TBI was a factor in the deaths of 1,007 Kentuckians as well as the live discharges of 3,454 from licensed, acute-care hospitals across the state (table 1).  TBI played a role in the death or hospitalization of over 12 Kentucky residents per day.  Acquired brain injury, ABI, resulted in 1,686 deaths and 2,584 live discharges, almost 11 per day. 

    The demographics of TBI in 2007 mirrored those for 2006.  59% of non-fatal and 72% of fatal TBI occurred in males.  However, in 2007 the leading mechanism of injury, motor vehicle traffic crash (MVTC) fell for the first time, supplanted by falls (31% vs. 28%).  The 2007 fall in MVTC deaths may be a direct result of the primary seat belt law enacted at the end of 2006.  For those aged 65 and over, falls were the leading cause of TBI, 56%.  MVTC contributed to over half, 57%, of TBI amongst those aged 15-24 and were the leading cause from ages 5-44.  Falls led among the youngest demographic, 0-4.

   As expected the incidence of TBI was highest in the larger counties.  The top four in TBI incidence are among the top seven most populous counties in Kentucky in 2007.  A notable exception was Clay County, which was 13th in TBI incidence, by 50th in population.  Unsurprisingly, Clay County had the third highest age-adjusted rate in the state.  Owsley also stood out with an age-adjusted rate that was first in the state in 2007, while being 119th in population.  Owsley has consistently been either the first or second highest rate since 2001.  Another notable exception was Christian County, which was 10th in population but 34th in frequency (118th in age-adjusted rate).  Because it borders Tennessee, we can infer that a large number of TBI cases from those who reside in Christian County are treated in Tennessee.  Another counties in a similar vein are Whitley, Warren, Bell, Harlan, Graves, Logan and McCracken.  These counties illustrate an important point: if this report shows a county in have a high rate of TBI we can be confident that intervention/education is needed.  However, if a county has a low incidence of TBI, we cannot say for sure that it is not a significant problem there. 

    ABI was slightly more skewed toward the middle and older age groups, with 87% occurring in persons aged 25 and older, compared to 80% of TBI.  Also in contrast to TBI, of which 62% of cases occurred in males, ABI affected the genders in close proportions.  Akin to 2006 data, nearly all ABI were a result of either anoxia or exposure to toxic substances (table 24).  Alcohol and drugs were involved in most of the non-fatal ETS.  Drugs were common in fatal ETS as well, as were carbon monoxide poisoning and post-operative shock.

  Among those ABI discharges that were reported to have some relationship with an injury (i.e. included E code) 86% of the non-fatal causes were poisonings.  Poisoning, suffocation or drowning were indicated in over 80% of the fatal injury-related ABI (table 27). (Note that we are making a distinction between injury-related and traumatic, with trauma being considered one of several forms of injury.  ABI is, by the statutory definition, non-traumatic).