URBAN AND RURAL TRAUMATIC BRAIN INJURIES IN COLORADO

PURPOSE: The purpose of this study was to compare and contrast the epi demiology of traumatic brain injury among urban and rural residents of Colorado. METHODS: Cases of traumatic brain injury (ICD 800, 801, 803 , 804, 850-854) for 1991 and 1992 from the Colorado surveillance syste m of hospitalized and fatal traumatic brain injuries were used. Urban cases resided in counties designated by the U.S. Census Bureau as metr opolitan statistical areas (MSA). Rural cases were divided into two gr oups: ''rural, nonremote,'' if the country of residence was adjacent t o an MSA county or if it had a population of 2500, and ''rural, remote ,'' if not. and ''rural, remote,'' if not. RESULTS: Average annual age -adjusted rates of hospitalized and fatal traumatic brain injury varie d significantly from 97.8 per 100,000 population for the most urban gr oup to 172.1 per 100,000 population for the residents of rural, remote counties. Similarly, total mortality ranged from 18.1 per 100,000 pop ulation among residents of the most urban counties to 33.8 among resid ents of rural, remote counties. Prehospital mortality ranged from 10.0 to 27.7 traumatic brain injuries per 100,000 population. CONCLUSIONS: These results provide justification for expanding efforts to prevent traumatic brain injury to include the small, but high-risk group of re sidents in rural areas. (C) 1997 by Elsevier Science Inc.