Disability pensions in relation to traumatic brain injury: a population study

From a Danish national register of hospitalizations, all patients were iden tified who had a discharge diagnosis of traumatic brain injury between the years 1979-1993 inclusive, at ages 18-66 years inclusive. These were classi fied as having suffered either a concussion (n = 74398), a cranial fracture (n = 4452) or a cerebral contusion (n = 8141). Patients in each of these g roups were then checked in annual registers of disability pension awards be tween 1979-1995. Disability pensions had been awarded to 16% of the concuss ion group, 18% of the fracture group, and 33% of the contusion soup. Date o f application, grounds for the application, and the pension level awarded w ere noted. Analysis of the date of application for the disability pension r evealed that in all groups a high proportion of the pension applications ha d been made prior to the injury. Among the concussion group, the pension aw ard appeared to be independent of the injury itself Rather, being awarded a disability pension appeared to be related to conditions which themselves a re risk factors for a traumatic brain injury, e.g. chronic skeletomuscular disease and psychiatric disorders including alcoholism. Comparison with pop ulation statistics revealed that the relative risk of being assigned a low or intermediate disability pension is markedly elevated among the concussio n group, especially at younger ages and among males. For the fracture and c ontusion groups, a clear post-injury elevation in rate was detectable, espe cially for highest level pensions.