Intentional traumatic brain injury: Epidemiology, risk factors, and associations with injury severity and mortality

Background: Intentional injury is associated with significant morbidity and mortality and has been associated with certain demographic and socioeconom ic groups, Less is known about the relationship of intentional traumatic br ain injury (TBI) to injury severity, mortality, and demographic and socioec onomic profile, The objective of this study was to delineate demographic an d event-related factors associated with intentional TBI and to evaluate the predictive value of intentional TBI on injury severity and mortality. Methods: Prospective data were obtained for 2,637 adults sustaining TBIs be tween January 1994 and September 1998, Descriptive, univariate, and multiva riate analyses were conducted to determine the predictive value of intentio nal TBI on injury severity and mortality. Results: Gender, minority status, age, substance abuse, and residence in a zip code with low average income were associated with intentional TBI, Mult ivariate analysis found minority status and substance abuse to be predictiv e of intentional injury after adjusting for other demographic variables stu died. Intentional TBI was predictive of mortality and anatomic severity of injury to the head. Penetrating intentional TBI was predictive of injury se verity with all injury severity markers studied. Conclusion: Many demographic variables are risk factors for intentional TBT , and such injury is a risk factor for both injury severity and mortality, Future studies are needed to definitively link intentional TBI to disabilit y and functional outcome.