Center for Health Statistics -

James E. McGreevey
Governor
State of New Jersey

Clifton R. Lacy, M.D.
Commissioner
New Jersey Department of Health

Eddy A. Bresnitz, M.D., M.S.
State Epidemiologist/
Senior Assistant Commissioner

Katherine Hempstead, Ph.D.
Director
Center of Health Statistics

Katherine Hempstead, Ph.D.
Kelly Forsythe Chelnik, M.P.H.
Doug London
Colette Lamothe-Galette, M.P.H.

July 2004

INTRODUCTION

Traumatic brain injury and spinal cord injury are both injuries of the central nervous system. They are among the most serious types of injuries in terms of survival probabilities, treatment and rehabilitation costs, and the likelihood of permanent disability. The direct and indirect cost of these injuries, measured by medical costs and treatments, as well as foregone income and ongoing need for services, is substantial.

Of these two injuries, traumatic brain injury (TBI) is by far the more common. There were nearly 8,000 traumatic brain injuries in New Jersey in 2000 resulting in death or inpatient hospitalization. Of these, nearly 1,000 were fatal. Many more traumatic brain injuries were treated in the emergency department or ambulatory care settings. There were approximately 260 spinal cord injuries (SCI) resulting in inpatient hospitalization in 2000. Leading causes of TBI and SCI are similar: motor vehicle crashes, unintentional falls, and intentional causes, namely self-inflicted injury and assault.

The Center for Health Statistics of the New Jersey Department of Health is funded by the Centers for Disease Control and Prevention (CDC) to conduct central nervous system injury surveillance. New Jersey is one of 12 states that supplies data to the CDC to comprise national estimates of the annual incidence of TBI and SCI. New Jersey's central nervous system injury surveillance system includes injuries to New Jersey residents that result in death or inpatient hospitalization in New Jersey. Specific details of the case definitions for TBI and SCI are provided in the technical notes. The 2000 CNS injury surveillance data is the first year of data prepared by New Jersey for submission to CDC. While these data have obvious value for those particularly concerned with TBI and SCI, they can also be viewed as valuable proxies for serious injuries in general. The leading causes of TBI and SCI are also the leading causes for serious injury overall. Injury prevention efforts should be focused on these major causes – motor vehicle crashes, unintentional falls, and intentional injuries

CNS INJURY HIGHLIGHTS: NEW JERSEY, 2000

Central nervous system injury disproportionately affects the elderly. Rates of TBI and SCI rise with age, and the major cause of injury among the elderly is falls (Table 2 and Figure 2).
TBIs are also more likely to be fatal among the elderly as compared with other age groups (Figure 7).
Falls are also the leading cause of TBI and SCI among the very young (Table 2 and Figure 2).
Blacks have heightened rates of TBI and SCI from assaults (Figure 5 and Table 5). In the case of SCI, this often results from assaults with firearms (Figure 4 and Table 6).
Whites have the highest rates of self-inflicted TBI, usually suicide with a firearm. A very high proportion of these injuries are fatal (Figure 2 and Table 2).
Motor vehicle injuries have declined steadily over the past several decades, in New Jersey as well as the nation as a whole. Yet motor vehicle crashes are nevertheless the leading cause of TBI and SCI (Figure 8 and Table 1).
The majority of these injuries occur to occupants of motor vehicles, but Blacks have disproportionately high rates of TBIs from motor vehicle crashes in which they are pedestrians (Table 6 and Figure 6).
The proportion of TBIs from motor vehicle crashes which is fatal is highest among Hispanics (Table 5 and Figure 5A).
Age-adjusted TBI rates are highest in Southern New Jersey. This is largely driven by higher rates of motor vehicle crashes in southern counties of the state (Table 1).

LIST OF TABLES AND FIGURES

Chapter 1: Traumatic Brain Injury

Figure 1: Traumatic brain injury rates by age and gender, New Jersey, 2000
Table 1: Traumatic brain injury by age and gender, New Jersey, 2000
Figure 2: Traumatic brain injury rates by age and cause, New Jersey, 2000
Table 2: Traumatic brain injury by age and cause, New Jersey, 2000
Figure 3: Traumatic brain injury rates by age and race/ethnicity, New Jersey, 2000
Table 3: Traumatic brain injury by age and race/ethnicity, New Jersey, 2000
Figure 4: Age-adjusted traumatic brain injury incidence rates by cause and gender,
New Jersey, 2000
Table 4: Traumatic brain injury by cause and gender, New Jersey, 2000
Figure 5: Age-adjusted rate of traumatic brain injury by race/ethnicity and cause,
New Jersey, 2000
Table 5: Traumatic brain injury by race/ethnicity and cause, New Jersey, 2000
Figure 6: Traumatic brain injury by cause and outcome, New Jersey, 2000
Figure 7: Traumatic brain injury by age and outcome, New Jersey, 2000

Maps

Map 1: Traumatic Brain Injury rates by county, New Jersey, 2000
Map 2: Traumatic Brain Injury rates from motor vehicle crashes by County, New Jersey, 2000
Map 3: Traumatic Brain Injury rates from falls by county, New Jersey, 2000
Map 4: Traumatic Brain Injury rates from intentional Injuries by county, New Jersey, 2000

Chapter 2: Spinal Cord Injury

Table 1: Spinal cord injury by age and gender, New Jersey, 2000
Figure 1: Spinal cord injury by cause, New Jersey, 2000
Table 2: Spinal cord injury by cause, New Jersey, 2000
Figure 2: Spinal cord injury by cause and gender, New Jersey, 2000
Table 3: Spinal cord injury by cause and gender, New Jersey, 2000
Table 4: Spinal cord injury by age and cause, New Jersey, 2000
Figure 3: Spinal cord injury by age and cause, New Jersey, 2000
Table 5: Spinal cord injury by race and ethnicity, New Jersey, 2000
Table 6: Spinal cord injury by race/ethnicity and cause, New Jersey, 2000
Figure 4: Spinal cord injury by race/ethnicity and cause, New Jersey, 2000

Combined central nervous system injuries

Table 1: Spinal cord injury and traumatic brain injury by county, New Jersey, 2000
Figure 1: Spinal cord injury and traumatic brain injury by length of hospital stay,
New Jersey, 2000

Chapter 3: Motor Vehicle Traffic

Traumatic Brain Injury (TBI)

Figure 1: Motor vehicle-related traumatic brain injury by age and gender, New Jersey, 2000
Table 1: Motor vehicle-related traumatic brain injury by age and gender, New Jersey, 2000
Table 2: Motor vehicle-related traumatic brain injury by race/ethnicity, New Jersey, 2000
Figure 2: Motor vehicle-related traumatic brain injury by race/ethnicity, New Jersey, 2000
Table 3: Motor vehicle-related traumatic brain injury by age and outcome, New Jersey, 2000
Table 4: Motor vehicle-related traumatic brain injury by outcome and position, New Jersey, 2000
Figure 4A: Motor vehicle-related traumatic brain injury by outcome and position,
New Jersey 2000
Figure 4B: Motor vehicle traffic traumatic brain injury by outcome, New Jersey, 2000
Table 5: Motor vehicle-related traumatic brain injury by race/ethnicity and outcome, New Jersey, 2000 24
Figure 5A: Motor vehicle-related traumatic brain injury by race/ethnicity and outcome, New Jersey, 2000
Table 6: Motor vehicle-related traumatic brain injury by race/ethnicity and position, New Jersey, 2000
Figure 6: Motor vehicle-related traumatic brain injury by race/ethnicity and position, New Jersey, 2000
Figure 7: Motor vehicle-related traumatic brain injury by age and race/ethnicity,
New Jersey, 2000
Table 7: Motor vehicle-related traumatic brain injury by age and race/ethnicity,
New Jersey, 2000
Figure 8: Transportation-related traumatic brain injury by mechanism and outcome, New Jersey, 2000
Table 8: Transportation-related traumatic brain injury by mechanism and outcome, New Jersey, 2000

Spinal Cord Injury (SCI)

Table 1: Transportation-related spinal cord injury by mechanism, New Jersey, 2000
Figure 1: Transportation-related spinal cord injury by mechanism, New Jersey, 2000
Table 2: Motor vehicle-related spinal cord injury by position, New Jersey, 2000
Figure 2: Motor vehicle-related spinal cord injury by age and race/ethnicity, New Jersey, 2000 28
Table 3: Motor vehicle-related spinal cord injury by age and race/ethnicity, New Jersey, 2000
Table 4: Motor vehicle-related spinal cord injury by age and gender,
New Jersey, 2000
Figure 4: Motor vehicle-related spinal cord injury by age and gender,
New Jersey, 2000
Figure 5: Motor vehicle-related spinal cord injury by race/ethnicity and position,
New Jersey, 2000
Table 5: Motor vehicle-related spinal cord injury by race/ethnicity and position,
New Jersey, 2000

Traumatic Brain Injury and Spinal Cord Injury

Table 1: Motor vehicle-related spinal cord injury and traumatic brain injury by county & age-adjusted rates of motor vehicle-related traumatic brain injuries by county, New Jersey, 2000

Chapter 4: Falls

Traumatic brain injury

Figure 1: Traumatic brain injury caused by falls, New Jersey, 2000
Table 1: Traumatic brain injury from falls by type, New Jersey, 2000
Figure 2: Age-adjusted rate of traumatic brain injury from falls by gender and type,
New Jersey, 2000
Table 2: Traumatic brain injury from falls by gender and type, New Jersey, 2000
Figure 3A: Traumatic brain injury from falls <25years, New Jersey, 2000
Figure 3B: Traumatic brain injury from falls 25-44 years, New Jersey, 2000
Figure 3C: Traumatic brain injury from falls 45-64, New Jersey, 2000
Figure 3D: Traumatic brain injury from falls 65+, New Jersey, 2000
Table 3: Traumatic brain injury from falls by age and gender, New Jersey, 2000
Figure 4: Rate of traumatic brain injury from falls by race, ethnicity, and outcome,
New Jersey, 2000
Table 4: Traumatic brain injury from falls by race, ethnicity and outcome, New Jersey, 2000
Figure 5: Age-adjusted rate of traumatic brain injury from falls by race/ethnicity,
New Jersey, 2000
Table 5: Traumatic brain injury from falls by type and outcome, New Jersey, 2000
Table 6: Traumatic brain injury from falls by age and county, New Jersey, 2000

Spinal Cord Injury

Figure 1: Spinal cord injury from falls by race/ethnicity and gender, New Jersey, 2000
Table 1: Spinal cord injury from falls by race/ethnicity and gender, New Jersey, 2000
Figure 2: Spinal cord injury from falls by type and gender, New Jersey, 2000
Table 2: Spinal cord injury from falls by type and gender, New Jersey, 2000
Figure 3: Spinal cord injury from falls by age and type, New Jersey, 2000
Table 3: Spinal cord injury from falls by age and type, New Jersey, 2000

Chapter 5: Intentional Injury

Figure 1: Intentional traumatic brain injury by age and cause, New Jersey, 2000
Table 1: Intentional traumatic brain injury by age, gender and cause, New Jersey, 2000
Figure 2: Outcome of intentionally caused traumatic brain injuries by race, New Jersey, 2000
Table 2: Outcome of intentionally caused traumatic brain injury by race and cause, New Jersey, 2000
Figure 3: Intentional traumatic brain injury by gender, outcome and cause, New Jersey, 2000
Table 3: Intentional traumatic brain injury by gender, outcome and cause, New Jersey, 2000
Table 4: Intentional traumatic brain injury by age and mechanism, New Jersey, 2000
Table 5: Intentional traumatic brain injury and spinal cord injury by cause,
New Jersey, 2000
Table 6: Intentional traumatic brain injury by race/ethnicity, gender and cause,
New Jersey, 2000
Figure 4: Age-adjusted rates of intentional traumatic brain injury by race/ethnicity and gender, New Jersey, 2000
Figure 5: Intentionally caused traumatic brain injury by county, New Jersey, 2000
Table 7: Intentionally caused traumatic brain injury by county, New Jersey, 2000

TECHNICAL NOTES

ACKNOWLEDGEMENTS

Funded by the Public Health and Health Services Block Grant

For questions about this report: chs@doh.state.nj.us

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