Sex- and age-specific differences in product-related traumatic brain injury morbidity in the United States, 2004–2023

Introduction: To examine trends in product-related traumatic brain injury morbidity by sex and age group in the Unites States between 2004 and 2023. Method: Product-related injury morbidity data were extracted from the National Electronic Injury Surveillance System (NEISS). Eight types of products, five injury locations, two sexes, and five age groups were categorized. Joinpoint regression models were performed to detect time periods showing significant product-related traumatic brain injury morbidity changes between 2004 and 2023. Average annual percent changes (AAPCs) in morbidity rates and 95% confidence intervals (95% CIs) quantified significant morbidity changes. Results: The age-standardized product-related traumatic brain injury morbidity rate more than doubled in the United States between 2004 and 2023, rising from 236.6 to 574.8 per 100,000 persons (AAPC = 5.1%, 95% CI: 3.7%, 6.5%), with notable fluctuation during the COVID pandemic in 2019–2021. Under-15 children and old adults ≥ 65 years had the highest product-related traumatic brain injury morbidity rates between 2004 and 2023. Floors/flooring materials and stairs/steps were the most common products causing traumatic brain injuries, accounting for 31.7% of injuries, and homes were the most frequent occurring location, accounting for 59.3% of total product-related injury morbidity. Morbidity rates and spectrums by type of product and by occurring location varied greatly across sex and age groups. Conclusions: Product-related traumatic brain injury morbidity rates increased in the United States between 2004 and 2023, with some morbidity fluctuations in 2019–2021, likely reflecting the effect of the COVID-19 pandemic. Practical Applications: Further research and prevention efforts are recommended to interpret the observed morbidity changes, curb recent product-related traumatic brain injury morbidity increases and reduce morbidity disparities across sex and age groups.