Traumatic Brain Injury, Alaska, 2016-2021.

Objectives: Alaska has among the highest traumatic brain injury (TBI) mortality rates in the United States. We characterized the epidemiology of TBIs in the country's largest and most sparsely populated state to guide prevention efforts.

Methods: This cross-sectional study analyzed TBI-associated hospitalization and mortality rates in Alaska from 2016 through 2021. Data included people with TBI-associated hospitalization or death in Alaska. We compared age-adjusted rates using national data, with analysis by age, sex, race and ethnicity, and injury mechanism. Logistic regression explored factors influencing mortality among hospitalized patients with TBI.

Results: TBI-associated hospitalization rates per 100 000 population in Alaska were highest among adults aged ≥75 years (310.4), by sex among males (123.3), and by race among American Indian and Alaska Native (AI/AN) people (186.7). Patients with TBI-associated hospitalizations due to self-harm were approximately 8.6 times as likely to die as patients with unintentional injuries. Alaska's age-adjusted TBI-associated mortality rate per 100 000 population was twice the national rate (36.2 vs 17.3). TBI-associated mortality rates in Alaska exceeded national averages across all demographic characteristics and injury mechanisms. Adults aged ≥75 years, males, and AI/AN people in Alaska had TBI-associated death rates that were 1.3, 1.9, and 2.0 times higher, respectively, than national rates. Alaska's TBI-associated mortality rate from suicide was 2.6 times the national average, with notable racial disparities for AI/AN people.

Conclusions: TBIs are a considerable source of morbidity and mortality in Alaska, with disproportionate effects observed among population groups. These findings underscore the need for increased focus on mechanism-specific TBI prevention activities, particularly for older adults and AI/AN people.