A study of traumatic brain injury in Puerto Rico.

Objective: Characterize the traumatic brain injury (TBI) population in the Puerto Rico Trauma Hospital.

Materials and methods: Retrospective review of data from all encounters with ICD-10-CM codes corresponding to the US National Center for Health Statistics, CDC, TBI case definition in calendar years 2019-2022. Variables included age, sex, mechanism of injury, Glasgow Coma Scale, Injury Severity Score, length of stay, and discharge disposition.

Results: A total of 947 patients with TBI were identified after record review. The majority were men (80.7%), and the median age was 39 years. Most cases were severe, with a median Glasgow Coma Scale of 7 and a median Injury Severity Score of 17. The most common mechanisms of injury were motorcycle injuries (23.0%) and motor vehicle collisions (22.9%). Falls accounted for 19.9% of cases, and the occurrence increased with age. The median length of stay was 20 days with no difference between sexes (P = 0.24). In hospital mortality (18.1%) was similar across all calendar years and higher (P < 0.001) for males (20.7%) compared with females (8.2%). More females (84.6%) were discharged home than males (69.9%) (P < 0.001).

Conclusions: TBI care is a service in high demand in Puerto Rico, with a high burden and severity of injury among young men. The next step should include a detailed characterization of TBI in other hospitals in Puerto Rico and on strengthening rehabilitation services in health systems on the island. Comprehensive preventive strategies are required to address key mechanisms of TBI in Puerto Rico.