Population estimates of undocumented incident traumatic brain injuries among combat-deployed US military personnel

Research Type: 
Concussion Literature

Summary: In 2006-2008 the incidence of TBI in the Military seemed to dramatically increase, but most believe this increase was largely due to improved reporting techniques, and that a substantial number of SMs who sustained a concussion before that time went undiagnosed. This study was undertaken to estimate the number of undocumented incident traumatic brain injuries (TBIs) prior to that time. Negative binomial regression was used to model monthly incident TBI counts between December 2010 and June 2012 and then estimate expected monthly counts of incident TBIs during 2 periods: January 2003-Octover 2006 and November 2006-November 2010. Monthly amputation counts from DoD surveillance data were used as a proxy for changing injury rates. Monthly active component deployment estimates derived from the Congressional Research Service, Brookings Institution, and Defense Manpower Data Center were used to estimate the size of the at-risk population each month. The difference between expected monthly incident TBI counts and reported counts is presented as the estimated number of undocumented incident TBIs. The full model estimates that 21,257 active component military personnel experienced undocumented incident TBIs while deployed in Iraq or Afghanistan between January 2003 and October 2006, more than 4 times the 5,272 incident TBIs actually documented during that period.

Citation:  Chase, R. P. and R. L. Nevin (2014). "Population Estimates of Undocumented Incident Traumatic Brain Injuries Among Combat-Deployed US Military Personnel." J Head Trauma Rehabil.
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