Why traumatic brain injuries should be recognized as a chronic disease

Brain Injury Canada and the Canadian Consortium for Traumatic Brain Injury Research (CCRT) have released a position paper on moderate to severe traumatic brain injury (TBI). Both organizations are advocating for it to be recognized as a chronic disease in Canada, which would help better address this “silent epidemic” that places a heavy burden on patients, their loved ones and society as a whole. “We are increasingly aware of the impact of TBIs, but in the absence of conclusive data in the country, this public health issue remains unknown. We talk a lot about concussions, but moderate to severe TBIs are nevertheless the leading cause of death and disability in children, adolescents and adults under the age of 40,” says Dr. Alexis Turgeon, a critical care and trauma physician working at the CHU de Québec at Laval University, as well as at the Enfant-Jésus Hospital. Read: Innovative program helps B.C. patients with overdose related brain injuries The inclusion of TBIs within the Canadian Chronic Disease Surveillance System would make it possible to standardize the collection of epidemiological data, to monitor them in the continuum of care and to promote research in order to improve their management, explained Dr. Turgeon who is also the co-director of the CCRT. Today, TBI is often considered an isolated event. In 50% of cases, these injuries are the consequence of a fall, road accidents or shocks related to sports. The latter are also the main cause of hospitalization among five- to 19-year-olds, representing 45% of all admissions for TBI in this age group. Read: ‘Way past due’: Resource helps healthcare providers identify, treat brain injuries from domestic abuse Moderate to severe TBIs can cause cognitive impairments (problems with attention and memory, ability to process visual and spatial information, communication, self-awareness, etc.), physical and sensory fragilities (decreased physical strength—including paralysis—coordination problems, pain, sensory disturbances, hearing and/or vision loss), behavioral changes (impulsivity, uncontrolled anger and aggression) and emotional fluctuations (emotional lability, anxiety, depression). Between 2002 and 2016, approximately 235,471 deaths occurred in Canada due to injury—22.6% of them (53,200 deaths) were associated with a diagnosis of TBI. "The issue with TBIs is not the survival of patients," says Dr. Turgeon. “[But rather] the condition they're going to survive in. TBIs profoundly affect their quality of life and that of their loved ones. Their daily life can change completely." In their position paper, Brain Injury Canada and the CCRT report statistics that speak for themselves: More than half of Canadians experiencing homelessness in Canada have a history of TBI. Patients with TBI are 2.5 times more likely to be incarcerated. TBIs disproportionately affects Indigenous Canadians. 60% of Canadian victims of domestic violence reported having suffered a TBI. In school-aged Canadians, TBIs are linked to a 50% increase in psychological distress and an almost three times higher rate of suicide attempts. After a TBI, the employment rate drops dramatically, from 75% to 13%. The brief also points out that “contrary to old theories, new evidence links moderate to severe traumatic brain injury to cognitive and neurological decline.” The World Health Organization defines a chronic disease as a condition having one or more of the following characteristics: "permanence, non-reversible pathological changes as a cause, requiring training of the patient for rehabilitation and/or a prolonged period observation, supervision or treatment." For Brain Injury Canada and the CCRT, TBIs fully meet this definition. “Recognizing traumatic brain injury as a chronic disease is essential,” insists Dr. Turgeon. "This would allow us to improve our knowledge of this important health issue and thus help us improve patient prognosis by identifying more effective treatments and interventions." He adds that this recognition by Canada would translate into funding for “quality research that will significantly improve the quality of life of individuals and their loved ones,” whose day-to-day issues often become more difficult over time. "It's a huge burden that is currently being overlooked." This article was translated from French and originally ran in our sister publication Profession Santé.

Why traumatic brain injuries should be recognized as a chronic disease

Register for free access or login.

Related Topics