Intentional traumatic brain injury in Ontario, Canada.

BACKGROUND Violence and traumatic brain injury (TBI) are two major public health concerns. This violence-related TBI, however, has not been studied in Canada and there is little literature on a profile of risk factors and injury severity regarding TBI because of self-inflicted/suicidal and assault/homicidal injury compared with unintentional TBI. METHODS Cross-sectional study using the comprehensive data set (CDS) of Ontario trauma registry (OTR) from 1993 to 2001. SETTING Data from a large trauma registry were used to assess demographic and injury-related characteristics, injury severity and incident time associated with TBI that were either caused unintentionally, were self-inflicted or resulted from an assault. RESULTS This study identified 1,409 (8.0%) intentional TBIs and 16,211 (92.0%) unintentional TBIs. Of the intentional TBIs, 389 (27.6%) was self-inflicted TBI (Si-TBI) and 1,020 (72.4%) was other-inflicted TBI (Oi-TBI). The most common cause of Si-TBI was "jumping from high places" (32.1%), followed by "firearms" (30.6%). About half of Oi-TBI was because of "fight and brawl" (48.3%), followed by "struck by objects" (26.1%). Si-TBI was associated with younger age, female gender, and having more alcohol/drug abuse history. For Oi-TBI, younger age, male gender, having more alcohol/drug abuse history were independently associated. CONCLUSION This research provides the first comprehensive overview of intentional TBI based on Canadian data. The CDS of the OTR provided the ability to identify who is at risk for intentional TBI. Prevention programs and more targeted rehabilitation services should be designed for this vulnerable population.