ACQUIRED BRAIN INJURY in MASSACHUSETTS
a report generated in response to and requested by the
Brain Injury Commission
Massachusetts Department of Public Health
Massachusetts Rehabilitation Commission
October 2014
ACQUIRED BRAIN INJURY in MASSACHUSETTS
Deval L. Patrick, Governor
John Polanowicz, Secretary of Health and Human Services
Cheryl Bartlett, Commissioner of Public Health
Charles Carr, Commissioner, Massachusetts Rehabilitation Commission
October 2014
CONTRIBUTING AUTHORS, AFFILIATIONS and PARTICIPATING AGENCIES
Primary Authors:
Holly Hackman, M.D., MPH: Epidemiologist, Office of Statistics and Evaluation, Massachusetts Department of Public Health (MDPH)
Francesca LaVecchia, Ph.D.: Clinical Neuropsychologist, Massachusetts Rehabilitation Commission; Assistant Adjunct Professor of Psychiatry and Core Faculty, Behavioral Neurosciences Doctoral Program, Boston University School of Medicine
Debra S. Kamen, M.S.: Retired Assistant Commissioner, Community Living Division, Massachusetts Rehabilitation Commission
Contributing Authors:
Amy Bettano, MPH, CPH: Epidemiologist, Prevention and Wellness Trust Fund, Office of
Statistics and Evaluation, Bureau of Community Health and Prevention, MDPH
James Buszkiewicz, MPH: Epidemiologist, Nutrition, Physical Activity and Obesity, Office of
Statistics and Evaluation, Bureau of Community Health and Prevention, MDPH
Molly Crockett, MPH: Epidemiologist, Office of Integrated Surveillance and Informatics
Services, Bureau of Infectious Disease, MDPH
Alfred DeMaria, Jr., M.D.: Medical Director, Infectious Diseases, Bureau of Infectious
Disease, MDPH
Paul Hunter: Director, Childhood Lead Poisoning Prevention Program, Bureau of
Environmental Health, MDPH
Richard Knowlton, M.S.: Epidemiologist, Massachusetts Cancer Registry, Office of Data
Management and Outcomes Assessment, MDPH
Gabrielle Parkinson, M.S., NSCA-CPT: Epidemiologist/Data Analyst, Paul Coverdell National Acute Stroke Registry, Office of Statistics and Evaluation, Bureau of Community Health and Prevention, MDPH
Special Thanks To
Senator Harriette L. Chandler
Co-Chair, Brain Injury Commission
Representative Thomas P. Conroy
Co-Chair, Brain Injury Commission
Representative Kimberly N. Ferguson
Rosalie Edes
Assistant Secretary, Disability Policies & Programs
Executive Office of Health and Human Services
Massachusetts Department of Public Health
Cheryl Bartlett, R.N.
Commissioner
Thomas Land, Ph.D.
Director, Office of Data Management and Outcomes Assessment
Laura Nasuti, MPH, Ph.D.
Deputy Director, Office of Statistics and Evaluation
Bureau of Community Health and Prevention
Alicia J. Fraser, MPH, DSc
Assistant Director, Environmental Epidemiology Program
Bureau of Environmental Health
Letitia Davis, Sc.D., Ed.M.
Director, Occupational Health Surveillance Program
Bureau of Community Health and Prevention
Gillian A. Haney, MPH
Director, Office of Integrated Surveillance and Informatics Services
Bureau of Infectious Disease
Beth Hume, MPH
Project Director, Injury Surveillance Program
Bureau of Community Health and Prevention
Special thanks also to the numerous MDPH reviewers and contributors who assisted in the completion of the report and who are not mentioned above.
Massachusetts Rehabilitation Commission
Charles Carr
Commissioner
Kasper Goshgarian
Deputy Commissioner
Kerri Zanchi
Assistant Commissioner, Community Living
Brain Injury and Statewide Specialized Community Services
Ernestine Fenton
Program Coordinator
Edward Loring
Administrative Assistant
Beth Williams
Senior Program Coordinator
This publication may be accessed at:
http://www.mass.gov/eohhs/docs/mrc/acquired-brain-injury-ma.pdf
Suggested Citation: Hackman H, LaVecchia F, Kamen D, et al. Acquired Brain Injury in Massachusetts. Boston, MA: Massachusetts Department of Public Health and Massachusetts Rehabilitation Commission; October, 2014.
Table of Contents
List of Tables.......................................................................................................................i-iii List of Diagrams....................................................................................................................iv List of Figures.......................................................................................................................iv Executive Summary..........................................................................................................v-viii I. Brain Injury Commission History................................................1-2
II. Overview of Acquired Brain Injury.........................................3-12
III. Epidemiology of Acquired Brain Injury in Massachusetts
A. Data Sources, Methods and Technical Notes.................................................13-20
B. Central Nervous System (CNS) Neoplasms....................................................21-29
C. Infectious Diseases Associated with Disorders of the CNS............................30-40
D. Metabolic Disorders Affecting the CNS...........................................................41-52
E. Neurotoxic Disorders.......................................................................................53-55
F. Neurovascular Diseases and Conditions.........................................................56-68
G. Traumatic Brain Injury.....................................................................................69-80
H. Progressive Disorders of the CNS..................................................................81-86
I. Summary of Data Findings..............................................................................87-92
IV. Prevention of Acquired Brain Injury: Strategies and Initiatives.................................93-99
V. Acquired Brain Injury Resources...........................................................................100-103
VI. Appendices104-128
Appendices
Appendix A: Glossary of Acronyms and Initialisms
Appendix B: ICD-9-CM and ICD-O Codes Used for Definitions of Acquired Brain Injury
B-1CNS Neoplasms
B-2Infectious Diseases Associated with Disorders of the CNS B-3Metabolic Disorders Affecting the CNS
B-4Neurovascular Diseases and Conditions
B-5Traumatic Brain Injury
Appendix C: Map of EOHHS Regions and Towns
List of Tables
Table B1: Malignant and Non-malignant Brain and CNS Tumors by Anatomic Site, MA Residents, 2008-2010
Table B2: Brain and CNS Tumors by Age Group, MA Residents, 2008-2010
Table B3: Brain and CNS Tumors by Race/Ethnicity, MA Residents, 2008-2010
Table B4: Brain and CNS Tumors by Sex, MA Residents, 2008-2010
Table B5: Insurance at Diagnosis for All Brain and CNS Tumors, MA Residents, 2008-2010
Table C1: Inpatient Hospitalizations, Observation Stays and Emergency Department Discharges Associated with Infectious Disease-related Acquired Brain Injury, MA Residents, 2008-2010
Table C2: Average Annual Counts and Crude Rates of Hospital Stays and Emergency Department Discharges Associated with Infectious Disease-related Acquired Brain Injury by Age Group, MA Residents, 2008-2010
Table C3: Average Annual Counts and Crude Rates of Hospital Stays and Emergency Department Discharges Associated with Infectious Disease-related Acquired Brain Injury by Sex, MA Residents, 2008-2010
Table C4: Average Annual Counts and Crude Rates of Hospital Stays and Emergency Department Discharges Associated with Infectious Disease-related Acquired Brain Injury by Race/Ethnicity, MA Residents, 2008-2010
Table C5: Annual Counts and Crude Rates of Hospital Stays and Emergency Department Discharges Associated with Infectious Disease-related Acquired Brain Injury by Executive Office of Health and Human Services (EOHHS) Region of Residence, MA Residents, 2008-
2010
Table C6: Average Annual Primary Payer Type Category for Inpatient Hospitalizations, Observation Stays and Emergency Department Discharges Associated with Infectious Disease-related Acquired Brain Injury, MA Residents, 2008-2010
Table C7: Average Annual Inpatient Hospitalizations Associated with Infectious Disease- related Acquired Brain Injury by Disposition Category and Age Group, MA Residents, 2008-
2010
Table D1: Inpatient Hospitalizations, Observation Stays and Emergency Department Discharges Associated with Metabolic Disorders Affecting the Central Nervous System, MA Residents, 2008-2010
i
Table D2: Average Annual Counts and Crude Rates of Hospital Stays and Emergency Department Discharges Associated with Metabolic Disorders Affecting the Central Nervous System by Age Group, MA Residents, 2008-2010
Table D3: Average Annual Counts and Crude Rates of Hospital Stays and Emergency Department Discharges Associated with Metabolic Disorders Affecting the Central Nervous System by Sex, MA Residents, 2008-2010
Table D4: Average Annual Counts and Crude Rates of Hospital Stays and Emergency Department Discharges Associated with Metabolic Disorders Affecting the Central Nervous System by Race and Ethnicity, MA Residents, 2008-2010
Table D5: Average Annual Counts and Crude Rates of Hospital Stays and Emergency Dep
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