DoD Worldwide Numbers for TBI
DVBIC is the Defense Department’s office of responsibility for tracking traumatic brain injury (TBI) data in the U.S. military. On this page you’ll find annual and quarterly reports that provide data on the number of active-duty service members — anywhere U.S. forces are located — with a first-time TBI diagnosis since 2000.
Service members can sustain a TBI during day-to-day activities, such as while playing sports or participating in recreational events, military training and military deployment. The majority of traumatic brain injuries sustained by members of the U.S. Armed Forces are classified as mild TBI, also known as concussion. Most service members who sustain a mild TBI return to full duty within seven to 10 days through rest and the progressive return to activity process, in which patients gradually return to normal activity using a standardized, staged-approach. Further treatment is available if symptoms persist after the recommended rest period. Review our clinical resources for more information.
Annual Totals at a Glance
Department of Defense Numbers for Traumatic Brain Injury Worldwide – Number of Service Members Diagnosed: This graph depicts the number of service members diagnosed every year since 2000, and corresponds with the number of service members diagnosed with the traumatic brain injury table above. It shows annual increases in identified service members with TBI, peaking in 2011 at nearly 33,000 cases, after which there has been a steady decline each year. This graph was updated on June 21, 2018.
Department of Defense Numbers for Traumatic Brain Injury Worldwide – Number of Service Members Diagnosed by Branch of Service: This graph depicts the number of service members diagnosed every year since 2000, according to service. Army accounts for the largest number of service members with traumatic brain injury, peaking in 2011 with nearly 20,000 identified cases, followed by Marine Corps, Air Force and Navy service members. This graph was updated on June 21, 2018.
Department of Defense Numbers for Traumatic Brain Injury Worldwide – Number of Service Members Diagnosed by Severity: This graph depicts the number of service members diagnosed with a traumatic brain injury, every year since 2000, according to the severity of the sustained injury. Mild traumatic brain injuries are shown to be by far the largest source of service member traumatic brain injuries, with over 20,000 cases in 2014 alone, followed by other severity injuries, accounting for less than 9,000 cases total. This graph was updated on April 2016.
About the Data
Where do the numbers come from?
The data is obtained from multiple sources, including the Armed Forces Health Surveillance Branch, which operates the Defense Medical Surveillance System, a continuously expanding relational database that documents military and medical experiences of service members throughout their careers. Also, the Theater Medical Data Store (link is external), a Web-based application used to track, analyze and manage a service members’ medical treatment information recorded on the battlefield.
How are TBI cases defined?
A TBI case is defined based on the Department of Defense (DoD) Standard Surveillance Case Definition for TBI used by the Armed Forces Health Surveillance Branch for routine surveillance and reporting.
The first inpatient or outpatient TBI medical encounter is identified using billing codes from insurance claims defined in the appropriate version of the International Classification of Diseases. The International Classification of Diseases, 10th edition, Clinical Modification (ICD-10-CM) took effect Oct. 1, 2015, replacing the ICD-9-CM coding guidelines. Military treatment facilities code medical encounters using ICD-10-CM and other DoD specific codes.
The first inpatient or outpatient TBI medical encounter is identified using billing codes from insurance claims defined in the appropriate version of the International Classification of Diseases. The International Classification of Diseases, 10th edition, Clinical Modification (ICD-10-CM) took effect Oct. 1, 2015, replacing the ICD-9-CM coding guidelines. Military treatment facilities code medical encounters using ICD-10-CM and other DoD specific codes.
If a service member has sustained more than one TBI, are all of them counted?
No. If a service member has had more than one TBI, only one of their injuries is counted for the purpose of this reporting.
If a service member has sustained more than one type of TBI, are both counted?
TBIs are classified as mild, moderate, severe, or penetrating. If a service member has sustained more than one type of TBI, the highest TBI severity is reported. For example, a service member with a previous ‘mild’ TBI will be counted as having a ‘moderate’ TBI if the individual is later diagnosed with a ‘moderate’ TBI. The date of their first TBI medical encounter determines the date on which they’re reported as a TBI surveillance case. This approach is intended to correct situations where new medical information is collected after the initial diagnosis and to avoid over counting the number of service members who have sustained a TBI.
How often are the numbers updated?
The numbers are updated both quarterly and annually. The numbers of service members diagnosed with a TBI for the current year and immediate past calendar year are updated quarterly. For all other years, the numbers are updated annually to reflect changes in the administrative databases.
What does a quarter cover?
The calendar year is divided into four quarters, often abbreviated Q1, Q2, Q3 and Q4. The four quarters that make up the year for the purposes of TBI surveillance reports are:
- Q1 represents the period January 1 – March 31
- Q2 represents the period April 1 – June 30
- Q3 represents the period July 1 – September 30
- Q4 represents the period October 1 – December 31
What other surveillance activities does DVBIC perform?
DVBIC performs more in-depth analysis on TBI-related data to include descriptions of risk and patterns of health care. Important public health findings are disseminated in medical journals. Health system management internal reports are provided to senior military leaders and may be available to military treatment facilities upon request. For public health purposes, DVBIC also collaborates with the Air Force Medical Readiness Decision Support Systems, Joint Trauma Analysis and Prevention of Injuries in Combat, Navy and Marine Corps Public Health Center, and Department of Veterans Affairs. For further information, please email the DVBIC surveillance team.
