The Lifetime Prevalence of Hospitalised Head Injury in Scottish Prisons: A Population Study

McMillan, T. , McKay, D., Graham, L., Pell, J. and McConnachie, A. (2019) The Lifetime Prevalence of Hospitalised Head Injury in Scottish Prisons: A Population Study. The International Brain Injury Association’s 13th World Congress on Brain Injury, Toronto, Canada, 13-16 Mar 2019.

Abstract

Background: There is a need to understand the epidemiology of head injury in prisoners in order to plan interventions to reduce associated disability and risk of reoffending. This is the first study to determine the lifetime prevalence of hospitalised head injury (HHI) in a national population of prisoners and is part of a programme of research associated with the implementation of a health service for people with brain injury in the criminal justice system in Scotland1. Methods: Whole life hospital records of everyone aged 35 years or younger and resident in a prison in Scotland on a census day in 2015 were electronically linked via their unique NHS identifier and checked for ICD-9 and 10 codes for head injury (excluding extracranial injury codes). Using a case control design, these data were compared with a sample from the general population matched 3:1 for age, gender and area-based social deprivation. The likelihood of having sustained a ‘more severe’ brain injury was estimated in two ways. The presence of ICD codes for intracranial injury excluding concussion or having more than two hospital admissions with a head injury diagnosis. Results: HHI was found in 24.6% of 4,374 prisoners and was significantly more prevalent than the 17.9% of 13,122 individuals with HHI in the matched general population sample (OR 2.13; 95%CI, 1.90, 2.39). Having three or more HHI was more common in prisoners (OR 3.04; 95%CI 2.33, 3.97) as were HHI with ICD codes for intracranial injuries (OR 1.51; 95%CI 1.28, 1.79), suggesting that more severe HHI is more prevalent in prisoners than the general population. Overall 10.9% of prisoners had at least one indicator of having sustained a ‘more severe’ brain injury. Conclusion: Prisoners in Scotland aged 35 years or younger have a higher lifetime prevalence of HHI than a demographically matched general population and are more likely to have had repeated HI or intracranial injuries. Further work is required to elucidate relationships between self-report of HI and hospitalised records and to ascertain persisting effects of HI in prisoners and the need for services to reduce effects of associated disability and on the risk of reoffending. 1 http://www.nphn.scot.nhs.uk/wp-content/uploads/2016/07/NPHN-Brain-Injury-and-Offending-Final-Report.pdf

• Item Type: Conference or Workshop Item
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McConnachie, Professor Alex and Pell, Professor Jill and Graham, Dr Lesley and McMillan, Professor Tom
• Authors: McMillan, T., McKay, D., Graham, L., Pell, J., and McConnachie, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre