The burden of traumatic brain injuries

More effective strategies are required to reduce the burden of traumatic brain injuries in Australia, new research has found.

New research, published today in the Medical Journal of Australia, has shed light on the number of people taken to hospital with, and dying in hospital of, a moderate to severe traumatic brain injury.

A traumatic brain injury is an injury to the brain caused by an external force, including road accidents, falls, and being struck by an object, person or animal (here).

“[Traumatic brain injury] varies in severity, from mild to severe, and is better classified according to brain injury pathology identified by neuroimaging (eg, Abbreviated Injury Scale [AIS] head injury code) than by using the Glasgow Coma Scale (GCS) (here),” the researchers wrote.

“Moderate to severe [traumatic brain injury] often has substantial lasting consequences for the person, their family, and their caregivers.

“[Traumatic brain injury] can also require considerable health care resources and have a significant socio-economic impact (here and here),” they wrote.

In their study, lead author Adjunct Clinical Associate Professor Gerard O’Reilly and his colleagues drew on data from the Australia New Zealand Trauma Registry dating from 1 July 2015 to 30 June 2020.

In an interview with InSight+, Associate Professor O’Reilly, the head of epidemiology and biostatistics from the National Trauma Research Institute at the Alfred, in Melbourne, said they found the number of people being hospitalised with this injury had remained unchanged over a five-year period.

“This research demonstrated that moderate to severe traumatic brain injury remains a major burden across Australia, with no real change in the number of hospitalisations or deaths in hospital in recent years,” Associate Professor O’Reilly said.

“Specifically, the number of hospitalisations following moderate to severe traumatic brain injury remains at more than 5000 per year, of which approximately 15% die in hospital.”

Over the five-year period, they found 16 350 people were hospitalised with moderate to severe traumatic brain injury in Australia.

The mean age at admission was 50.5 years, and 71.2% of patients were male.

The mean age of people who died in hospital was 60.4 years, and 69.2% of those were male.

Younger males were over-represented in the findings, prompting the need for more effective strategies to help people most at risk of a traumatic brain injury, Associate Professor O’Reilly said.

“This research was able to shine a light on the groups most at risk of moderate to severe traumatic brain injury, namely, but not exclusively, younger men,” Associate Professor O’Reilly said.

“Identifying and tailoring effective injury prevention interventions to this group is key to reducing the nationwide burden of moderate to severe traumatic brain injury.”

The research revealed the need for more data gathering on and analysis of traumatic brain injuries in Australia, Associate Professor O’Reilly said.

“This research was prompted by the huge impact of traumatic brain injury for people across Australia and a lack of existing analyses and publication of baseline data in recent decades,” Associate Professor O’Reilly said.

“Ongoing important work will lead to a better understanding of three key factors,” he said.

“First, it will help us understand the systemwide determinants of hospitalisation and death following moderate to severe traumatic brain injury.

“Second, it will also help us explore the quality indicators for acute care from the perspective of the person (or their carer) who sustains a brain injury.

“Third, further research will also shed more light on the determinants and quality indicators for priority groups, namely Aboriginal and Torres Strait Islander people,” he said.

Read the research in the Medical Journal of Australia.

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