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Incidence of traumatic brain injury in New Zealand

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Authors:
Summary:

The BIONIC (Brain Injury Outcomes New Zealand In the Community) study examined data from all cases of TBI (admitted to hospital or not, fatal or non-fatal) registered in an urban (Hamilton) and rural (Waikato District) population over a 1-year period (from 1 March 2010 to 28 Feb 2011) and estimated the burden of TBI in rural and urban populations in New Zealand across all ages and TBI severities. The total incidence of TBI per 100,000 person-years was 790 cases (749 mild TBI and 41 moderate-to-severe TBI). Almost 70% of all TBI cases were in children (0–14 years) and younger adults (15–34 years). Males were nearly twice as likely as females to have a TBI (rate ratio 1.77). The leading causes of TBI were falls (38%), mechanical forces (21%), transport accidents (20%) and assaults (17%). Compared with New Zealand Europeans, Māori had a 23% greater risk of mild TBI. People living in rural areas were twice as likely to have moderate-to-severe TBI (73 per 100,000 person-years) compared with people living in urban areas (31 per 100,000 person-years).

Comment:
This study confirms the silent epidemic that is TBI. Although the research has been meticulous in identifying cases, such dedication to diagnosis/coding is not happening in clinical settings. Others have shown that unrecognised TBI is prevalent in Aotearoa and as a result we see misdiagnosis (as ADHD), mismanagement (failure to address learning issues) and misdemeanors (high prevalence of Māori prison population with undiagnosed TBI). As the authors suggest, strategies to not only prevent TBI but diagnose and manage it are required for Māori.
Reference: Lancet Neurol 2013;12(1):53-64
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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