Hospital Morbidity due to Head Injuries in New Zealand in 1980–1988

Abstract

We studied the morbidity in New Zealand using hospital discharge data from 1980 to 1988, and found a reduced head injury (HI) rate over this time overall, but no change in the rate among Maori males and an increased rate among Maori females. In 1988 the rate was 228/100,000 with peaks among males and females aged under 10, males aged 15–25, and both sexes over 84 years old. The rate among young Maori males was higher than in other groups until the age of 55. Motor vehicle crashes caused most head injuries, followed by falls, non-intentional incidents (such as sporting injuries), assaults and pedal cycle accidents. Maori females had a high rate of assault. Hospital stay was longest among pedestrians, and increased with increasing age due to co-morbidity. Prevention strategies were based on the causes of HI.

Trends in Head Injury Incidence in New Zealand: A Hospital-Based Study from 1997/1998 to 2003/2004

“…New Zealand's 2006 practice guidelines for TBI [22] note significant ethnic disparities in TBI incidence. In contrasting the 1980-1988 data reported by Caradoc-Davis and Dixon [2] to the present data, it can be observed that while the incidence of the entire population (1997/1998) does not appear to have changed, the overall incidence for Maori males (1997/1998 and 1998/1999) is much lower than that previously published, with a similar reduction for Maori females. This suggests that while disparities do still exist, this gap is narrowing.…”

“…The results of this study suggest that the overall ageadjusted hospital-based incidence of traumatic head injury in New Zealand in 2003/2004 (342/100,000/year for total and 458/100,000/year for Maori people) is notice- ably greater (especially in Maori people) when compared to the estimated 200-300 people per 100,000 annually elsewhere [1] as well as the overall age-adjusted New Zealand rate of 228 per 100,000 reported by Caradoc-Davies and Dixon [2] in 1980-1988. While it is informative to note this increase relative to international studies which have used similar hospitalization databases, the accuracy of these hospital-based data remains questionable as they are still likely to exclude cases of mild brain injury (estimated 70-90% of all TBI cases), many of whom do not seek medical care.…”

“…Age was divided into 5-year age bands ranging from 0 to 85+. Data from 1997/1998 and 1998/1999 were obtained for ICD-9 diagnostic codes in accordance with those reported by Caradoc-Davies and Dixon [2] , including facial and cranial fractures (800-804), concussion (850), cerebral laceration and contusion (851), cerebral haemorrhage following injury (852), unspecified cerebral haemorrhage following injury (853), and brain injury not otherwise specified (854). Data from 1999/2000 to 2003/2004 were divided into newer ICD-10 categories S00-S09, reflecting injuries to the head (superficial injury of the head; open wound of the head; fracture of the skull and facial bones; dislocation, sprain and strain of joints and ligaments of the head; injury of the cranial nerves; injury of the eye and orbit; intracranial injury; crushing injury of the head; traumatic amputation of part of the head; other and unspecified injuries of the head).…”

“…Caregivers are described as often being overwhelmed and ill-equipped to provide for the complex needs of individuals with TBI [11,12] . In the only previous review of hospital morbidity due to head injury in New Zealand, Caradoc-Davies and Dixon [2] noted that while the overall incidence of head injury decreased over time from 1980 to 1988, this rate remained stable for Maori males and increased for Maori females. While our interest is in the incidence of TBI, in keeping with the work of Caradoc-Davies and Dixon [2] , the remainder of this paper will refer to head injury rather than TBI.…”

“…In the only previous review of hospital morbidity due to head injury in New Zealand, Caradoc-Davies and Dixon [2] noted that while the overall incidence of head injury decreased over time from 1980 to 1988, this rate remained stable for Maori males and increased for Maori females. While our interest is in the incidence of TBI, in keeping with the work of Caradoc-Davies and Dixon [2] , the remainder of this paper will refer to head injury rather than TBI. This term was adopted rather than TBI as, reflecting upon the diagnostic codes typically used in publication on the incidence of TBI, it is apparent that not all injuries included in these codes would involve an injury to the brain, though they do reflect injury to the head.…”