Grant Christey., Midland Trauma System, Waikato DHB, Hamilton, NZ
Grant Christey is a general surgeon and trauma specialist at Waikato Hospital, clinical lead of the Midland Trauma System and Honorary Associate Professor in Surgery at the Waikato Clinical School. He holds positions in national and international organisations committed to improving trauma care and injury prevention.
Hospitalised Traumatic Brain Injuries in the Midland Region
Bentley, M., Midland Trauma System, Waikato District Health Board, Hamilton, New Zealand. Christey, G., Midland Trauma System, Waikato District Health Board, Hamilton, New Zealand; Waikato Clinical School, University of Auckland, Hamilton, New Zealand.
Introduction: Globally, traumatic brain injury (TBI) is the foremost cause of death and disability in both children and young adults (Lancet Neurology, 2010). Despite the high total incidence in New Zealand (790/100,000) (Feign et al. 2013), little is known about TBI in the inpatient setting and patient pathways following hospital discharge.
Aims: To investigate the volume, injury characteristics, resource allocation and patient journey of Midland residents hospitalised with a TBI.
Methods: A retrospective review of Midland Trauma Registry data between January 1, 2012 and December 31, 2019 was conducted. Eligible patients (N=4875) were Midland residents hospitalised with an injury to the brain parenchyma.
Results: An average 609 Midland residents were hospitalised with a TBI diagnosis per year, increasing 152% from 479 in 2012 to 727 in 2019. Concomitant injuries occurred in 78.1% of TBI patients. TBI diagnoses explained 66.1% of total Injury Severity Scale scores. Of all patients, 72.1% had TBI AIS severity scores of 1-2 (mild-moderate). The remaining 1364 patients (171 per year) had TBI AIS severity scores ≥3 (serious, severe, critical and maximum). Brain surgery was required by 3.5% of patients, 25.5% received other surgery, 14.9% were admitted to intensive care and 3.7% died as a results of their injuries (TBI or other). Mean length of hospital stay for TBI patients was 5.8±9.3 days. Across the hospital journey, 468 transfers to out-of-region facilities for acute-care and/or rehabilitation occurred for Midland domiciled TBI patients, an average of 59 transfers each year.
Conclusion: TBI resulting in hospitalisation in Midland residents are prevalent, diverse and complex demanding important hospital resource utilisation. The number of out-of-region transfer rates signify challenges along acute-care and rehabilitation pathways.