Paul McBride Paul McBride is a senior analyst at the Health Quality Safety Commission, working in partnership with the National Trauma Network to improve care in major trauma. Before this, he worked as a quality improvement analyst with the Nelson Marlborough District Health Board, and previously in community development. He has a broad analytics background and holds a PhD in evolutionary biology.
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Major Traumatic Brain Injury in NZ 2017-2020
A serious traumatic brain injury (sTBI, AIS head ≥ 3) occurs in more than a third of New Zealand’s major trauma patients. These patients are more than three times as likely to die from their injuries as patients without an sTBI. This difference can be explained by overall injury severity, physiological factors, and age for less severe sTBIs (AIS head 3 or 4), an additional risk exists for the most serious sTBIs (AIS head 5). Risk of death is lower for patients who receive definitive care at a neuroscience facility. However, this factor is complicated by the transfer process—patients with essentially unsurvivable injuries will remain at their receiving hospital, while those with severe but survivable injuries will be transferred. Using data from the New Zealand Trauma Registry (NZTR), I present a range of analyses to unpick patterns of injury, treatment, and outcome for major trauma sTBI patients across New Zealand. These analyses show variation in process and outcomes for patients, with major implications for geographic and demographic equity.
A serious traumatic brain injury (sTBI, AIS head ≥ 3) occurs in more than a third of New Zealand’s major trauma patients. These patients are more than three times as likely to die from their injuries as patients without an sTBI. This difference can be explained by overall injury severity, physiological factors, and age for less severe sTBIs (AIS head 3 or 4), an additional risk exists for the most serious sTBIs (AIS head 5). Risk of death is lower for patients who receive definitive care at a neuroscience facility. However, this factor is complicated by the transfer process—patients with essentially unsurvivable injuries will remain at their receiving hospital, while those with severe but survivable injuries will be transferred. Using data from the New Zealand Trauma Registry (NZTR), I present a range of analyses to unpick patterns of injury, treatment, and outcome for major trauma sTBI patients across New Zealand. These analyses show variation in process and outcomes for patients, with major implications for geographic and demographic equity.
