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Traumatic brain injury - New Zealand's 'silent epidemic'

Thursday 22 Nov 2012 12:36 p.m.

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By 3 News online staff

After being grossly underestimated for years, New Zealand’s rate of traumatic brain injury (TBI) is at “epidemic proportions”, according to a new study.

A TBI occurs when the normal function of the brain is disrupted by an external force, like a bump or a blow to the head. It’s described as the leading cause of long-term disability in children and young adults worldwide, but its prevalence has been poorly understood in New Zealand until now.

The BIONIC (Brain Injury Outcomes New Zealand In the Community) study, published today in international medical journal The Lancet, estimates more than 36,000 new traumatic brain injuries occur in New Zealand each year – or 790 cases per 100,000 people per year. That rate is far higher than in other developed parts of the world. Developed countries in Europe have between 47 and 453 cases per 100,000 per year, and in North America the rate is between 51 and 618 cases per 100,000.

However New Zealand’s rate of TBI is not only high compared with the same statistics in other countries – it’s also more prevalent here than some other, perhaps better-recognised health conditions.

“One new TBI happens every 15 minutes, far more than the number of new heart attacks and greater than five times the number of new strokes,” says Professor Valery Feigin of AUT University’s National Institute for Stroke and Applied Neuroscience.

“The true burden of TBI in New Zealand is far greater than expected and new strategies are urgently needed to reverse this silent epidemic,” he says.

Prof Feigin led the research team behind the BIONIC study, believed to be the first of its kind in the world. The study looked at the rate of TBI among more than 173,200 Waikato residents over 2010 and 2011.

Risk factors

It found that there was an increased risk of TBI for young people, men, Maori and rural inhabitants.

  • Children aged 0-14 years and young adults aged 15-34 years constituted almost 70 percent of all TBI cases;
  • Males had a 77 percent greater risk of TBI than females;
  • Maori had 23 percent greater risk of TBI when compared with New Zealand Europeans;
  • The risk of moderate-severe TBI to the rural population was almost 2.5 times greater than it was to those living in urban areas;
  • TBIs were most often due to falls (37.7 percent), mechanical forces (21 percent), transport accidents (20.2 percent) and assaults (16.7 percent).

‘The consequences of mild TBI are not mild at all’ - Feigin

Prof Feigin says many people fail to realise when they’ve had a brain injury, and its believed 35 percent of people with acute TBI do not seek immediate medical attention,

“People need to know that if they’ve had any head injury which results in losing consciousness or being dazed and confused then they need to seek medical attention immediately,” he says.

While 95 percent of all cases were classed as ‘mild TBI’, Professor Feigin says these cases are still very serious.

“The consequences of mild TBI are not mild at all. Generally speaking, mild TBI is characterised by a relatively short loss of memory of the event of the injury or what has happened just after the injury, and/or a very minor loss of consciousness at the time of the injury.

“TBIs can and often do result in significant and long-standing deficits ranging from mild memory difficulties to dementia, seizures, depression and social disadaptation. If people with mild TBI are treated in a timely manner then many of these consequences can be avoided.”

TBI is projected to become the third largest cause of global disease burden by 2020. Already an estimated 54-60 million people worldwide sustain a TBI each year, with some 2.2-3.6 million incurring moderate or severe TBI. Previous studies have estimated the cost of TBI to the New Zealand health system to be around $100 million per year, but that figure is now expected to rise.

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