Hospitalised and Fatal Head Injuries in Viti Levu, Fiji: Findings from an Island-Wide Trauma Registry (TRIP 4)

Abstract

Background: Globally, head injury is a substantial cause of mortality and morbidity. A disproportionately greater burden is borne by low- and middle-income countries. The incidence and characteristics of fatal and hospitalised head injuries in Fiji are unknown. Methods: Using prospective data from the Fiji Injury Surveillance in Hospital system, the epidemiology of fatal and hospitalised head injuries was investigated (2004–2005). Results: In total, 226 hospital admissions and 50 fatalities (66% died prior to admission) with a principal diagnosis of head injury were identified (crude annual rates of 34.7 and 7.7/100,000, respectively). Males were more likely to die and be hospitalised as a result of head injury than females. The highest fatality rate was among those in the 30–44-year age group. Road traffic crashes were the leading causes of injuries resulting in death (70%), followed by ‘hit by person or object’ and falls (14% each). Among people admitted to hospital, road traffic crashes (34.5%) and falls (33.2%) were the leading causes of injury. The leading cause of head injuries in children was falls, in 15–29-year-olds road traffic crashes, and in adults aged 30–44 years or 45 years and older ‘hit by person or object’. Among the two major ethnic groups, Fijians had higher rates of falls and ‘hit by person or object’ and Indians higher rates for road traffic crashes. There were no statistically significant differences between the overall rates of head injuries or the fatal and non-fatal rates among Fijians or Indians by gender following age standardisation to the total Fijian national population. Conclusion: Despite underestimating the overall burden, this study identified head injury to be a major cause of death and hospitalisation in Fiji. The predominance of males and road traffic-related injuries is consistent with studies on head injuries conducted in other low- and middle-income countries. The high fatality rate among those aged 30–44 years in this study has not been noted previously. The high case fatality rate prior to admission to the hospital requires urgent attention.

Severe traumatic brain injuries from motor vehicle‐related events in New Caledonia: epidemiology, outcome and public health consequences

“…The most severe and extensive injuries were reported in motorcyclists (ISS=60 [36-68]; p=0.03) ( Table 3). Overall, the mean length of time on ventilation was 11 [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] days and the mean length of stay in hospital was 24 [13-54] days. No difference in length of time ventilated and length of stay in hospital was observed between the five groups of collision mechanism.…”

“…Surprisingly, we found a low fatality case rate among children, who should also be considered as a vulnerable group. 8 Once again, mechanism of crash and age group of victims in pre-hospital death would have been useful to better appreciate the paediatric burden of RTC in New Caledonia.…”

“…Regular road safety campaigns have been run over the past decade based on cultural issues, including local psychoactive drugs consumption. To the best of our knowledge, available data on TBI as a consequence of RTC is limited in New Caledonia 8 . The objective of this article is to describe the incidence and outcome of severe TBI caused by RTC in different types of road users in New Caledonia and to discuss the public health impact of such findings.…”

Injury characteristics in women in relation to their menopausal status

“…The frequencies of particular causes of injuries reported in the literature vary widely. In the general population of women and men, traffic accidents are responsible for from 7.5% to about 70% of all injuries [12][13][14]. Differences in the incidence of various types of injuries with regard to gender [13][14][15][16] were also reported.…”

“…In the general population of women and men, traffic accidents are responsible for from 7.5% to about 70% of all injuries [12][13][14]. Differences in the incidence of various types of injuries with regard to gender [13][14][15][16] were also reported. Lima et al highlight the high proportion of syncope in the pathogenesis of injury in women aged 70-74, as well as studies conducted among patients of more than 70 years of age, which showed a significant percentage of injuries due to falls on the same level [17].…”