Increased risk of death for people with traumatic brain injury

Australians admitted to hospital with traumatic brain injury seven times more likely to die within a year

Traumatic brain injury (TBI), known as the silent epidemic, is the leading cause of death and disability worldwide

• Australian-first research points to stark conclusions: Results from one of the largest studies in the world on TBI from Macquarie University found that patients were 7.5 times more likely to die in the first 12 months after hospitalisation.
• Research triggers calls for greater TBI awareness and improved continuation of care: The silent epidemic is responsible for more than 10 million deaths worldwide.
• A huge burden for society and families: Studies estimates the lifetime cost of new cases of brain injury that occurred in 2008 alone was $8.6 billion in Australia.

5 November 2018: Today, one of the largest Australian studies ever conducted on traumatic brain injury (TBI) by researchers at Macquarie University and published in prestigious Journal of Head Trauma Rehabilitation, is being presented at the World Safety Conference in Thailand, to highlight the need to be aware of the severity of the ‘silent epidemic.’

The elevated risk of death associated with TBI, particularly in severe cases, is not well documented but researchers believe that it could be linked to a number of factors, including complications of medical care, mental health impacts which may result in self-harm, or the fact that advanced medical care is keeping people alive in the initial stages of injury.

Lead researcher and Postdoctoral Research Fellow at the Australian Institute of Health Innovation at Macquarie University, Dr. Reidar Lystad, said that educating the groups most affected is a good place to start.

“We simply can’t afford to do nothing. TBI is devastatingly linked to a shopping list of maladies and now off the back of this research, overwhelmingly to death," Dr. Lystad said.

For our very young and old, we must protect them as best we can, and for everyone in between, we need more education to get everyone to protect their brain.

While most TBI deaths occur within the first few weeks of sustaining a TBI, the risk of death remains elevated during the 12 months post-injury.

The call from researchers is that preventing falls, which account for 80% of TBI’s in adult, is of paramount importance. The researchers also believe there is scope to broaden continuation of care provided to patients leaving hospital after a TBI, to mitigate some of the risk factors involved with the injury in the 12 months that follow.

The research looked at almost 7,000 Aussie adults hospitalised for TBI and compared them each with an Aussie adult of similar demographics who has not experienced TBI to understand if there was a difference in lifespan in the 12 months following the date of the injury.

They found that a person hospitalised for TBI is 7.5 times more likely to die during the 12 months following their injury than a non-injured person of similar demographics. Additionally, of the people hospitalised for the condition who died within 12 months, 87 per cent of these deaths were attributable to the brain injury and not to any other ailment.

To-date there has been no such study exploring excess mortality after TBI in the Australian population.

Dr. Lystad notes that it’s even more critical to prevent these injuries.

“Our research points to the dramatic difference in quality and length of life that those who experience a traumatic brain injury experience versus those who do not. We hope our work helps to shine a light on the impact of brain injuries – even those that seem minor – to prevent them before they happen,” Dr Lystad said.

The societal impacts of not addressing TBI, the leading cause of death and disability worldwide, are enormous.

Access Economics estimates the lifetime cost of new cases of brain injury that occurred in 2008 alone was $8.6 billion in Australia and the average hospital treatment cost during the first 12 months after moderate to severe TBI is estimated to be in excess of $40,000 per patient.

The research also found marked differences in who in our society is most susceptible to TBI. Men are twice as likely to sustain a TBI compared to women; commonly attributed to a greater tendency to engage in high risk behaviour or being under the influence of substances. A second peak occurs in the elderly, commonly due to accidents involving falls. People with alcohol and drug-related problems are at greater risk as well as those of lower socio-economic status.

Traumatic brain injury is also linked to losses in attention span, working memory, processing speed, learning, memory and executive functions as well as increased occurrences of fatigue, headache, dizziness, tinnitus, concentration and memory problems, sensitivity to noise or light, sleep disturbances, irritability, mental slowing and emotional liability.

For further information, please contact:

Dr Reidar Lystad

Centres related to this research:

Centre for Healthcare Resilience and Implementation Science