Every four minutes an Australian is hospitalised with a head injury, with cases rising nearly 7% after dropping during Covid-19 lockdowns and disproportionately affecting the most vulnerable Australians, new data shows.
A report from the Australian Institute of Health and Welfare (AIHW) published on Thursday has found that in 2020-21 head injuries accounted for more than one in five of all injury emergency department presentations.
It found head injuries were also responsible for one in five injury hospitalisations and 17% of all injury deaths.
The report also found the rate of head injury hospitalisations has increased over the past decade by an average of 1.4% each year between 2017–18 and 2020–21. After a decline in 2019–20 likely due to the impacts of Covid–19, the rates in 2020–21 increased by 6.7%.
Prof Rebecca Ivers, the head of population health at the University of New South Wales, said the report carried important findings that the most vulnerable Australians were at the greatest risk of head injury. This included babies, the elderly, victims of domestic violence, First Nations people, those of lower socio-economic status and those living in rural and remote locations.
The report found head injury hospitalisations are generally more severe compared with all injury hospitalisations. It found 92% of head injury hospitalisations had an emergency admission, an average of nearly four days spent in hospital and 10 in-hospital deaths for every 1,000 people.
Falls were the leading cause, accounting for more than half of head injury hospitalisations (57%) and deaths (67%).
The report found youngest and oldest age groups were most at risk. Head injuries contributed to about half of all injury emergency department presentations and hospitalisations for 0-4 year olds, while those aged 65 and over made up almost three-quarters of all head injury deaths (73%).
Transport was the second leading cause of head injury hospitalisations (14%) and deaths (12%). This included injured car occupants, motorcyclists, cyclists and pedestrians.
Dr Heather Swanston, an AIHW spokesperson, said transport was the leading cause of head injury-related deaths in ages 0-14 (64%) and 15-24 (59%). Ivers said children were susceptible to falls and transport because they often fell off change tables and bunk beds and werevulnerable in transport crashes if they were not appropriately restrained with correctly fitted car seats.
The consequences of these injuries were especially concerningbecause “if you have a child disabled through a head injury, the impact is lifelong and very costly to family and community”.
The increase in transport injuries was also highly concerning, Ivers said. “Post-Covid, people have gotten out in their cars and forgotten how to behave driving.”
She said as cities get bigger, there was a need to get fewer people driving and more riding bikes, but there was a problem with the lack of protective infrastructure.
Assault was the third-highest cause of head injury hospitalisations, accounting for 11% , while suicide was the third leading cause of deaths from head injuries, accounting for 9% of the 2,400 deaths.
The report found women were over nine times more likely to have been assaulted by their spouse or domestic partner compared with the rate for males with a head injury hospitalisation due to assault.
Overall, males made up two in three head injury emergency department presentations and deaths and 55% of head injury hospitalisations.
The report also revealed 24% of all concussive hospitalisations were caused by sport. Cycling was associated with the greatest number of sports-related head injury hospitalisations (9,774 cases), followed by equestrian activities (2,584), recreational walking (2,187) and surfing (1,138).
Head and neck injuries are the most common injury hospitalisation, accounting for more than 22% of cases, followed by hip and leg injuries making up 20% of cases, shoulder and arm 17%, wrist and hand 15%, trunk 12% and finally ankle and foot 5%, according to the AIHW Injury in Australia report.
