Gerard M O'Reilly MBBS, FACEM, MPH, MBiostat, AStat, PhD, Afsana Afroz PhD, Kate Curtis RN, PhD, Grad Dip Crit Care Nurs, MNurs(Hons), FCENA, Biswadev Mitra MBBS, MHSM, PhD, FACEM, Yesul Kim BA, Grad Dip Psychol, PhD, Emma Solly PhD, Courtney Ryder BScBEng(Biomed)(Hons), PhD, Kate Hunter BAppSc(Nursing), GradDipEd(Nurse Education), MPH, PhD, Delia V Hendrie BSc, BA, MA, PhD, Nick Rushworth BA(Hons), MA, AMusA, Jin Tee BMSC, MBBS, MD, FRACS, Mark C Fitzgerald MBBS, MD(Research), GradCertInet, FACEM, AFRACMA
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Participants: People who died during the five-year study period between 2015 and 2020 and were recorded in the NCIS as having intracranial injury as a cause or contributor to death. Major outcome measures: The primary outcome was the location of death, specifically whether death occurred outside an acute hospital setting.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>There were 3751 deaths with msTBI, of which 1064 (28.4%) occurred outside of an acute hospital setting and 605 (16.1%) occurred outside any medical service. The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in the Northern Territory followed by Queensland. The odds of death occurring outside <i>any</i> medical service area (e.g. hospital, rehabilitation, nursing home) were higher for: younger adults (OR 3.6, 95% CI: 1.0–12.7), those with penetrating injuries (OR 8.9, 95% CI: 4.5–17.3), and where the time between injury and death was less than 24 h. The odds of death outside any medical service area were less for people with msTBI in South Australia (OR 0.1, 95% CI 0.0–0.2).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Approximately, one in six msTBI deaths occurred outside of any medical service area. Opportunities exist to improve access to emergency care for people sustaining msTBI across Australia.</p>\n </section>\n </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70051","citationCount":"0","resultStr":"{\"title\":\"The incidence and determinants of traumatic brain injury deaths occurring outside hospital in Australia\",\"authors\":\"Gerard M O'Reilly MBBS, FACEM, MPH, MBiostat, AStat, PhD, Afsana Afroz PhD, Kate Curtis RN, PhD, Grad Dip Crit Care Nurs, MNurs(Hons), FCENA, Biswadev Mitra MBBS, MHSM, PhD, FACEM, Yesul Kim BA, Grad Dip Psychol, PhD, Emma Solly PhD, Courtney Ryder BScBEng(Biomed)(Hons), PhD, Kate Hunter BAppSc(Nursing), GradDipEd(Nurse Education), MPH, PhD, Delia V Hendrie BSc, BA, MA, PhD, Nick Rushworth BA(Hons), MA, AMusA, Jin Tee BMSC, MBBS, MD, FRACS, Mark C Fitzgerald MBBS, MD(Research), GradCertInet, FACEM, AFRACMA\",\"doi\":\"10.1111/1742-6723.70051\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To identify the determinants of death occurring outside of hospital following moderate to severe traumatic brain injury (msTBI) across Australia.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Design, setting: Retrospective observational study using National Coronial Information System (NCIS) data. Participants: People who died during the five-year study period between 2015 and 2020 and were recorded in the NCIS as having intracranial injury as a cause or contributor to death. Major outcome measures: The primary outcome was the location of death, specifically whether death occurred outside an acute hospital setting.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>There were 3751 deaths with msTBI, of which 1064 (28.4%) occurred outside of an acute hospital setting and 605 (16.1%) occurred outside any medical service. The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in the Northern Territory followed by Queensland. 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The incidence and determinants of traumatic brain injury deaths occurring outside hospital in Australia
Objective
To identify the determinants of death occurring outside of hospital following moderate to severe traumatic brain injury (msTBI) across Australia.
Methods
Design, setting: Retrospective observational study using National Coronial Information System (NCIS) data. Participants: People who died during the five-year study period between 2015 and 2020 and were recorded in the NCIS as having intracranial injury as a cause or contributor to death. Major outcome measures: The primary outcome was the location of death, specifically whether death occurred outside an acute hospital setting.
Results
There were 3751 deaths with msTBI, of which 1064 (28.4%) occurred outside of an acute hospital setting and 605 (16.1%) occurred outside any medical service. The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in the Northern Territory followed by Queensland. The odds of death occurring outside any medical service area (e.g. hospital, rehabilitation, nursing home) were higher for: younger adults (OR 3.6, 95% CI: 1.0–12.7), those with penetrating injuries (OR 8.9, 95% CI: 4.5–17.3), and where the time between injury and death was less than 24 h. The odds of death outside any medical service area were less for people with msTBI in South Australia (OR 0.1, 95% CI 0.0–0.2).
Conclusion
Approximately, one in six msTBI deaths occurred outside of any medical service area. Opportunities exist to improve access to emergency care for people sustaining msTBI across Australia.
期刊介绍:
Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine.
Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.