INJURIES TO THE HEAD, SPINE AND PERIPHERAL NERVES; EPIDEMIOLOGY OF NEUROTRAUMA IN NEW SOUTH WALES, SOUTH AUSTRALIA AND THE AUSTRALIAN CAPITAL TERRITORY 1977. REPORT ON A STUDY

Abstract

The present report is a comprehensive study of statistical data on mortality, morbidity and costs to the community of the effects of cranio-cerebral, spinal and peripheral nerve injury from all causes in New South Wales in 1977. This epidemiological overview of neurotrauma is designed to serve as a detailed reference book for planning of various aspects of, and improvements in, our preventive and first aid services; for monitoring trends and changes occurring over the years; for planning and distribution of manpower and facilities; and for improvement of patient care and cost efficiency. An important though not unexpected finding of this study is that road accidents are the dominant cause of neurotauma, leading to two-thirds of the mortality and probably in excess of one half of the permanent disability. The consequent recommendations stemming from this fall into two categories: prevention and initial care. Considering that human error is responsible for the majority of accidents and that almost half the drivers dying from neurotrauma sustained in road accidents had high blood alcohol levels, appropriate preventive measures might have considerably reduced the road toll in 1977. The mortality survey revealed that two-thirds of all neurotrauma victims were dead before they were admitted to hospital. This draws immediate attention to our organisation of first aid at the accident site and two separate aspects of quality of care: quality of care at hospital and first aid, emergency and transport services. The study was initiated and sponsored by the Neurosurgical Society of Australasia, conducted by its Trauma Subcommittee, in collaboration wth the Division of Health Services Research, Health Commission of New South Wales.