Incidence of traumatic brain injury in New Zealand: a population-based study
Abstract
Background Traumatic brain injury (TBI) is the leading cause of long-term disability in children and young adults worldwide. However, accurate information about its incidence does not exist. We aimed to estimate the burden of TBI in rural and urban populations in New Zealand across all ages and TBI severities.Methods We did a population-based incidence study in an urban (Hamilton) and rural (Waikato District) population in New Zealand. We registered all cases of TBI (admitted to hospital or not, fatal or non-fatal) that occurred in the population between March 1, 2010, and Feb 28, 2011, using multiple overlapping sources of information. We calculated incidence per 100,000 person-years with 95% CIs using a Poisson distribution. We calculated rate ratios [RRs] to compare the age-standardised rates between sex, ethnicity, and residency (urban, rural) groups. We used direct standardisation to age-standardise the rates to the world population.Results The total incidence of TBI per 100,000 person-years was 790 cases (95% CI 749-832); incidence per 100,000 person-years of mild TBI was 749 cases (709-790) and of moderate to severe TBI was 41 cases (31-51). Children (aged 0-14 years) and adolescents and young adults (aged 15-34 years) constituted almost 70% of all TBI cases. TBI affected boys and men more than women and girls (RR 1·77, 95% CI 1·58-1·97). Most TBI cases were due to falls (38% [516 of 1369]), mechanical forces (21% [288 of 1369]), transport accidents (20% [277 of 1369]), and assaults (17% [228 of 1369]). Compared with people of European origin, Maori people had a greater risk of mild TBI (RR 1·23, 95% CI 1·08-1·39). Incidence of moderate to severe TBI in the rural population (73 per 100,000 person-years [95% CI 50-107) was almost 2·5 times greater than in the urban population (31 per 100 000 person-years [23-42]).Interpretation Our findings suggest that the incidence of TBI, especially mild TBI, in New Zealand is far greater than would be estimated from the findings of previous studies done in other high-income countries. Our age-specific and residency-specific data for TBI incidence overall and by mechanism of injury should be considered when planning prevention and TBI care services.Funding Health Research Council of New Zealand.
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Participants in both treatment groups were more likely to be female, middle-aged, and of European ethnicity, which does not represent the most common characteristics of individuals who experience mTBI in New Zealand.
“Participants in both treatment groups were also more likely to be female, middle age and of European ethnicity; however, this does not represent the most common characteristics of individuals who experience mTBI in NZ.92”
From Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study (2025) · cites this paper as [92]
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- Authors
- Feigin, V. L., Theadom, A., Barker-Collo, S., Starkey, N. J., McPherson, K., Kahan, M., Dowell, A., Brown, P., Parag, V., Kydd, R., Jones, K., Jones, A., & Ameratunga, S.
- Affiliations
- Auckland University of Technology (NZ)
- University of Auckland (NZ)
- University of Waikato (NZ)
- University of Otago (NZ)
- University of California System (US)
- Corresponding author
- Feigin, Valery L
- ORCID
- Venue
- The Lancet Neurology
- Publisher
- Elsevier BV
- Published
- 2013-01
- Volume
- 12
- Issue
- 1
- Pages
- 53-64
- ISSN
- 1474-4422 (ISSN-L)
- OpenAlex
- W2161340781
- Cited by
- 729
- References
- 56
- Citations by year
- 2026: 32 · 2025: 41 · 2024: 70 · 2023: 55 · 2022: 52 · 2021: 63 · 2020: 55 · 2019: 56 · 2018: 60 · 2017: 60 · 2016: 41 · 2015: 58 · 2014: 58 · 2013: 23 · 2012: 4
- FWCI
- 34.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet Neurology (publishedVersion)
- PubMed (publishedVersion)
- Research Commons (University of Waikato) (submittedVersion)
- Funders
- Accident Compensation Corporation
- Health Research Council of New Zealand
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Keywords
- traumatic brain injury, incidence, mild traumatic brain injury, moderate to severe traumatic brain injury, urban-rural differences, falls, transport accidents, assault, sex differences, ethnicity, Māori, children and adolescents, New Zealand, injury burden, injury surveillance, hospitalization, mortality
- MeSH terms
- Adolescent, Adult, Brain Injuries, Female, Humans, Male, Middle Aged, New Zealand, Population Surveillance, Risk Factors, Incidence, Young Adult
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