The research team tracked over 2,000 people living in or around Glasgow.  757 had sustained a head injury that required admission to one of five hospitals in Glasgow between 1995 and 1996.  The rest of the group were split between those who had been admitted to hospital for other reasons, excluding any head trauma, but over the same period and healthy people living in the community. The three groups were matched for age, gender and levels of deprivation.

In all, 40% of people (305) who had sustained a head injury were dead within 13 years of the event. This was higher than the rate among those admitted with other injuries (28%) and those in the community, almost one in five of whom died (19%).   The findings showed that the greatest risk of death was highest in the first year after injury but that the risk persisted for at least a further 12 years.  During this period the head-injured were almost three times more likely to die of circulatory, respiratory, digestive, psychiatric and external causes, than those living injury free in the community. 

The study also showed that those who had sustained other injuries were also more likely to die of these causes, but the risk was not as high. Therefore the mere fact that someone was injured and need hospital treatment effected their long term survival prospects, although the risk was much more significant if their injury happened to be a head injury. The annual rate of death from all causes among the head-injured was almost 31 per 1,000 people compared with just under 14 per 1,000 for those living in the community.

As might be expected, those with more serious injuries were more likely to die than those with mild injuries during the critical first year. But those with mild head injury were also twice as likely to die, during the same period as their community counter parts.

What was more worrying was that more than a year after the initial injury it was the young and middle aged head injured individuals who were far more likely to die than those who were older and in the non injured community test group. Deaths among those aged 15 to 54 with a head injury were more than six times higher than those without a head injury.   The findings showed that this applied irrespective of factors, such as gender and level of deprivation, which you think would be influential. 

The researchers found that lifestyle factors before the injury, such as excessive alcohol intake,  living alone or the person having a history of mental health problems did affect survival. However, these factors were also present amongst the other two test groups.  There are no clear explanations for the higher death rates among the young and middle aged, say the authors.

"The reason for greater vulnerability in younger adults is unclear, but requires further consideration, especially given the particularly higher risk of head injury in younger adults," the researchers say.

This is a very interesting study.  It may suggest that we need to provide more community support to the young and middle aged victims of head injuries to ensure their greatest chance of survival.  Does this age group slip through the net of community support and care? Are the older group captured by more general elderly community services which might not be specific head injury services but which ensure the individuals are cared for and monitored closely?   May it also be that as a society we spend more time and money looking after the elderly and leave the younger sections of society to fend for themselves? 

As someone who works with head injured victims I have seen first hand how people can fall into depression, turn to alcohol and recreational drugs when they are not able to work, are having financial difficulties and their home and family life has been disrupted by their injury.  Initial treatment following the injury is usually excellent unfortunately it is the next stage of rehabilitation and life adjustment that is not always catered for properly.  Services across the UK are patchy. We know that head injured victims in Southampton are being treated on an inadequate ward because the specialist unit was closed months ago because of staff shortages and does not appear likely to reopen any time soon.

It is for these reasons that Brain Injury Awareness week is so important. It's aim is to raise awareness of those suffering head and brain injury.  Awareness week is 9 - 15th May.



Claire Howard

Partner - Personal Injury team