Characteristics of trauma mortality in the Northern Territory, Australia

Kathleen M Mcdermott,Linda Ward,Steven M Hudson,David J Read,Matt B Brearley

doi:10.1186/s40621-017-0111-1

Abstract

BackgroundWhile factors including remoteness, alcohol consumption, age and Indigenous ethnicity are well-documented associations of trauma mortality, less is known of trauma seasonality. This is particularly relevant to Australia’s Northern Territory, with its tropical regions experiencing a climate of wet (hot and humid) and dry (warm) seasons annually. The aim of this study was to therefore, examine the characteristics of trauma mortality in the Top End, Northern Territory, Australia.MethodsA retrospective review of the National Coroners Information System (NCIS) database from 1 January 2003 to 31 December 2007 analysed four-hundred and sixteen traumatic deaths where the trauma event and death occurred within the Top End of the Northern Territory.ResultsThe annual traumatic death rate for the Top End was 58.7 per 100 000, with variance between regions (accessible 38.1; remote 119.1 per 100000, respectively). Overall alcohol was involved in 56.5% of cases. The three most frequent mechanisms of death were suicide, transport related and assault, accounting for 81.5% of deaths. These respective mechanisms of death demonstrated seasonal influence, with transport related deaths 2.5 times more likely to occur in the dry than the wet season (p < 0.001), while assault related deaths were 3.3 times more likely to occur during the wet season (p = 0.005), and suicide was 1.6 times more likely to occur during the wet season (p = 0.022). Transport related deaths were 2.2 times more likely in remote and very remote settings than in accessible or moderately accessible regions (p < 0.003), whereas death by suicide was less likely to occur in remote and very remote regions than in accessible or moderately accessible areas (p = 0.012).ConclusionExcessively high rates of traumatic death in the Top End of the Northern Territory were evident, with contrasting seasonal and regional profiles. Based upon the data of this investigation, existing programmes to minimise trauma in the Northern Territory ought to be evaluated for seasonal and regional specificity.

Highlights

While factors including remoteness, alcohol consumption, age and Indigenous ethnicity are welldocumented associations of trauma mortality, less is known of trauma seasonality
It is well established that injury mortality increases with remoteness from major cities (Danne 2003; Fatovich and Jacobs 2009; Mitchell and Chong 2010), is the second highest cause of death for Indigenous people (Australian Institute of Health and Welfare (AIHW) 2007) and that alcohol consumption is correlated to injury mortality (Demetriades et al 2004)
Indigenous ethnicity and alcohol involvement into account, suicide was 1.6 times more likely to occur during the wet season (p = 0.022) (Table 2)

Summary

Introduction

Alcohol consumption, age and Indigenous ethnicity are welldocumented associations of trauma mortality, less is known of trauma seasonality. It is well established that injury mortality increases with remoteness from major cities (Danne 2003; Fatovich and Jacobs 2009; Mitchell and Chong 2010), is the second highest cause of death for Indigenous people (Australian Institute of Health and Welfare (AIHW) 2007) and that alcohol consumption is correlated to injury mortality (Demetriades et al 2004) These factors are relevant to the Northern Territory (NT), Australia, where mean alcohol consumption equates to 14 L per McDermott et al Injury Epidemiology (2017) 4:15 approximately 500 000 square kilometres (Gowing et al 2015) including the capital city of Darwin, the Katherine region to the south and Arnhem region to the east producing a very low population density (Australian Bureau of Statistics 2013). The dry season (April – September) is known for warm sunny days with low humidity and cool nights, providing ideal conditions for outdoor activities and is peak tourism season with a tourist population approaching half a million annually (Tourism NT: Quickstats report 2016)

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