The incidence and cost of SCI resulting from road crashes in Victoria, Australia

Background: Road crashes represent a leading cause of traumatic spinal cord injury (tSCI) in highly motorised countries. However, despite advances in road safety knowledge, tSCI continues to occur. The aim is to understand the incidence and sub-types of tSCI among different road user types, the types of crashes in which SCI occurs, and to document the cost of providing lifetime care for a no-fault government insurer. Method: Retrospective analysis of the 2000-2015 Victorian Transport Accident Commission (TAC) compensation claims data (Australia). The dataset contains details of 23,289 persons injured in road crashes and hospitalised, and includes compensation data linked to Police and Hospital data (ICD 9 codes). Lifetime care costs were determined by actuaries. Results: 266 road users sustained a tSCI (69% male, age: 39 yrs; 31% female, age: 45 yrs), with drivers representing (45%), followed by passengers, motorcyclists (23%), pedestrians (7.9%), and cyclists (7.1%). Relative to all hospitalisations, the incidence of tSCI was 1.06%, 0.83%, 3.06%, 0.64% and 1.60% for these road user groups respectively. The total lifetime care cost was estimated to be $AU 427.25 million (mean: $AU 1.67 million). Differences were evident in tSCI across road user type, with 5.5% overall sustaining a C1C4 complete injury, 7.5% sustaining a C1-C4 central cord tSCI, and 9.4% with T1-T6 complete SCI. Run-offroad high speed impacts were common. Discussion: Identifying crash types and the cost of tSCI is important to ensure appropriate prioritisation of road safety measures. In discussing this, recommendations for future data capture are made.