Background and Aim The Transport Accident Commission commissioned this study to identify and describe the characteristics of high-priority road traffic injuries as a basis to discuss options to prevent them for Victoria.

Methods Data consisted of injury claims from 2015–2019 (n=27,164), expressed in injury outcome measures including:

• Maximum Abbreviated Injury Score (MAIS 1–6)

• Years Lived with Disability (YLD)

• Permanent Medical Impairment (PMI)

• Life Cost (LC).

The International Classification of Diseases (ICD-code) together with the highest overall severity level and the location of the most severely injured body region per person were used to investigate the type of injuries associated with high LC and YLD.

Results In total, there were 881 ICD-codes in the dataset. The injury burden was highly disproportionately distributed, with only 5 codes (0.5%) and 15 codes (1.7%) making up 25% and 50% of LC, respectively. 4 of the 5 codes associated with the highest LC were severe head and brain injuries. In addition:

• One third of LC were Severe Acquired Brain Injuries

• Quadriplegias had the highest mean LC and highest mean YLD

• Other Spinal injuries had the highest sum of YLD

• MAIS 3+ made up 16% of claims, almost 60% of the total LC and 74% of the total YLD.

The risk of high priority injury outcomes was higher for unprotected road users, occupants in older cars and not using protective equipment.

Conclusion MAIS 4+ head and spine injuries are the highest priority injuries to prevent, followed by all MAIS 3+ injuries, especially head and brain injuries.