4.3 Article

Prevalence of Medical and Psychiatric Comorbidities Following Traumatic Brain Injury

Journal

JOURNAL OF HEAD TRAUMA REHABILITATION
Volume 34, Issue 4, Pages E1-E10

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/HTR.0000000000000465

Keywords

comorbidities; medical conditions; outcomes; prevalence; rehabilitation; traumatic brain injury

Funding

  1. National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR): Indiana University School of Medicine/Rehabilitation Hospital of Indiana [90DP0036]
  2. Icahn School of Medicine at Mount Sinai [90DP0038]
  3. Rocky Mountain Regional Brain Injury System [90DP0034]
  4. Ohio State University [90DP0040]
  5. University of Alabama at Birmingham [90DP0044]
  6. Traumatic Brain Injury Model Systems National Data and Statistical Center [90DP0013, 90DP0084]
  7. Moss TBI Model System [90DP0037]
  8. North Texas TBI Model System [90DP0045]
  9. National Institutes of Health National Center for Medical Rehabilitation Research (NICHD) [K01HD074651]
  10. EUNICE KENNEDY SHRIVER NATIONAL INSTITUTE OF CHILD HEALTH & HUMAN DEVELOPMENT [K01HD074651] Funding Source: NIH RePORTER

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Objective: To examine the prevalence of selected medical and psychiatric comorbidities that existed prior to or up to 10 years following traumatic brain injury (TBI) requiring acute rehabilitation. Design: Retrospective cohort. Setting: Six TBI Model Systems (TBIMS) centers. Participants: In total, 404 participants in the TBIMS National Database who experienced TBI 10 years prior. Interventions: Not applicable. Main Outcome Measure: Self-reported medical and psychiatric comorbidities and the onset time of each endorsed comorbidity. Results: At 10 years postinjury, the most common comorbidities developing postinjury, in order, were back pain, depression, hypertension, anxiety, fractures, high blood cholesterol, sleep disorders, panic attacks, osteoarthritis, and diabetes. Comparing those 50 years and older to those younger than 50 years, diabetes (odds ratio [OR] = 3.54; P = .0016), high blood cholesterol (OR = 2.04; P = .0092), osteoarthritis (OR = 2.02; P = .0454), and hypertension (OR = 1.84; P = .0175) were significantly more prevalent in the older cohort while panic attacks (OR = 0.33; P = .0022) were significantly more prevalent in the younger cohort. No significant differences in prevalence rates between the older and younger cohorts were found for back pain, depression, anxiety, fractures, or sleep disorders. Conclusions: People with moderate-severe TBI experience other medical and mental health comorbidities during the long-term course of recovery and life after injury. The findings can inform further investigation into comorbidities associated with TBI and the role of medical care, surveillance, prevention, lifestyle, and healthy behaviors in potentially modifying their presence and/or prevalence over the life span.

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