Pre-existing Health Conditions and Repeat Traumatic Brain Injury
Abstract
Saunders LL, Selassie AW, Hill EG, Horner MD, Nicholas JS, Lackland DT, Corrigan JD. Pre-existing health conditions and repeat traumatic brain injury.
Objective
To assess and compare the effect of Pre-existing epilepsy/seizure disorder and drug/alcohol problem on the hazard of repeat traumatic brain injury (TBI) in persons with TBI who participated in a follow-up study.
Design
Retrospective cohort.
Setting
Acute care hospitals in South Carolina.
Participants
Participants were from the South Carolina Traumatic Brain Injury Follow-up Registry cohort of persons (N=2118) who were discharged from an acute care hospital in South Carolina and who participated in a year-1 follow-up interview.
Interventions
Not applicable.
Main Outcome Measures
Repeat TBI was defined by 2 isolated events of TBI in the same person at least 72 hours apart and recorded in hospital discharge or emergency department records from 1999 through 2005.
Results
A Cox proportional hazards model was used to assess the associations of Pre-existing epilepsy/seizure disorder and drug/alcohol problem with time to repeat TBI, controlling for other confounding factors. There were 2099 persons with information on both Pre-existing conditions. There were 147 (7%) persons who sustained repeat TBI after recruitment to the follow-up study, and 82 (3.9%) had a previous TBI before recruitment for which they were seen in the hospital discharge or emergency department since 1996. The hazard of repeat TBI for persons with Pre-existing epilepsy/seizure disorder was 2.3 times the hazard for those without (hazard ratio, 2.3; 95% confidence interval, 1.2–4.4; P=.011). Pre-existing drug/alcohol problem was not associated with repeat TBI. Other variables significantly associated with repeat TBI were having a prior TBI, being insured under Medicaid, and having no insurance.
Conclusions
Pre-existing epilepsy/seizure disorder predisposes to repeat TBI. Appropriate management of seizure control may be an important strategy to allay the occurrence of repeat TBI.
aDepartment of Health Sciences and Research, Medical University of South Carolina, Charleston, SC
bDepartment of Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina, Charleston, SC
cDepartment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
dMental Health Service, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, SC
eDepartment of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH
Reprint requests to Lee L. Saunders, PhD, Dept of Rehabilitation Sciences, Medical University of South Carolina, 77 President St, Ste 117, MSC 700, Charleston, SC 29425
Supported by the Division of Injury Response (grant no. U17/CCU421926), National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention (CDC). The study was performed pursuant to a jointly financed cooperative arrangement between the NCIPC, the National Center for Chronic Disease Prevention and Health Promotion, CDC, and the Social Security Administration (SSA), Office of Disability Income and Support Programs.
The opinions and conclusions expressed are solely the authors and should not be construed as representing the opinions or policy of CDC, SSA, or any agency of the federal government.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
ABSTRACT