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.
Key Words
List of Abbreviations:
AIS (Abbreviated Injury Scale), CI (confidence interval), CPH (Cox proportional hazard), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), SCTBIFR (South Carolina Traumatic Brain Injury Follow-up Registry), TBI (traumatic brain injury)To read this article in full you will need to make a payment
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Article info
Footnotes
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.
Identification
Copyright
© 2009 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
