Prevalence of comorbidities post mild traumatic brain injuries: a traumatic brain injury model systems study

Abstract

Traumatic brain injury (TBI) is associated with an increased risk of long-lasting health-related complications. Survivors of brain trauma often experience comorbidities which could further dampen functional recovery and severely interfere with their day-to-day functioning after injury. Of the three TBI severity types, mild TBI constitutes a significant proportion of total TBI cases, yet a comprehensive study on medical and psychiatric complications experienced by mild TBI subjects at a particular time point is missing in the field. In this study, we aim to quantify the prevalence of psychiatric and medical comorbidities post mild TBI and understand how these comorbidities are influenced by demographic factors (age, and sex) through secondary analysis of patient data from the TBI Model Systems (TBIMS) national database. Utilizing self-reported information from National Health and Nutrition Examination Survey (NHANES), we have performed this analysis on subjects who received inpatient rehabilitation at 5 years post mild TBI. Our analysis revealed that psychiatric comorbidities (anxiety, depression, and post-traumatic stress disorder (PTSD)), chronic pain, and cardiovascular comorbidities were common among survivors with mild TBI. Furthermore, depression exhibits an increased prevalence in the younger compared to an older cohort of subjects whereas the prevalence of rheumatologic, ophthalmological, and cardiovascular comorbidities was higher in the older cohort. Lastly, female survivors of mild TBI demonstrated increased odds of developing PTSD compared to male subjects. The findings of this study would motivate additional analysis and research in the field and could have broader implications for the management of comorbidities after mild TBI.

Review of the Brain’s Behaviour after Injury and Disease for Its Application in an Agent-Based Model (ABM)

“…Such a process hinders healing but also entails potential long-term effects [ 111 , 112 , 113 ] such as chronic traumatic encephalopathy (CTE) in the case of recurrent mild TBI, common in sportsmen. In fact, up to 90% of athletes in the US [ 114 ] may experience memory and attention impairments, suicidal behaviour, or even cardiovascular complications [ 115 , 116 ].…”

“…Such a process hinders healing but also entails potential long-term effects [111][112][113] such as chronic traumatic encephalopathy (CTE) in the case of recurrent mild TBI, common in sportsmen. In fact, up to 90% of athletes in the US [114] may experience memory and attention impairments, suicidal behaviour, or even cardiovascular complications [115,116]. TBI usually produces three major effects: acute subdural haematoma-associated with traumatic cerebrovascular injury (TCVI) in a limited number of cases (less than 2% [116])brain contusion, and diffuse axonal injury [117].…”

Traumatic brain injury and risk of heart failure and coronary heart disease: A nationwide population-based cohort study

“…TBI can be classified into mild, moderate, and severe injury types based on patient scores reported using the GCS [29]. Mild traumatic brain injuries can result from concussions during sports activities, falls in elderly subjects, and battlefield injuries; while moderate to severe TBI are responsible for the majority of death and disability [29]. The incidence of mild TBI has been reported to be higher than that of moderate to severe TBI [30].…”

Review of the Brain Behaviour after Injury and Disease for Its Application in an Agent Based Model (ABM)

“…It is relatively common in any physically intensive activity (sports, military practice), acts of violence or accidents (traffic, falls), and can cause some of the aforementioned physical or behavioural symptoms, normally immediately after injury (peaking within the first 24h, during which the brain undergoes gliosis -scar-like multiplication and/or growth of glial cells [91], hindering healing) but entailing potential long-term effects [92][93][94] such as Chronic Traumatic Encephalopathy (CTE) in the case of recurrent milt TBI, typical in sportsmen (up to 90% of athletes in the US [95]) who may experience memory and attention impairments, suicidal behaviour or even cardiovascular complications [96,97].…”