Risk of epilepsy after traumatic brain injury: a retrospective population-based cohort study

Yeh, Chun Chieh; Chen, Ta Liang; Hu, Chaur Jong; Chiu, Wen Ta; Liao, Chien Chang

doi:10.1136/jnnp-2012-302547

Cited by 90 publications

(85 citation statements)

References 31 publications

(25 reference statements)

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“…Fourth, information on the severity of TBI (such as Glasgow coma scale) and hyperlipidemia, which may be associated with the occurrence of depression, was unavailable. Although some studies have indicated that the severity of TBI may relate to the length of intensive care unit stay [40][41][42] or TBI classification into 2 categories based on the ICD-9-CM: mild brain injury (ICD-9-CM 850) and severe brain injury (ICD-9-CM 851-854), 43 the potential limitations of TBI severity definition were still existing. However, some studies 44,45 have indicated that the severity of TBI was not associated with emotional dysfunction in early postsurgery periods.…”

Section: J Clin Psychiatry 77:4 April 2016mentioning

confidence: 99%

Increased Risk of New-Onset Depression in Patients With Traumatic Brain Injury and Hyperlipidemia

Wee

Ho²,

Liang³

et al. 2016

J. Clin. Psychiatry

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Objective: Depression is a common complication after traumatic brain injury (TBI). This study aimed to evaluate the risk of hyperlipidemia for new-onset depression after TBI and the role of statin medications using a longitudinal population database. Method: A matched longitudinal cohort study of 3,792 subjects (1,264 TBI patients with preexisting hyperlipidemia 272.1, 272.2, 272.4] and 2,528 age-and sex-matched TBI patients without hyperlipidemia) was conducted using the Taiwan Longitudinal Health Insurance Database from January 2001 to December 2008. The incidence and hazard ratios (HRs) for the development of new-onset depression (ICD-9-CM code: 296.2X-296.3X, 300.4, and 311.X) after TBI were compared between the 2 groups. Results: The incidence rate of depression in TBI with preexisting hyperlipidemia was 136.61 per 10,000 person-years. TBI patients with preexisting hyperlipidemia had a 1.72-fold increased incidence rate ratio compared with those without hyperlipidemia (P = .0056). A Cox model showed hyperlipidemia to be an independent predictor of depression (HR = 1.61; 95% CI, 1.03-2.53). TBI patients with hyperlipidemia who were not treated with statins experienced a 1.95-fold incidence risk ratio (P = .0017) and higher risk of new-onset depression (HR = 1.61; 95% CI, 1.03-2.53) compared to TBI patients without hyperlipidemia. Conclusions: Preexisting hyperlipidemia could be an independent predictor of new-onset depression in TBI patients, and TBI patients with preexisting hyperlipidemia who were not treated with statins presented a higher risk of new-onset depression than TBI patients without hyperlipidemia. Our findings may provide some insight into the important role of statin medications in the development of new-onset depression in patients with traumatic brain injury. T raumatic brain injury (TBI) is a leading cause of neurologic deficits, cognitive impairment, and psychiatric disorders in survivors.1 It has become a major public issue for an estimated 3.17 million individuals in the United States 2 and was associated with 3.39 times the medical costs in TBI patients with psychiatric disorders compared to those without psychiatric disorders. 3Among these psychiatric disorders, depression is the most common psychiatric complication of TBI and ranges from 6% to 77%, with variations according to the studied population and the diagnostic criteria or rating instruments used. [4][5][6][7] Depression is associated with a 3-fold increase of medical regimens in patients with chronic illness or comorbidities. the range of hyperlipidemia prevalence was from 19.9% to 33.5% among adults aged ≥ 20 years. Hyperlipidemia was also related to the risk of cardiovascular disease, 20 diabetes mellitus, 21 and hypertension, 22 which are all risk factors for depression. Furthermore, some evidence indicate that statin medications, an antihyperlipidemic agent, has neuroprotective effects on the hippocampus, which may be associated with the depression developed in TBI animal models. 23,24 Therefore, hyperlipidemia...

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Section: J Clin Psychiatry 77:4 April 2016mentioning

confidence: 99%

Increased Risk of New-Onset Depression in Patients With Traumatic Brain Injury and Hyperlipidemia

Wee

Ho²,

Liang³

et al. 2016

J. Clin. Psychiatry

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show abstract

“…Severe TBI was defined as brain injury including brain contusion, SDH, epidural haemorrhage subarachnoid haemorrhage and intracranial haemorrhage. According to earlier studies (33,34), we categorized the diagnoses of skull fracture combined with intracerebral hemorrhage (children with both skull fracture and intracerebral hemorrhage diagnostic codes (800-804 and 851-854) conditions, or diagnostic codes include skull fracture with intracranial injury (800.1-800.4, 800.6-800.9, etc.)) into the severe brain injury group.…”

Section: Study Populationmentioning

confidence: 99%

Association of traumatic brain injury in childhood and attention-deficit/hyperactivity disorder: a population-based study

et al. 2016

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Background:We evaluated the risk of attention-deficit hyperactivity disorder (ADHD) following childhood traumatic brain injury (TBI). Methods: Using Taiwan's National Health Insurance Research Database, we included 10,416 newly diagnosed TBI children (aged ≤12 y) between 2001 and 2002 and 41,664 children without TBI, who were frequency matched by sex, age, and year of the index medical service with each TBI child, as controls. Children who had been diagnosed with ADHD prior to their medical service index were excluded. Each individual was followed for 9 y to identify ADHD diagnosis. We also compared the ADHD risk in children who were treated for fractures but not TBI as sensitivity analysis. results: During the 9-y follow-up period, children with TBI had a higher ADHD risk (adjusted hazard ratio (AHR) = 1.32, 95% confidence interval (CI) = 1.19, 1.45) than did those without TBI. Furthermore, children with mild and severe TBI had higher AHRs for ADHD than did those without TBI (AHR = 1.30; 95% CI = 1.10, 1.53; and AHR = 1.37; 95% CI = 1.22, 1.55). However, no significant association was observed between fractures and ADHD. conclusion: TBI in childhood is associated with a greater likelihood of developing ADHD. t raumatic brain injury (TBI) is the leading cause of death and disability in children and often results in persistent behavioral disturbances and neurocognitive deficits in attention, learning, and memory (1-3). Children with cognitive impairment following TBI impose a great economic and social burden on their families and communities. In addition, these children are more likely to have slower psychosocial development and exhibit poor academic achievement. Therefore, the relationship between TBI and neuropsychiatric consequences has become a crucial research topic.Attention-deficit-hyperactivity disorder (ADHD), a neurodevelopmental disorder, is associated with impulsivity, excessive talking, difficulty in sustaining attention, being easily distracted, and injuries (4-6). Studies have reported a relationship between ADHD and childhood TBI (7-10). Unlike other diseases resulting from various pathogenic mechanisms, TBI is caused by a complex interplay among damages occurring in the neuroanatomy, neurochemistry, and neurophysiology because of primary and secondary processes (11). A meta-analytic review showed that neurocognitive outcomes after pediatric TBI have a dose-response relationship with injury severity. Babikian and colleagues found that patients with severe TBI exhibited poorer performance in intelligence quotient tests, executive functioning, processing speed, attention maintenance, verbal immediate memory, and delayed memory, whereas patients with mild TBI exhibited no change (12). In addition, several studies have suggested that children with moderate to severe TBI are significantly more likely to develop ADHD symptoms than are those with mild TBI (8,(13)(14)(15)(16)(17). A longitudinal birth cohort study reported no association between preschool mild TBI and ADHD after adjusting for potential co...

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“…According to the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), we defined TBI as ICD-9-CM 800, 801, 803, 804, and 850-854, [10][11][12]17 and stroke as ICD-9-CM 430-437. 18 Coexisting medical conditions in this study were defined as hypertensive diseases (ICD-9-CM 401-405), mental disorders (ICD-9-CM 290-319), diabetes (ICD-9-CM 250), pneumonia (ICD-9-CM 480-486), hyperlipidemia (ICD-9-CM 272.0, 272.1, 272.2, and 272.4), liver cirrhosis (ICD-9-CM 571), myocardial infarction (ICD-9-CM 410), and smoking cessation (identified with administration code [case type = 77] in Taiwan's National Health Insurance system).…”

Section: Methodsmentioning

confidence: 99%

“…8 Socioeconomic impacts of disability following TBI are potentially long-term or lifelong, 7,9 and TBI remains a worldwide leading cause of disability and death. [10][11][12] Yi-Chun Chou and Ta-Liang Chen contributed equally to the article.…”

mentioning

confidence: 98%

Risk and Mortality of Traumatic Brain Injury in Stroke Patients

Chou

Yeh

et al. 2014

Journal of Head Trauma Rehabilitation

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Risk of epilepsy after traumatic brain injury: a retrospective population-based cohort study

Abstract: The risk of epilepsy after TBI varied by patient gender, age, latent interval and complexity of TBI. Integrated care for early identification and treatment of post-trauma epilepsy were crucial for TBI patients.

Cited by 90 publications

References 31 publications

Increased Risk of New-Onset Depression in Patients With Traumatic Brain Injury and Hyperlipidemia

Increased Risk of New-Onset Depression in Patients With Traumatic Brain Injury and Hyperlipidemia

Association of traumatic brain injury in childhood and attention-deficit/hyperactivity disorder: a population-based study

Risk and Mortality of Traumatic Brain Injury in Stroke Patients

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