Abstract Details

Title Risks of Multisystem Medical and Psychiatric Comorbidities in Mild and Moderate/Severe Traumatic Brain Injury Patients Compared to non-Head Ortho Trauma and Healthy Control

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Sports Neurology and Neuro Trauma Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 003

Objective We investigated the influence of traumatic brain injury (TBI) severity on multisystem medical and psychiatric comorbidities using healthy controls and non-head ortho trauma (NHOT) patients.

Background While much of the literature focused on assessing the risks of neurological and psychiatric comorbidities following TBI, little is known about the incidence of medical comorbidities after mild versus moderate/severe TBI.

Design/Methods

We conducted a retrospective cohort study of 4,351 mild (mTBI) and 4,351 moderate /severe (msTBI) adult patients matched to healthy and NHOT controls. Behavioral and medical comorbidities were defined by ICD-9/10 codes. Patients with comorbidities prior to the index visit were excluded. Groups were followed for up to 10 years to identify the incidence of comorbidities after trauma. We used Cox proportional hazards models to determine the association between TBI and comorbidity incidence after multivariable adjustment.

Results TBI patients were 55% male (median age of 46, IQR=30-58 years) at enrollment and well-matched to healthy and NHOT controls. Compared to NHOT and healthy controls, both mTBI and msTBI are associated with an increased risk of neurological disorders such as Alzheimer’s disease, and epilepsy (p<0.05). Only msTBI increased risk of ischemic stroke and Parkinson’s disease (p<0.05). Psychiatric comorbidities such as psychosis, drug abuse and suicidality were also more common post-TBI compared to both NHOT and healthy controls (p<0.001). Both TBI and NHOT were associated with increased risks of cardiometabolic comorbidities such as hypertension, diabetes and obesity compared to healthy controls (p <0.01).

Conclusions

Mild and moderate/severe TBI and ortho trauma patients are at risk of developing long-term medical comorbidities post-injury. TBI patients are also at high risks of psychiatric and neurological comorbidities following head injury. Prospective studies are warranted to better describe the burden of long-term multisystem comorbidities post-injury.

Authors/Disclosures
PRESENTER	No disclosure on file
Farid Radmanesh, MD, MPH	Dr. Radmanesh has nothing to disclose.
	No disclosure on file
Taha Yahya	Taha Yahya has nothing to disclose.
	No disclosure on file
Samuel Snider, MD (Massachusetts General Hospital, Brigham, Harvard)	Dr. Snider has nothing to disclose.
Hanife Saglam, MD (West Virginia University)	Dr. Saglam has nothing to disclose.
Hadi Abou-El-Hassan, MD	Dr. Abou-El-Hassan has nothing to disclose.
Saef Izzy, MD, FAAN (Brigham and Women'S Hospital, Harvard Medical School)	The institution of Dr. Izzy has received research support from NINDS. The institution of Dr. Izzy has received research support from The Gillian Reny Stepping Strong Center for Trauma Innovation. Dr. Izzy has received publishing royalties from a publication relating to health care.
Ross Zafonte, DO (Rehabilitation Inst. of Michigan)	Dr. Zafonte has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for MYOMO. Dr. Zafonte has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kisbee. Dr. Zafonte has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Frontiers in Neurology. The institution of Dr. Zafonte has received research support from NIDILRR. The institution of Dr. Zafonte has received research support from NIH. The institution of Dr. Zafonte has received research support from FPHS study. Dr. Zafonte has received publishing royalties from a publication relating to health care.

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