Abstract Details

Title Head Injury and All-Cause Mortality in Community-Dwelling Adults

Topic General Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 6-005

Objective To examine the association between prior head injury and long-term survival among community-dwelling adults.

Background Head injury is associated with significant morbidity and mortality in the short term. Research regarding long-term associations of head injury with survival in community-based populations remains limited.

Design/Methods The Atherosclerosis Risk in Communities (ARIC) Study is an ongoing prospective cohort study comprised of 15,792 community-dwelling adults in the U.S. who were initially recruited in 1987-1989. Head injury was defined using self-report and hospital-based International Classification of Diseases diagnostic codes and was analyzed as a time-varying exposure. All-cause mortality was ascertained via the National Death Index through 31 December 2019. We used generalized gamma accelerated failure time [AFT] models to estimate the ratio of survival time among individuals with and without head injury, adjusting for sociodemographic characteristics.

Results Our analysis included 12,202 individuals with no history of head injury at baseline (1987–1989). Median baseline age was 54 years (IQR 49–59). More than half were female (59.4%) and 28.0% were black. Head injuries occurred in 1,814 participants (14.9%), most of which were classified as mild. Median time from enrollment to first head injury was 18.4 years (IQR 9.1–23.6). In adjusted AFT models, head injury shortened survival time by 24% (time ratio [TR] = 0.76, 95% CI: 0.74–0.79) with evidence of dose-response (one head injury: TR = 0.75, 95% CI: 0.73–0.77; two or more: TR = 0.67, 95% CI: 0.64 – 0.70). Estimates were similar for men and women and among black and white participants. The reduction in survival time was more pronounced for hospital-diagnosed head injury (TR = 0.64, 95% CI: 0.66–0.71) versus self-reported head injury (TR = 0.96, 95% CI: 0.90–1.02).

Conclusions In this community-based cohort, head injury was associated with decreased long-term survival time in a dose-dependent manner.

Authors/Disclosures
Holly Elser, MD, PhD (Hospital of the University of Pennsylvania) PRESENTER	Dr. Elser has nothing to disclose.
Rebecca F. Gottesman, MD, PhD (Johns Hopkins University)	The institution of Dr. Gottesman has received research support from NIH.
	No disclosure on file
	No disclosure on file
Ramon R. Diaz-Arrastia, MD, PhD, FAAN (University of Pennsylvania)	Dr. Diaz-Arrastia has stock in BrainBox, LLC. Dr. Diaz-Arrastia has stock in Nia Therpeutics. The institution of Dr. Diaz-Arrastia has received research support from National Institutes of Health. The institution of Dr. Diaz-Arrastia has received research support from Department of Defense.
	No disclosure on file
Andrea L. Schneider, MD, PhD (University of Pennsylvania)	Dr. Schneider has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN - Neurology.

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