Epidemiology of recurrent traumatic brain injury in the general population

Lasry, Oliver; Liu, Erin Y.; Powell, Guido; Ruel-Laliberté, Jessica; Marcoux, Judith; Buckeridge, David L.

doi:10.1212/wnl.0000000000004671

Cited by 53 publications

(47 citation statements)

References 65 publications

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“…Consistent with our results, these included prior TBI, drug use or alcohol intoxication, and comorbid psychiatric conditions. 26 Although female sex has previously been associated with an overall increased risk of stroke and venous thromboembolism in the general population, in our study, we observed that male sex was a risk factor after TBI for bleeding and recurrent TBI. [27][28][29][30][31] The present study identified alcohol use and depression as risk factors associated with recurrent TBI, similar to findings from previous studies of bleeding risk 21,32 and recurrent TBI.…”

Section: Discussioncontrasting

confidence: 49%

Bleeding and Thromboembolism After Traumatic Brain Injury in the Elderly: A Real Conundrum

Glass

Vadlamani

Hwang

et al. 2019

Journal of Surgical Research

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Background: Elderly patients presenting with a traumatic brain injury (TBI) often have comorbidities that increase risk of thromboembolic (TE) disease and recurrent TBI. A significant number are on anticoagulant therapy at the time of injury and studies suggest that continuing anticoagulation can prevent TE events. Understanding bleeding, recurrent TBI, and TE risk after TBI can help to guide therapy. Our objectives were to 1) evaluate the incidence of bleeding, recurrent TBI, and TE events after an initial TBI in older adults and 2) identify which factors contribute to this risk. Methods: Retrospective analysis of Medicare claims between May 30, 2006 and December 31, 2009 for patients hospitalized with TBI was performed. We defined TBI for the index admission, and hemorrhage (gastrointestinal bleeding or hemorrhagic stroke), recurrent TBI, and TE events (stroke, myocardial infarction, deep venous thrombosis, or pulmonary embolism) over the following year using ICD-9 codes. Unadjusted incidence rates and 95% confidence intervals (CIs) were calculated. Risk factors of these events were identified using logistic regression. Results: Among beneficiaries hospitalized with TBI, incidence of TE events (58.6 events/1000 person-years; 95% CI 56.2, 60.8) was significantly higher than bleeding (23.6 events/1000 person-years; 95% CI 22.2, 25.1) and recurrent TBI events (26.0 events/1000 person-years; 95% CI 24.5, 27.6). Several common factors predisposed to bleeding, recurrent TBI, and TE outcomes. Conclusions: Among Medicare patients hospitalized with TBI, the incidence of TE was significantly higher than that of bleeding or recurrent TBI. Specific risk factors of bleeding and TE events were identified which may guide care of older adults after TBI.

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Section: Discussioncontrasting

confidence: 49%

Bleeding and Thromboembolism After Traumatic Brain Injury in the Elderly: A Real Conundrum

Glass

Vadlamani

Hwang

et al. 2019

Journal of Surgical Research

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“…Repetitive traumatic brain injury (rTBI) has been growing into a worldwide issue. In the United States, it is estimated that generally at least 5.50% of traumatic brain injury (TBI) patients experienced rTBI in the following year (Lasry et al, 2017). Compared with the general population, rTBI is more common in athletes of contact sports, including boxing and football (Mckee et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

A New Model of Repetitive Traumatic Brain Injury in Mice

Chen

Zhu

et al. 2020

Front. Neurosci.

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Repetitive traumatic brain injury (rTBI) is a major health care concern that causes substantial neurological impairment. To better understand rTBI, we introduced a new model of rTBI in mice induced by sudden rotation in the coronal plane combined with lateral translation delivered twice at an interval of 24 h. By routine histology, histological examination of Prussian blue-stained sections revealed the presence of microbleed in the corpus callosum and brain stem. Amyloid precursor protein (β-APP) and neurofilament heavy-chain (NF-200) immunohistochemistry demonstrated axonal injury following rTBI. Swelling, waving, and enlargement axons were observed in the corpus callosum and brain stem 24 h after injury by Bielschowsky staining. Ultrastructural studies by electron microscopy provided further insights into the existence and progression of axonal injury. rTBI led to widespread astrogliosis and microgliosis in white matter, as well as significantly increased levels of tumor necrosis factor (TNF)-α and interleukin (IL)-1β. rTBI mice showed a significantly increased loss of righting reflex (LRR) duration within each time point compared with that of sham animals, which was under 15 min. rTBI mice exhibited depression-like behavior at 1 month. rTBI mice also demonstrated deficits in MWM testing. These results suggested that this model might be suitable for investigating rTBI pathophysiology and evaluating preclinical candidate therapeutics.

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“…Recovery from TBI is a complex process and severe brain injuries commonly result in a wide range of disorders of consciousness (DOC). This condition is characterized by high heterogeneity in clinical phenotypes and, mainly, in prognostic models (Langlois et al, 2006;Menon et al, 2010;Lasry et al, 2017) that contributed to disappointing results in several clinical trials (Menon, 2009).…”

Section: Introductionmentioning

confidence: 99%

The Impact of Medical Complications in Predicting the Rehabilitation Outcome of Patients With Disorders of Consciousness After Severe Traumatic Brain Injury

Lucca

Lofaro

Leto

et al. 2020

Front. Hum. Neurosci.

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Epidemiology of recurrent traumatic brain injury in the general population

Abstract: rTBI is an important contributor to the general population TBI burden. Certain risk factors can help identify individuals at higher risk of these repeated injuries. However, higher quality research that improves on rTBI surveillance methodology is needed.

Cited by 53 publications

References 65 publications

Bleeding and Thromboembolism After Traumatic Brain Injury in the Elderly: A Real Conundrum

Bleeding and Thromboembolism After Traumatic Brain Injury in the Elderly: A Real Conundrum

A New Model of Repetitive Traumatic Brain Injury in Mice

The Impact of Medical Complications in Predicting the Rehabilitation Outcome of Patients With Disorders of Consciousness After Severe Traumatic Brain Injury

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