Looking Down the Road with Brain Injury

Traumatic brain injury patients at increased risk for premature death

(RxWiki News) For some injuries, recovery may be a lifelong process that includes risks along the way. Traumatic brain injury may be such a condition.

A recent study found that those who experienced a traumatic brain injury were more likely to die prematurely than those who had not.

The risk of an early death was elevated further among those with a brain injury and a psychiatric or substance abuse condition.

"Ask your neurologist about your long-term recovery from traumatic brain injury."

This study, led by Seena Fazel, MD, of the Department of Psychiatry at the University of Oxford in England, looked at the long-term risk of early death in those who had sustained a traumatic brain injury.

The researchers used national records to analyze the long-term outcomes of 218,300 Swedish adults who had experienced a traumatic brain injury between 1969 and 2009.

These researchers compared deaths among these individuals, starting from six months after their injury, to 2.16 million individuals in the general population who did not have a traumatic brain injury.

The general population individuals were "matched" to those with the injuries based on their age and sex.

The researchers also compared the rates of early death between those with traumatic brain injuries and 150,513 of their siblings.

When looking at whether there were differences in early deaths among these groups, the researchers especially focused on deaths as a result of suicide, injury or assault.

The researchers found that those who had experienced a traumatic brain injury had about three times greater odds of dying early when compared to those of the same age and sex in the general population.

The traumatic brain injury patients had about 2.6 times greater odds of premature death when compared to their siblings.

All three causes of death investigated in particular occurred at higher rates in those with traumatic brain injury compared to those without this injury.

The odds of committing suicide were three times higher among those with traumatic brain injury than among those in the general population.

Those with the brain injuries also had four times higher odds of dying from another injury or dying from assault.

The researchers also found that higher numbers of those with traumatic brain injury in general had premature deaths if they had any psychiatric or substance abuse conditions.

While only 0.5 percent of those without a psychiatric or substance abuse problem died prematurely among the brain injury patients, 6.2 percent of those with a substance abuse problem died prematurely.

In addition, 3.8 percent of those who had either a psychiatric or a substance abuse condition — a larger group overall — died prematurely.

"Traumatic brain injury is associated with substantially elevated risks of premature mortality, particularly for suicide, injuries, and assaults, even after adjustment for sociodemographic and familial factors," the researchers wrote.

They suggested that clinical guidelines for care of those with traumatic brain injury take into account the potential for psychiatric or substance abuse problems.

This study was published January 15 in the journal JAMA Psychiatry. The research was funded by the Wellcome Trust, the Swedish Prison and Probation Service and the Swedish Research Council. The authors reported no potential conflicts of interest.

Review Date: 
January 16, 2014