Jonathan Silver, MD reviewing Sariaslan A et al. PLoS Med 2016 Aug 23.

The adverse consequences may continue into adulthood.

Because traumatic brain injury (TBI) frequently occurs during childhood and adolescence, ascertaining whether consequences persist into adulthood is important. Using data on a Swedish birth cohort of 1,143,470 individuals born between 1973 and 1985, researchers identified people with a TBI by age 25, and followed them for multiple outcomes until age 45.

Of the cohort, 104,290 (9%) had sustained at least one TBI by age 25; 77% had mild TBIs, and 12% had recurrent injuries. Numerically, those with TBI were more likely male and to have been in households with “adverse psychosocial indicators” (e.g., low parental education and family income, lifetime parental psychiatric disorder, and criminal history).

In comparisons with 68,268 unaffected siblings, TBI was associated with greater risks later for premature mortality, psychiatric inpatient admissions and outpatient visits, being on disability and welfare, and lower education. These risks were stronger with greater severity of injury, having more than one injury, and older age at first injury. For example, the relative increased risk for psychiatric hospitalization was 1.52 with mild TBI and 1.75 with moderate-severe TBI, even after adjustments for parental and individual characteristics. Relative risks for premature mortality was 1.26 and 1.92, respectively.

CITATION(S):

Sariaslan A et al. Long-term outcomes associated with traumatic brain injury in childhood and adolescence: A nationwide Swedish cohort study of a wide range of medical and social outcomes. PLoS Med 2016 Aug 23; 13:e1002103.

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