Citation

Dams-O'connor K, Spielman L, Gordon W, Manley GT, Puccio AM, Singh A, Valadka A, Yue JK, Yuh EL, Casey SS, Cooper SR, Cheong M, Hricik AJ, Knight EE, Lingsma H, Maas A, Menon D, Morabito DJ, Mukherjee P, Okonkwo DO, Pacheco JL, Schnyer DM, Sinha TK, Vassar MJ. J. Neurotrauma 2013; 30(24): 2014-2020.

Affiliation

Icahn School of Medicine at Mount Sinai, Rehabilitation Medicine, One Gustave Levy Place, Box 1240B, New York, New York, United States, 10029, 212-241-7587, 212-241-0137 ; Kristen.dams-o'connor@mountsinai.org.

Copyright

(Copyright © 2013, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2013.3049

PMID

23924069

Abstract

The idea that multiple traumatic brain injury (TBI) can have a cumulative detrimental impact on functioning is widely accepted. Most research supporting this idea comes from athlete samples, and it is not known whether remote history of prior TBI impacts functioning after acute TBI in community-based samples. This study investigates whether a prior history of TBI with loss of consciousness (LOC) is associated with worse health and functioning in a sample of individuals who require emergency department (ED) care for an acute TBI. Twenty-three percent of the 586 individuals with acute TBI in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study reported having sustained a prior TBI with LOC. Individuals with prior TBI were more likely to be unemployed (χ2=17.86, p=0.000), report a variety of chronic medical and psychiatric conditions (4.75≤χ2≥24.16, p<0.05), and report substance use (16.35≤χ2≥27.57, p<0.01) prior to the acute injury compared to those with no prior TBI history. Those with a prior TBI had less severe acute injuries, but experienced worse outcomes at 6-month follow-up. Results of a series of regression analyses controlling for demographics and acute injury severity indicated that individuals with prior TBI reported more mood symptoms, more post-concussive symptoms, lower life satisfaction, and had slower processing speed and poorer verbal learning compared to those with no prior TBI history. These findings suggest that history of TBI with LOC may have important implications for health and psychological functioning following acute TBI in community-based samples.

Language: en