Citation

Izzy S, Tahir Z, Grashow R, Cote DJ, Al Jarrah A, Dhand A, Taylor H, Whalen M, Nathan DM, Miller K, Speizer F, Baggish A, Weisskopf M, Zafonte RD. J. Neurotrauma 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7484

PMID

unavailable

Abstract

While chronic neurological effects from concussion have been widely studied, little is known about possible links between concussion and long-term medical and behavioral comorbidities. We performed a retrospective cohort study of 9,205 adult concussion patients, matched to non-concussion controls from a hospital-based electronic medical registry. Patients with comorbidities prior to the index visit were excluded. Behavioral and medical comorbidities were defined by ICD-9/10 codes. Groups were followed for up to 10 years to identify comorbidity incidence after a concussion. Cox proportional hazards models were used to calculate associations between concussion and comorbidities after multivariable adjustment. Concussion patients were 57% male (median age:31; IQR=23-48 years) at enrollment with a median follow up time of 6.1 years (IQR=4.2-9.1) and well-matched to healthy controls. Most (83%) concussions were evaluated in outpatient settings (5% inpatient). During follow-up, we found significantly higher risks of developing cardiovascular risks including hypertension (HR=1.7, 95%CI: 1.5-1.9), obesity (HR=1.7, 95%CI: 1.3-2.0), and diabetes (HR=1.8, 95%CI: 1.4-2.3) in the concussion group compared to controls. Similarly, psychiatric and neurologic disorders such as depression (HR=3.0, 95%CI: 2.6-3.5), psychosis (HR=6.0, 95%CI: 4.2-8.6), stroke (HR=2.1 95%CI: 1.5-2.9), and epilepsy (HR=4.4, 95%CI: 3.2-5.9) were higher in the concussion group. Most comorbidities developed less than five years post-concussion. The risks for post-concussion comorbidities were also higher in patients under 40 years old compared to controls. Concussion patients demonstrated an increased risk of developing medical and behavioral health comorbidities. Prospective studies are warranted to better describe the burden of long-term comorbidities in concussion patients.

KEYWORDS: Concussion; medical health; behavioral health; long-term comorbidities; cardiovascular risk; psychiatric disorders.

Language: en

Keywords

EPIDEMIOLOGY; OUTCOME MEASURES; TRAUMATIC BRAIN INJURY; HUMAN STUDIES; RECOVERY