@article{ref1,
title="Long-term risk of stroke after traumatic brain injury: a population-based medical record review study",
journal="Neuroepidemiology",
year="2022",
author="Sperl, Michael A. and Esterov, Dmitry and Ransom, Jeanine E. and Mielke, Michelle M. and Witkowski, Julie E. and Brown, Allen W.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVE To reliably inform secondary prevention strategies and reduce morbidity and mortality after traumatic brain injury (TBI), we sought to understand the long-term risk of stroke after TBI in patients aged 40 years and older in comparison to age- and sex-matched referents from a population-based cohort. <br><br>MATERIALS AND METHODS TBI cases in Olmsted County, Minnesota from January 1, 1985 to December 31, 1999 were confirmed by manual review, classified by injury severity and mechanism, and non-head trauma was quantified. Each TBI case was matched to 2 sex- and age-matched population-based referents without TBI and with similar severity non-head trauma. Records of cases and referents were manually abstracted to confirm stroke diagnosis. Stroke events during initial hospitalization for TBI were excluded. <br><br>RESULTS In total, 1,410 TBI cases were confirmed, 61% classified as Possible TBI (least severe, consistent with concussive), with the most common mechanism being falls. There were 162 stroke events among those with TBI (11.5%), and 269 among referents (9.5%). Median time to stroke from the index date for those with TBI was 10.2 years (Q1-Q3 5.2 - 17.8), and for referents 12.1 years (Q1-Q3 6.2-17.3), P = 0.215. All-severity TBI was associated with increased risk of stroke (HR: 1.32, 95% CI: 1.06-1.63, P = 0.011), but only Definite TBI (consistent with moderate-severe) was associated with significant risk (HR: 2.20, 95% CI: 1.04-4.64, P = 0.038) when stratified by severity. <br><br>DISCUSSION/Conclusion By confirming TBI cases, stroke diagnoses, and injury severity classification using manual review with levels of accuracy not previously reported, these results indicate moderate-severe TBI increases long-term risk for stroke. These findings confirm the need to regularly assess long-term vascular risk after TBI to implement disease prevention strategies.<p /> <p>Language: en</p>",
language="en",
issn="0251-5350",
doi="10.1159/000525111",
url="http://dx.doi.org/10.1159/000525111"
}