THE LONG-TERM SEQUELAE OF TBI IN SURGICAL AND NONSURGICAL CASES

Abstract

Background The acute effects of traumatic brain Injury (TBI) are well documented but there is no systematic quantification of its long-term sequelae in German-language literature. The purpose of this study is to compare the frequency of conditions linked to prior TBI with their frequency in the non-brain-injured population. Methods A matched cohort study was carried out on the basis of routine data from the BARMER statutory health insurance carrier. The exposure group consisted of patients treated over the period 2006-2009 for TBI at a variety treatment intensities. The control group consisted of BARMER insurees without prior TBI who were matched with the patients in the exposure group for age, sex, and preexisting diseases. Late sequelae were sought in the routine data for a period of ten years after the injury. The outcome rates of the exposure and control groups were compared with Kaplan-Meier estimators and Poisson regression. Results 114,296 persons with TBI in the period of 2006-2009 were included. The mortality within ten years of TBI was 305 per 1000 individuals. The relative mortality in the exposure group was higher than that in control individuals of the same age and sex, with an incidence rate ratio (IRR) of 1,67 (95% confidence interval (1.60;1.74). Immobility, dementia, epilepsy, endocrine disorders, functional disorders, depression, anxiety, cognitive deficits, headache, and sleep disorders were also more common in the exposure group. Person with TBI requiring high-intensity treatment including surgery displayed the highest relative incidence rates of the conditions studied over 10 years of follow-up. Conclusion Adverse sequelae of TBI can still be seen ten years after the exposure. These patients die earlier than person without TBI and suffer earlier and more frequently from associated conditions.

Keywords

• LONG-TERM SEQUELAE OF TBI