Concussion and Risk of Chronic Medical and Behavioral Health Comorbidities.
Details
Serval ID
serval:BIB_84F7DE087379
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Concussion and Risk of Chronic Medical and Behavioral Health Comorbidities.
Journal
Journal of neurotrauma
ISSN
1557-9042 (Electronic)
ISSN-L
0897-7151
Publication state
Published
Issued date
01/06/2021
Peer-reviewed
Oui
Volume
38
Number
13
Pages
1834-1841
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
While chronic neurological effects from concussion have been studied widely, little is known about possible links between concussion and long-term medical and behavioral comorbidities. We performed a retrospective cohort study of 9205 adult patients with concussion, matched to non-concussion controls from a hospital-based electronic medical registry. Patients with comorbidities before the index visit were excluded. Behavioral and medical comorbidities were defined by International Classification of Diseases, Ninth and Tenth Revision 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 multi-variable adjustment. Patients with concussion were 57% male (median age: 31; interquartile range [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 cardiovascular risks developing including hypertension (hazard ratio [HR] = 1.7, 95% confidence interval [CI]: 1.5-1.9), obesity (HR = 1.7, 95% CI: 1.3-2.0), and diabetes mellitus (HR = 1.8, 95% CI: 1.4-2.3) in the concussion group compared with controls. Similarly, psychiatric and neurological 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 with controls. Patients with concussion demonstrated an increased risk of development of medical and behavioral health comorbidities. Prospective studies are warranted to better describe the burden of long-term comorbidities in patients with concussion.
Keywords
Adolescent, Adult, Aged, Aged, 80 and over, Brain Concussion/diagnosis, Brain Concussion/epidemiology, Brain Concussion/psychology, Cardiovascular Diseases/diagnosis, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/psychology, Chronic Disease/epidemiology, Chronic Disease/psychology, Cohort Studies, Comorbidity, Databases, Factual, Female, Follow-Up Studies, Humans, Male, Mental Disorders/diagnosis, Mental Disorders/epidemiology, Mental Disorders/psychology, Middle Aged, Registries, Retrospective Studies, Risk Factors, Young Adult, behavioral health, cardiovascular risk, concussion, long-term comorbidities, medical health, psychiatric disorders
Pubmed
Web of science
Create date
07/12/2022 12:02
Last modification date
18/03/2025 8:14