Research Reports - The impact of previous traumatic brain injury on health and functioning

J Neurotrauma. 2013 Oct 23

Dams-O'Connor K, Spielman L, Singh A, Gordon WA, Yue JK, Yuh EL, Valadka AB, Lingsma HF, Mukherjee P, Puccio AM, Okonkwo DO, Schnyer DM, Maas AI, Manley GT, Casey SS, Cooper SR, Cheong M, Hricik AJ, Knight EE, Menon DK, Morabito DJ,
Pacheco JL, Sinha TK, Vassar MJ

Abstract The idea that multiple traumatic brain injury (TBI) can have a
cumulative detrimental effect on functioning is widely accepted. Most research
supporting this idea comes from athlete samples, and it is not known whether
remote history of previous TBI affects functioning after acute TBI (aTBI) in
community-based samples. This study investigates whether a previous history of
TBI with loss of consciousness (LOC) is associated with worse health and
functioning in a sample of individuals who require emergency department care for
an aTBI. Twenty-three percent of the 586 individuals with aTBI in the
Transforming Research and Clinical Knowledge in Traumatic Brain Injury study
reported having sustained a previous TBI with LOC. Individuals with previous TBI
were more likely to be unemployed (χ(2)=17.86; p=0.000), report a variety of
chronic medical and psychiatric conditions (4.75≤χ(2)≥24.16; p<0.05), and report
substance use (16.35≤χ(2)≥27.57; p<0.01) before the acute injury, compared to
those with no previous TBI history. Those with a previous 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 previous TBI reported more mood
symptoms, more postconcussive symptoms, lower life satisfaction, and had slower
processing speed and poorer verbal learning, compared to those with no previous
TBI history. These findings suggest that history of TBI with LOC may have
important implications for health and psychological functioning after aTBI in
community-based samples.

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