Research Reports - Head trauma with or without mild brain injury increases the risk of future traumatic death

J Neurotrauma. 2015 Jan 13

Vaaramo K(1), Puljula J, Tetri S, Juvela S, Hillbom M

Subjects who have recovered from traumatic brain injury (TBI) show an increased
risk of premature death. To investigate long-term mortality rates in a population
admitted to hospital on account of head injury (HI) we conducted a
population-based prospective case-control, record-linkage study, All subjects who
were living in Northern Ostrobothnia, and who were admitted to Oulu University
Hospital in 1999 because of HI (n=737) and 2196 controls matched with them by
age, gender and residence randomly drawn from the population of Northern
Ostrobothnia were included. Death rate and causes of death in HI subjects during
15 years of follow-up was compared with the general population controls. The
crude mortality rates were 56.9, 18.6 and 23.8% for subjects having
moderate-to-severe traumatic brain injury (TBI), mild TBI and head injury without
TBI, respectively. The corresponding approximate annual mortality rates were
6.7%, 1.4% and 1.9%. All types of index HI predicted a significant risk of
traumatic death in the future. Subjects who had HI without TBI had an increased
risk of both death from all causes (hazard ratio 2.00, 95% confidence interval
1.57-2.55) and intentional or unintentional traumatic death (4.01, 2.20-7.30) as
compared with the controls. The main founding was that even HI without TBI
carries an increased risk of future traumatic death. The reason for this remains
unknown and further studies are needed. To prevent such premature deaths,
post-traumatic therapy should include an interview focusing on life-style
factors.

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