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Prevalence of Medical and Psychiatric Comorbidities Following Traumatic Brain Injury

Hammond, Flora M. MD; Corrigan, John D. PhD; Ketchum, Jessica M. PhD; Malec, James F. PhD; Dams-O'Connor, Kristen PhD; Hart, Tessa PhD; Novack, Thomas A. PhD; Bogner, Jennifer PhD; Dahdah, Marie N. PhD; Whiteneck, Gale G. PhD

The Journal of Head Trauma Rehabilitation: July/August 2019 - Volume 34 - Issue 4 - p E1–E10
doi: 10.1097/HTR.0000000000000465
Original Articles

Objective: To examine the prevalence of selected medical and psychiatric comorbidities that existed prior to or up to 10 years following traumatic brain injury (TBI) requiring acute rehabilitation.

Design: Retrospective cohort.

Setting: Six TBI Model Systems (TBIMS) centers.

Participants: In total, 404 participants in the TBIMS National Database who experienced TBI 10 years prior.

Interventions: Not applicable.

Main Outcome Measure: Self-reported medical and psychiatric comorbidities and the onset time of each endorsed comorbidity.

Results: At 10 years postinjury, the most common comorbidities developing postinjury, in order, were back pain, depression, hypertension, anxiety, fractures, high blood cholesterol, sleep disorders, panic attacks, osteoarthritis, and diabetes. Comparing those 50 years and older to those younger than 50 years, diabetes (odds ratio [OR] = 3.54; P = .0016), high blood cholesterol (OR = 2.04; P = .0092), osteoarthritis (OR = 2.02; P = .0454), and hypertension (OR = 1.84; P = .0175) were significantly more prevalent in the older cohort while panic attacks (OR = 0.33; P = .0022) were significantly more prevalent in the younger cohort. No significant differences in prevalence rates between the older and younger cohorts were found for back pain, depression, anxiety, fractures, or sleep disorders.

Conclusions: People with moderate-severe TBI experience other medical and mental health comorbidities during the long-term course of recovery and life after injury. The findings can inform further investigation into comorbidities associated with TBI and the role of medical care, surveillance, prevention, lifestyle, and healthy behaviors in potentially modifying their presence and/or prevalence over the life span.

Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis, Indiana (Drs Hammond and Malec); Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, Ohio (Drs Corrigan and Bogner); Research Department, Traumatic Brain Injury Model Systems National Data and Statistical Center, Craig Hospital, Englewood, Colorado (Drs Ketchum and Whiteneck); Departments of Rehabilitation Medicine and Neurology, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Dams-O'Connor); Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (Dr Hart); Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama (Dr Novack); and North Texas TBI Model System, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas and Baylor Scott & White Medical Center - Plano, Plano, Texas (Dr Dahdah).

Corresponding Author: Flora M. Hammond, MD, Physical Medicine and Rehabilitation, Indiana University School of Medicine, 4141 Shore Dr, Indianapolis, IN 46254 (

The contents of this publication were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR): Indiana University School of Medicine/Rehabilitation Hospital of Indiana (grant 90DP0036), Icahn School of Medicine at Mount Sinai (grant 90DP0038), Rocky Mountain Regional Brain Injury System (grant 90DP0034), Ohio State University (grant 90DP0040), University of Alabama at Birmingham (grant 90DP0044), Traumatic Brain Injury Model Systems National Data and Statistical Center (grant 90DP0013 and 90DP0084), Moss TBI Model System (grant 90DP0037), North Texas TBI Model System (grant 90DP0045) and from the National Institutes of Health National Center for Medical Rehabilitation Research (NICHD; K01HD074651). NIDILRR is a center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS).

The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.

The authors declare no conflicts of interest.

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