Preinjury Health Status of Adults With Traumatic Brain Injury: A Preliminary Matched Case-Control Study : The Journal of Head Trauma Rehabilitation

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Preinjury Health Status of Adults With Traumatic Brain Injury: A Preliminary Matched Case-Control Study

Bulas, Ashlyn M. MPH; Li, Lihua PhD; Kumar, Raj G. PhD, MPH; Mazumdar, Madhu PhD; Rosso, Andrea L. PhD, MPH; Youk, Ada O. PhD; Dams-O'Connor, Kristen PhD

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Journal of Head Trauma Rehabilitation 37(3):p E186-E195, May/June 2022. | DOI: 10.1097/HTR.0000000000000703



To discern whether there is evidence that individuals who sustained a traumatic brain injury (TBI) had the greater odds of preexisting health conditions and/or poorer health behaviors than matched controls without TBI.


Brain Injury Inpatient Rehabilitation Unit at Mount Sinai Hospital. Midlife in the United States (MIDUS) control data were collected via random-digit-dialing phone survey.


TBI cases were enrolled in the TBI Health Study and met at least 1 of the following 4 injury severity criteria: abnormal computed tomography scan; Glasgow Coma Scale score between 3 and 12; loss of consciousness greater than 30 minutes; or post-TBI amnesia longer than 24 hours. Sixty-two TBI cases and 171 matched MIDUS controls were included in the analyses; controls were excluded if they reported having a history of head injury.


Matched case-control study.

Main Measures: 

Self-reported measures of depression symptoms, chronic pain, health status, alcohol use, smoking status, abuse of controlled substances, physical activity, physical health composite score, and behavioral health composite score.


Pre–index injury depression was nearly 4 times higher in TBI cases than in matched controls (OR= 3.98, 95% CI, 1.71-9.27; P = .001). We found no significant differences in the odds of self-reporting 3 or more medical health conditions in year prior to index injury (OR = 1.52; 95% CI, 0.82-2.81; P = .183) or reporting more risky health behaviors (OR = 1.48; 95% CI; 0.75-2.91; P = .254]) in individuals with TBI than in controls.


These preliminary findings suggest that the odds of depression in the year prior to index injury far exceed those reported in matched controls. Further study in larger samples is required to better understand the relative odds of prior health problems in those who sustain a TBI, with a goal of elucidating the implications of preinjury health on post-TBI disease burden.

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