Long-term survival after traumatic brain injury: A population-based analysis controlled for nonhead trauma

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Study investigated the contribution of co-occurring non-head injuries to hazard of death after traumatic brain injury (TBI). A random sample of Olmsted County, Minnesota, residents with confirmed TBI from 1987 through 1999 was identified for the study. Each case was assigned an age- and sex-matched, non-TBI “regular control” from the population. For “special cases” with accompanying non-head injuries, 2 matched “special controls” with non-head injuries of similar severity were assigned. All cases and both types of controls were followed for vital status from baseline (i.e., injury date for cases, comparable dates for controls) through 2008. Cases were compared first with regular controls and second with regular or special controls, depending on case type. A total of 1,257 cases were identified (including 221 special cases). For both cases versus regular controls and cases versus regular or special controls, the hazard ratio was increased from baseline to 6 months (10.82 and 7.13, respectively) and from baseline through study end (2.92 and 1.48, respectively). Among 6-month survivors, the hazard ratio was increased for cases versus regular controls (1.43) but not for cases versus regular or special controls (1.05). Results indicate that hazard of death was highest within the first 6 months after injury. Among 6-month survivors for any classification category or when all categories are combined, no significant difference in hazard of death was seen compared with controls after adjusting for non-head-injury severity.

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