A-138 Lifetime Repetitive Blast Overpressure Exposure Has Negative Impact on Quality of Life after Traumatic Brain Injury

Abstract

Abstract Objective The objective of this study was to i) address the impact repetitive blast exposure (RBE) has on recovery from TBI in service members and veterans (SMVs), ii) determine if the relative amount of blast exposure in a career changes this effect, iii) determine if any effects of blast exposure are different than known pre-existing neurotrauma such as pre-injury TBI history (piTBIHx) defined as previous TBI that occurred before the index injury for the study. Methods 341 SMVs with an uncomplicated mild, complicated mild, moderate, or severe TBI. piTBIHx was based on a structured interview and RBE was based on self-report. Participants were divided into six cohorts based on RBE and piTBIHx and given the TBI-Quality of Life (TBI-QOL). Four multivariate analysis of variance were completed for each domain separately (Emotional, Physical, Cognition, and Positive) to correct for multiple comparisons. Results Results indicate that HeavyRBE, in the absence of piTBIHx, was associated with worse QOL on measures of Anger (p = 0.032), Anxiety (p = 0.008), Explosive Behavior (p = 0.038), Headache (p = 0.030), Pain (p = 0.016), Cognitive Complaints-Executive Functioning (p = 0.009), and Cognitive Complaints-General (p = 0.013). ModerateRBE in the absence of piTBIHx was associated with more Cognitive Complaints-Executive Function (p = 0.005). ModerateRBE did not differ from the Heavy RBE group regardless of piTBIHx. Conclusion QOL after a TBI may be negatively impacted by a history of RBE. A lifetime of HeavyRBE was associated with worse QOL on numerous measures, however, Moderate RBE was only associated with worse cognitive complaints related to executive functioning.