Article 1: Repetitive traumatic brain injury: a population-based risk analysis of hospital discharge and emergency department visits among persons who had more than 1 brain injury in south carolina, 1996–2001

Abstract

Objectives: To quantify the incidence of repetitive traumatic brain injury (TBI), to identify risk factors, and to determine frequently associated injury mechanisms. Design: Cross-sectional. Setting: Hospital discharges and emergency department (ED) visits. Participants: 70,671 persons with TBI unduplicated with personal identifiers. Interventions: Not applicable. Main Outcome Measures: Repetitive TBI. Results: We identified 945 people with >1 occurrence of TBI; 35% were of higher severity than the preceding ones. Mean number of days elapsing between episodes was 431±390 days. The risk of repetitive TBI was significantly associated with chronic health problems (OR=1.76; 95% CI, 1.22–2.54); residing in counties where the poverty rate was >25% (OR=1.62; 95% CI, 1.39–1.89); and being a Medicare-insured person (OR=1.66; 95% CI, 1.39–1.99). The most common external causes of injury accounting for repetitive TBI were falls (30%), struck by object (20%), and motor vehicle (9%). Conclusion: Repetitive TBI is common in South Carolina. Persons with chronic health problems have the highest risk of repetitive TBI. This suggests the need to evaluate the effect of polypharmacy and disease-specific risk patterns for prevention.