Head injury linked to long-term mortality risk
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Head injury was associated with decreased long-term survival time in a community-based cohort with more than 30 years of follow-up, researchers wrote in JAMA Neurology.
“Head injury is associated with significant short-term morbidity and mortality,” Holly Elser, MD, PhD, of the department of neurology at the Hospital of the University of Pennsylvania, and colleagues wrote. “Research regarding the implications of head injury for long-term survival in community-dwelling adults remains limited.”
Elser and colleagues sought to assess the association of head injury with long-term all-cause mortality risk among adults, with consideration for head injury frequency and severity.
The authors included participants with and without head injury from the Atherosclerosis Risk in Communities study, an ongoing prospective study with follow-up from 1987 through 2019 in four Unites States communities, they reported.
Head injury frequency and severity were defined through self-report in response to interview questions as well as hospital-based diagnostic codes. All-cause mortality was reported through the National Death Index.
A total of 13,037 participants (mean age at baseline, 54 years; 57.7% women) were eligible. Median follow-up was 27 years.
Head injury occurred in 2,402 participants (18.4%), most of which were classified by authors as mild. The hazard ratio for all-cause mortality in those with head injury was 1.99 (95% CI, 1.88-2.11), compared with those with no head injury.
In addition, researchers reported evidence of a dose-dependent association with head injury frequency (one head injury: HR = 1.66 [95% CI, 1.56-1.77]; two or more: HR = 2.11 [95% CI, 1.89-2.37]) and severity (mild: HR = 2.16 [95% CI, 2.01-2.31]; moderate, severe or penetrating: HR = 2.87 [95% CI, 2.55-3.22]).
“This study reports an approximately twofold increase in long-term mortality risk associated with head injury in a diverse cohort of U.S. adults followed for 30 years,” Elser and colleagues wrote. “This robust and dose-dependent long-term association underscores the importance of public health measures aimed at preventing head injuries and targeted clinical interventions to reduce morbidity and mortality after head injury.”