Epidemiology of Comorbid Conditions Among Adults 50 Years and Older With Traumatic Brain Injury

J Head Trauma Rehabil. 2018 Jan/Feb;33(1):15-24. doi: 10.1097/HTR.0000000000000273.

Abstract

Objectives: Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI.

Setting: Level I Trauma centers.

Participants: Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134).

Design: A TBI-MS prospective cohort study.

Main measures: International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur.

Results: The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders.

Conclusion: This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Brain Injuries, Traumatic / complications*
  • Brain Injuries, Traumatic / epidemiology*
  • Brain Injuries, Traumatic / psychology
  • Chronic Disease
  • Cluster Analysis
  • Cohort Studies
  • Comorbidity
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence