scholarly journals Use of general practice before and after mild traumatic brain injury: a nationwide population-based cohort study in Denmark

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e017735 ◽  
Author(s):  
Stine Fjendbo Galili ◽  
Bodil Hammer Bech ◽  
Claus Vestergaard ◽  
Morten Fenger-Gron ◽  
Jakob Christensen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
General Practice ◽  
Cohort Study ◽  
Brain Injury ◽  
Population Based ◽  
First Year ◽  
Blurred Vision ◽  
Lower Socioeconomic ◽  
Before And After ◽  
N 93

ObjectivesTraumatic brain injury (TBI) is commonly seen in the emergency department (ED). Approximately 85%–90% of TBIs are mild (mTBI). Some cause symptoms such as headache, dizziness, anxiety, blurred vision, insomnia and concentration difficulties, collectively known as postconcussion syndrome (PCS). Some studies suggest that recovery from mTBI is complete. Others find that symptoms persist for months, even years. The aim of this study was to describe the use of general practice, before and after mTBI, as a proxy for symptoms in a large cohort.DesignNationwide population-based matched cohort study.SettingDanish EDs and general practice.ParticipantsAll patients (aged ≥18 years), first-time diagnosed with mTBI in a Danish ED between 1 January 1998 and 31 December 2010 (n=93 517). Ten reference persons per patient with mTBI were randomly matched on gender, age and general practice (n=935 170).Primary outcomeOverall use of general practice; consultations relating to mental and physical health.ResultsWe found higher use of general practice during the first year after mTBI for all ages, both genders and all types of contacts. Age 18–40 years: women, incidence rate ratio (IRR) 1.59 (95% CI 1.57 to 1.61); men, IRR 1.82 (95% CI 1.80 to 1.85). Age 41–65 years: women, IRR 1.75 (95% CI 1.72 to 1.78); men, IRR 1.85(95% CI 1.82 to 1.89). Age 66+ years: women, IRR 1.55 (95% CI 1.52 to 1.58); men, IRR 1.55 (95% CI 1.51 to 1.59). After the first year, the use decreased to the level before mTBI. Individuals with mTBI and higher use of general practice before mTBI had lower socioeconomic status and more comorbidities (P<0.001).ConclusionsThe use of general practice was higher in the first year after mTBI, specifically in the first 3 months. Patients with mTBI had different healthcare-seeking behaviour several years before diagnosis than their matched reference persons. Pretraumatic morbidity should be considered in the evaluation of PCS.

scholarly journals Psychotropic and pain medication use in individuals with traumatic brain injury—a Swedish total population cohort study of 240 000 persons

2021 ◽  
Vol 92 (5) ◽  
pp. 519-527
Author(s):  
Yasmina Molero ◽  
David James Sharp ◽  
Brian Matthew D'Onofrio ◽  
Henrik Larsson ◽  
Seena Fazel
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Total Population ◽  
Medication Use ◽  
Population Based ◽  
Pain Medication ◽  
Short Term ◽  
Pain Medications ◽  
Before And After

ObjectiveTo examine psychotropic and pain medication use in a population-based cohort of individuals with traumatic brain injury (TBI), and compare them with controls from similar backgrounds.MethodsWe assessed Swedish nationwide registers to include all individuals diagnosed with incident TBI between 2006 and 2012 in hospitals or specialist outpatient care. Full siblings never diagnosed with TBI acted as controls. We examined dispensed prescriptions for psychotropic and pain medications for the 12 months before and after the TBI.ResultsWe identified 239 425 individuals with incident TBI, and 199 658 unaffected sibling controls. In the TBI cohort, 36.6% had collected at least one prescription for a psychotropic or pain medication in the 12 months before the TBI. In the 12 months after, medication use increased to 45.0%, an absolute rate increase of 8.4% (p<0.001). The largest post-TBI increases were found for opioids (from 16.3% to 21.6%, p<0.001), and non-opioid pain medications (from 20.3% to 26.6%, p<0.001). The majority of prescriptions were short-term; 20.6% of those prescribed opioids and 37.3% of those with benzodiazepines collected prescriptions for more than 6 months. Increased odds of any psychotropic or pain medication were associated with individuals before (OR: 1.62, 95% CI: 1.59 to 1.65), and after the TBI (OR: 2.30, 95% CI: 2.26 to 2.34) as compared with sibling controls, and ORs were consistently increased for all medication classes.ConclusionHigh rates of psychotropic and pain medications after a TBI suggest that medical follow-up should be routine and review medication use.

Long-term risk of dementia among people with traumatic brain injury in Denmark: a population-based observational cohort study

2018 ◽  
Vol 5 (5) ◽  
pp. 424-431 ◽  
Author(s):  
Jesse R Fann ◽  
Anette Riisgaard Ribe ◽  
Henrik Schou Pedersen ◽  
Morten Fenger-Grøn ◽  
Jakob Christensen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Population Based ◽  
Observational Cohort Study ◽  
Observational Cohort

scholarly journals Population-based cohort study of the impacts of mild traumatic brain injury in adults four years post-injury

PLoS ONE ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. e0191655 ◽  
Author(s):  
Alice Theadom ◽  
Nicola Starkey ◽  
Suzanne Barker-Collo ◽  
Kelly Jones ◽  
Shanthi Ameratunga ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Population Based ◽  
Post Injury

TP2-3 Long-term survival and five year hospital resource usage following traumatic brain injury in scotland from 1997–2015: a population-based retrospective cohort study

2019 ◽  
Vol 90 (3) ◽  
pp. e14.2-e14
Author(s):  
JJM Loan ◽  
NW Scott ◽  
JO Jansen
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Population Based ◽  
Resource Usage ◽  
Hospital Resource ◽  
Post Injury ◽  
Term Survival ◽  
Long Term Survival

AimTo determine if survival and hospital resource usage differ following traumatic brain injury (TBI) compared with head injury without neurological injury(HI).MethodsThis retrospective population-based cohort study included all 25 319 patients admitted to a Scottish NHS hospital from 1997–2015 with TBI. Participants were identified using previously validated ICD-10 based definitions. For comparison, all 194 049 HI cases were identified. Our main outcome measures were hazards of all-cause mortality after TBI, compared with HI, over 18 years follow-up period; and odds of mortality at one month post-injury. Number of days spent as inpatients and number of outpatient attendances per surviving month post-injury were used as measures of resource utilisation.ResultsThe adjusted odds ratio for mortality in the first month post-injury for TBI was 7.12 (95% confidence interval [CI] 6.73–7.52; p<0.001). For the remaining 18 year study period, the hazards of morality after TBI were 0.93 (CI 0.90–0.96; p<0.001). TBI was associated with 2.15 (CI 2.10–2.20; p<0.001) more days spent as inpatient and 1.09 times more outpatient attendances (CI 1.07–1.11; p<0.001) than HI.ConclusionsAlthough initial mortality following TBI is high, survivors of the first month can achieve comparable long-term survival to HI. However this is associated with increased utilisation of hospital services in the TBI group.

scholarly journals Selective serotonin reuptake inhibitors and risk of epilepsy after traumatic brain injury – A population based cohort study

PLoS ONE ◽  
2019 ◽  
Vol 14 (7) ◽  
pp. e0219137 ◽  
Author(s):  
Jakob Christensen ◽  
Henrik Schou Pedersen ◽  
Morten Fenger-Grøn ◽  
Jesse R. Fann ◽  
Nigel C. Jones ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Population Based ◽  
Serotonin Reuptake Inhibitors ◽  
Selective Serotonin

Long-term risk of epilepsy after traumatic brain injury in children and young adults: a population-based cohort study

The Lancet ◽  
2009 ◽  
Vol 373 (9669) ◽  
pp. 1105-1110 ◽  
Author(s):  
Jakob Christensen ◽  
Marianne G Pedersen ◽  
Carsten B Pedersen ◽  
Per Sidenius ◽  
Jørn Olsen ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Young Adults ◽  
Cohort Study ◽  
Brain Injury ◽  
Population Based ◽  
Children And Young Adults
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