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

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

Author information

1
University of Pittsburgh Department of Physical Medicine and Rehabilitation, Pittsburgh, Pennsylvania (Messrs Kumar and Wang and Drs Juengst, Arenth, and Wagner); University of Pittsburgh Department of Epidemiology, Pittsburgh, Pennsylvania (Messrs Kumar and Wang); Icahn School of Medicine at Mount Sinai, New York, NY (Dr Dams-O'Connor); University of Washington Department of Rehabilitation Medicine, Seattle (Dr Dikmen); Northeastern University Department of Communication Sciences and Disorders, Boston, Massachusetts (Dr O'Neil-Pirozzi); Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts (Dr O'Neil-Pirozzi); Baylor Scott & White Health Medical Center - Plano, TX; Baylor Institute for Rehabilitation, Dallas, TX (Dr Dahdah); Indiana University School of Medicine Department of Physical Medicine and Rehabilitation, Indianapolis, Indiana (Dr Hammond); University of Miami Department of Physical Medicine and Rehabilitation, Miami, Florida (Dr Felix); and University of Pittsburgh Center for Neuroscience, University of Pittsburgh Safar Center for Resuscitation Research, and University of Pittsburgh Department of Neuroscience, Pittsburgh, Pennsylvania (Dr Wagner).

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.

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