February 4, 2011

Death After Head Injury

(Ivanhoe Newswire) -- According to IBIA (International Brain Injury Association), one million Americans are treated and released from hospital emergency departments as a result of traumatic head injury each year.  What's more, a recently published article finds that a head injury can blight the chances of survival up to 13 years after that event.  This is quite serious for the one million Americans admitted for this injury.

The article also brings up that injury severity seems to make little difference over the long term.

The research team followed over 2,000 people, 757 of which had sustained a head injury requiring admission to one of five hospitals in Glasgow between 1995 and 1996.  The remainders of the group were divided by those who had been admitted to the hospital for other reasons, but for the same period as those with a head injury, and healthy people living in the community.  The three groups were matched for age, gender, and levels of deprivation.

Altogether, 40 percent of people (305) who had sustained a head injury were dead within 13 years of the event. This was higher than the rate among those admitted with other injuries (28 percent) and those in the community, almost one in five of whom died (19 percent).
Although the heightened risk of death peaked in the first year after injury, it continued for at least an extra 12 years, when the head-injured were practically three times as likely to die of circulatory, respiratory, digestive, psychiatric and external causes as their community peers.

Those who had sustained further injuries were additionally more likely to die of these causes, however, the risk was not as high.

Among the head-injured, the annual rate of death from all causes was roughly 31 per 1,000 people compared with just fewer than 14 per 1,000 for those living in the community.  Those with more severe injuries were more likely to die than those with mild injuries during the critical first year; but those with mild head injury were moreover twice as likely to die.

The young and middle aged, more than a year later, were far more likely to die than those who were older, in comparison to those with no head injury.

The mortality rate for those aged 15 to 54 were more than six times higher than rates for those with no head injury, irrespective of potentially influential factors, such as gender and level of deprivation.

Lifestyle factors before the injury, such as disproportionate alcohol intake as well as living alone or a history of mental health problems do affect survival, however, these factors in addition feature among those admitted for other injuries.

According to authors, there are no apparent explanations for the higher death rates among the young and middle aged.

"The reason for greater vulnerability in younger adults is unclear, but requires further consideration, especially given the particularly higher risk of head injury in younger adults," the authors were quoted as saying.  Head injury accounts for most trauma deaths in this age group, the evidence shows.

SOURCE: Journal of Neurology Neurosurgery and Psychiatry, 31 January 2011