Traumatic Brain Injury Survivors Face Tripled Risk of Death: Study

Survivors of a traumatic brain injury may be three times more likely to face a premature death, according to the findings of new research from Sweden that increases concerns about the potential long-term effects of head traumas.  

In a study published in the medical journal JAMA Psychiatry on January 15, researchers from the Karolinska Institute in Stockholm, led by Dr. Seena Fazel of Oxford University, reviewed data on more than 200,000 patients over the course of 41 years.

Researchers studied patients who survived a traumatic brain injury for six months or longer, and found that patients who experienced such head injuries were three times as likely to suffer an early death.

In fact, the risk of death from causes such as suicide, injury and assault were also elevated in brain injury patients, with nearly half of those who died prematurely, experiencing these types of violent external causes of death.

The study compared mortality rates among patients who underwent traumatic head injuries, to more than 150,000 siblings who had not and 2 million controls from the general population who also had not experienced a brain trauma.

A traumatic brain injury is characterized as a severe blow to the head, which results in loss of consciousness for more than one hour, skull fracture, internal bleeding or a combination of the three.

Researchers used information from national patient registries and death records across four decades. They focused on patients born 1954 or later in Sweden, finding that patients had a 3-fold risk of premature death before the age of 56. The average age the person was when they suffered the brain injury was 18, while the average age of death was 40.

The study suggests that premature death rates of brain injury patients are much higher among those also suffering from psychiatric or substance abuse diagnoses, compared to those without. Nearly 70% of the patients were male, nine percent had preexisting psychiatric disorders and four percent had substance abuse histories.

Researchers found a higher risk of premature death was found in head trauma patients even compared to their siblings, but not as low as the general population controls. This suggests that other factors at play may include genetic or environmental contributors.

They also point to certain personality traits as key concerns for premature death, especially when factoring in suicide, injury and assault related deaths.

Researchers say preventable behaviors play a large role in the heightened risk. A person’s propensity toward impulsiveness, risk-taking or proneness to substance abuse may be the key to interventions. Recognizing these factors after diagnosis of a traumatic brain injury may help prevent premature death later. Prevention methods might include offering antidepressants prior to discharge to TBI patients who exhibit these characteristics.

Lasting Effects of Brain Injury

A recent study published in the Journal of the American Medical Association (JAMA) found patients who suffer traumatic brain injuries have a heightened risk of suffering from depression. In fact they are eight times as likely to become depressed than a person who did not suffer a TBI, highlighting the link between TBI and other risk factors.

Considering the new data, many of these injuries may cause parts of the brain which are responsible for judgment, decision making and risk taking to be affected.

Researchers continue to delve into the findings of other studies which have focused on the effects of brain injuries. In November 2013, a study found traumatic brain injuries and concussions may be linked to permanent brain damage, long after all symptoms of the head trauma have subsided.

Patients who experienced head injuries showed brain abnormalities four months after the incident. This was much longer than they experienced symptoms from the event.

Late last year, another study published in the journal Neurology found patients who suffer brain injuries and concussions may face a higher risk of developing Alzheimer’s disease. Older adults with a history of traumatic brain injury that resulted in cognitive impairment had more buildup of Alzheimer’s disease-associated plaques in the brain. The findings link the injuries to a heightened risk of developing the disease.

Another study found brain damage may occur in patients after suffering only one episode of mild traumatic brain injury. The patients who experienced mild traumatic brain injuries showed brain atrophy, a loss of gray and white matter, one year after the incident.

More than 1.7 million Americans are hospitalized after a traumatic brain injury each year, many from vehicle collisions, falls and sports injuries.