New Study Examines the Risk of Chronic Cardiovascular and Endocrine Conditions Among Young Population After Traumatic Brain Injury
Boston, MA – A new study in JAMA Network Open titled “Association of Traumatic Brain Injury With the Risk of Developing Chronic Cardiovascular, Endocrine, Neurological and Psychiatric Disorders” examined the rates of cardiovascular, endocrine, neurological and psychiatric comorbidities among patient population with brain injury. While the risk of neurological and psychiatric disorders is well defined among the Traumatic Brain Injury (TBI) population, the cardiovascular and endocrine comorbidity risk post TBI has received little attention. This prospective study examined the cardiovascular and endocrine comorbidity risk post using patients without any prior who experienced TBI from 2000-2019.
“This study shows the importance of proactive screening for cardiometabolic diseases after traumatic brain injury, regardless of age or injury severity. We found the rates of cardiovascular and endocrine comorbidities with anyone with TBI were significantly higher than those without TBI regardless of age. These risk in this particular population has largely been overlooked in studies and our hope is that these results spur proactive screening, and advance the standard of care, and eventually improving outcomes,” said the first author, Saef Izzy, MD, Assistant Professor of Neurology at Brigham and Women’s Hospital and Harvard Medical School.
“It is vital we continue to challenge our previous assumptions on traumatic brain injury especially in younger populations. The data in the study demonstrates that we should explore proactive targeted screenings in the TBI population to address these risk factors earlier, develop interventions and improve their long-term quality of life,” said senior-author Ross Zafonte, DO, President, Spaulding Rehabilitation Network, Chair of the Harvard Medical School Department of Physical Medicine and Rehabilitation at Spaulding, Earle P. and Ida S. Charlton Professor of Physical Medicine and Rehabilitation, Harvard Medical School.
Researchers studied data derived from the Mass General Brigham Research Patient Data Registry, which captures all inpatient, outpatient, and emergency department encounters from a large regional network of hospitals that includes level 1 trauma care centers, community hospitals, and inpatient rehabilitation facilities. The study team found a higher incidence rate of comorbidities among all groups with TBI against those without TBI regardless of age. The study group looked at 21 comorbidities across 4 organ systems. These included cardiovascular disease and risk factors (ie, hypertension, hyperlipidemia, obesity and coronary artery disease), endocrine disorders (ie, hypothyroidism, pituitary dysfunction, diabetes, adrenal insufficiency, and erectile dysfunction), neurological disorders (ie, ischemic stroke or transient ischemic attack, seizure, and all subtypes of dementia) and psychiatric disorders and substance misuse(ie depression, bipolar disorder, psychosis, anxiety disorder, sleep disorder, suicide ideation, intent or attempt, substance misuse).
These results expand the literature by demonstrating a significantly higher incidence of cardiovascular and endocrine risk factors for those with any level of brain injury; mild to moderate to severe. The risk of post-TBI-comorbidities was higher in all age groups when compared with age-matched non-TBI groups. Of particular note, was patients younger than 40 and post-TBI comorbidities were associated with higher mortality over a 10-ear follow up period. These findings highlight the need for proactive targeted screenings of these additional risk factors after TBI in all adults, regardless of age or severity. Future studies to assess the impact of screening on reducing risk factors in post-TBI populations in predicting outcomes is also warranted.
About Spaulding Rehabilitation Network
A member of the Mass General Brigham Health System, the Spaulding Rehabilitation Network includes Spaulding Rehabilitation Hospital, with a main campus in Charlestown the 3rd ranked rehabilitation hospital in the country by U.S. News & World Report, along with Spaulding Rehabilitation Hospital Cape Cod, Spaulding Hospital Cambridge, Spaulding Nursing and Therapy Center Brighton, and over 25 outpatient sites throughout Eastern Massachusetts. An acclaimed teaching hospital of Harvard Medical School and home to the Department of Physical Medicine and Rehabilitation, Spaulding is recognized as one of the top residency programs in the U.S. in the Doximity Residency Navigator. Spaulding also was recognized by the 2021 Disability Equality Index as a “Best Places to Work for Disability Inclusion.” For more information, visit www.spauldingrehab.org.