Global Disability Trajectories Over the First Decade Following Combat Concussion.
Christine L Mac Donald, Jason Barber, Ann Johnson and 2 others
PMID 35258037WHAT IT FOUND
After deployment, service members with combat concussion, whether or not blast was involved, were more likely to have greater long-term disability than controls without concussion.
Key findings
01Combat concussion was associated with a worse global disability trajectory, including blast-related concussion and non-blast concussion.
02Blast exposure without concussion was also associated with a worse global disability trajectory compared with non-blast controls.
03Even the good recovery trajectory showed a downward trend beginning around year 8.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
There was no pre-deployment Glasgow Outcome Scale Extended score, so baseline disability before deployment was not measured. The study did not control for differences in treatment centers used after injury. Few female service members were enrolled, so sex differences could not be examined well. Some findings did not remain significant after adjustment for multiple comparisons, including the age effect in one comparison. The death trajectory had very few members and was not included in comparative modelling. Other unmeasured factors may have influenced trajectories.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the blast-related concussion finding as evidence about isolated blast injury. In this study, all available clinical histories for that group showed blast exposure plus another head-injury mechanism, such as a fall, motor vehicle crash, or being struck by a blunt object.