The Longitudinal Effects of Comorbid Health Burden on Functional Outcomes for Adults With Moderate to Severe Traumatic Brain Injury.
Raj G Kumar, Jessica M Ketchum, John D Corrigan and 3 others
PMID 32108718WHAT IT FOUND
Among 10-year survivors of moderate to severe TBI, higher physical burden was associated with worse motor, cognitive, and life satisfaction trajectories; higher mental burden was associated with worse cognition and life satisfaction.
Key findings
01Multimorbidity was common: 69.5% of the analytic cohort had two or more health conditions besides TBI by 10 years post-injury.
02Physical and total health burden were significantly associated with FIM Motor trajectory shape, but mental burden was not.
03Physical, mental, and total health burden were significantly associated with FIM Cognitive and SWLS trajectory shape.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This was an observational study, so it cannot show that comorbidities caused worse outcomes or that treating them improves outcomes. The analytic cohort included only 10-year survivors with at least three follow-up visits; of 817 potentially eligible people, 404 were included, 141 had died, and 272 survived but were not included. Health conditions were self-reported at 10 years and not verified against medical records, and the burden score counted each condition equally without information on severity or treatment. Life satisfaction could only be completed by the person with TBI, so SWLS data were available for 326 of 393 participants. The study did not have timing of diagnoses, so it could not model how disease burden changed over time. The health burden score was a simple sum, not a validated TBI comorbidity index.
Declared interests
The authors reported no competing interests. The article metadata lists research support from NIH and the U.S. Government, non-PHS.
The easy way to misread this
Do not read these associations as proof that treating comorbid conditions will improve TBI outcomes. This study counted health conditions in 10-year survivors, did not test treatment, and used a simple sum score that treated each condition equally.