Epidemiology of Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury

Raj G. Kumar; Shannon B. Juengst; Zhensheng Wang; Kristen Dams-OʼConnor; Sureyya S. Dikmen; Therese M. OʼNeil-Pirozzi; Marie N. Dahdah; Flora M. Hammond; Elizabeth R. Felix; Patricia M. Arenth; Amy K. Wagner

doi:10.1097/HTR.0000000000000273

Epidemiology of Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury

Raj G. Kumar, Shannon B. Juengst, Zhensheng Wang, Kristen Dams-OʼConnor, Sureyya S. Dikmen, Therese M. OʼNeil-Pirozzi, Marie N. Dahdah, Flora M. Hammond, Elizabeth R. Felix, Patricia M. Arenth, Amy K. Wagner

Research output: Contribution to journal › Article › peer-review

59 Scopus citations

Abstract

Objectives: Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI. Setting: Level I Trauma centers. Participants: Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134). Design: A TBI-MS prospective cohort study. Main Measures: International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur. Results: The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders. Conclusion: This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.

Original language	English (US)
Pages (from-to)	15-24
Number of pages	10
Journal	Journal of Head Trauma Rehabilitation
Volume	33
Issue number	1
DOIs	https://doi.org/10.1097/HTR.0000000000000273
State	Published - 2018

Keywords

aging
brain injuries
comorbidity
epidemiology

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation
Clinical Neurology

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10.1097/HTR.0000000000000273

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Kumar, R. G., Juengst, S. B., Wang, Z., Dams-OʼConnor, K., Dikmen, S. S., OʼNeil-Pirozzi, T. M., Dahdah, M. N., Hammond, F. M., Felix, E. R., Arenth, P. M., & Wagner, A. K. (2018). Epidemiology of Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury. Journal of Head Trauma Rehabilitation, 33(1), 15-24. https://doi.org/10.1097/HTR.0000000000000273

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title = "Epidemiology of Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury",

abstract = "Objectives: Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI. Setting: Level I Trauma centers. Participants: Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134). Design: A TBI-MS prospective cohort study. Main Measures: International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur. Results: The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders. Conclusion: This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.",

keywords = "aging, brain injuries, comorbidity, epidemiology",

author = "Kumar, {Raj G.} and Juengst, {Shannon B.} and Zhensheng Wang and Kristen Dams-OʼConnor and Dikmen, {Sureyya S.} and OʼNeil-Pirozzi, {Therese M.} and Dahdah, {Marie N.} and Hammond, {Flora M.} and Felix, {Elizabeth R.} and Arenth, {Patricia M.} and Wagner, {Amy K.}",

note = "Funding Information: The authors acknowledge NIDILRR Grant 90DP0041 (R.G.K., A.K.W., S.B.J., P.M.A., Z.W.) (University of Pittsburgh); NIDILRR Grant 90DP0045 (M.D.); NIDILRR Grant 90DP0046 (E.R.F.) (University of Miami); NIDILRR 90DP0038-03-00, NIH/NICHD 1 K01 HD074651- 01A1 (K.D-O) (Icahn School of Medicine at Mount Sinai). Kristen Dams- O'Connor, PhD, serves as a consultant to the Brain Injury Association of America and Craig Hospital and provides clinical expert testimony in forensic cases. Marie Dahdah, PhD, receives some project from the Ginger Murchison Foundation. Publisher Copyright: {\textcopyright} Copyright 2018 Wolters Kluwer Health, Inc.",

year = "2018",

doi = "10.1097/HTR.0000000000000273",

language = "English (US)",

volume = "33",

pages = "15--24",

journal = "Journal of Head Trauma Rehabilitation",

issn = "0885-9701",

publisher = "Lippincott Williams and Wilkins",

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TY - JOUR

T1 - Epidemiology of Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury

AU - Kumar, Raj G.

AU - Juengst, Shannon B.

AU - Wang, Zhensheng

AU - Dams-OʼConnor, Kristen

AU - Dikmen, Sureyya S.

AU - OʼNeil-Pirozzi, Therese M.

AU - Dahdah, Marie N.

AU - Hammond, Flora M.

AU - Felix, Elizabeth R.

AU - Arenth, Patricia M.

AU - Wagner, Amy K.

N1 - Funding Information: The authors acknowledge NIDILRR Grant 90DP0041 (R.G.K., A.K.W., S.B.J., P.M.A., Z.W.) (University of Pittsburgh); NIDILRR Grant 90DP0045 (M.D.); NIDILRR Grant 90DP0046 (E.R.F.) (University of Miami); NIDILRR 90DP0038-03-00, NIH/NICHD 1 K01 HD074651- 01A1 (K.D-O) (Icahn School of Medicine at Mount Sinai). Kristen Dams- O'Connor, PhD, serves as a consultant to the Brain Injury Association of America and Craig Hospital and provides clinical expert testimony in forensic cases. Marie Dahdah, PhD, receives some project from the Ginger Murchison Foundation. Publisher Copyright: © Copyright 2018 Wolters Kluwer Health, Inc.

PY - 2018

Y1 - 2018

N2 - Objectives: Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI. Setting: Level I Trauma centers. Participants: Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134). Design: A TBI-MS prospective cohort study. Main Measures: International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur. Results: The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders. Conclusion: This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.

AB - Objectives: Aging individuals with traumatic brain injury (TBI) experience multiple comorbidities that can affect recovery from injury. The objective of this study was to describe the most commonly co-occurring comorbid conditions among adults 50 years and older with TBI. Setting: Level I Trauma centers. Participants: Adults 50 years and older with moderate/severe TBI enrolled in the TBI-Model Systems (TBI-MS) from 2007 to 2014 (n = 2134). Design: A TBI-MS prospective cohort study. Main Measures: International Classification of Disease-9th Revision codes collapsed into 45 comorbidity categories. Comorbidity prevalence estimates and trend analyses were conducted by age strata (50-54, 55-64, 65-74, 75-84, ≥85 years). A dimension reduction method, Treelet Transform, classified clusters of comorbidities that tended to co-occur. Results: The 3 most commonly occurring comorbid categories were hypertensive disease (52.6/100 persons), other diseases of the respiratory system (51.8/100 persons), and fluid component imbalances (43.7/100 persons). Treelet Transform classified 3 clusters of comorbid codes, broadly classified as (1) acute medical diseases/infections, (2) chronic conditions, and (3) substance abuse disorders. Conclusion: This study provides valuable insight into comorbid conditions that co-occur among adults 50 years and older with TBI and provides a foundation for future studies to explore how specific comorbidities affect TBI recovery.

KW - aging

KW - brain injuries

KW - comorbidity

KW - epidemiology

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Epidemiology of Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury

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