Theadom Alice, Parmar Priya, Jones Kelly, Barker-Collo Suzanne, Starkey Nicola J, McPherson Kathryn M, Ameratunga Shanthi, Feigin Valery L
1 National Institute for Stroke and Applied Neuroscience, Auckland University of Technology , Auckland, New Zealand .
J Neurotrauma. 2015 May 15;32(10):674-81. doi: 10.1089/neu.2014.3579. Epub 2015 Feb 25.
The aim of this study was to determine the frequency, mechanism(s), and impact of recurrent traumatic brain injury (TBI) over a 1-year period. Population-based TBI incidence and 1-year outcomes study with embedded case-control analysis. All participants (adults and children) who experienced a recurrent TBI (more than one) in the 12 months after an index injury and matched controls who sustained one TBI within the same period were enrolled in a population-based TBI incidence and outcomes study. Details of all recurrent TBIs sustained within 12 months of the initial index injury were recorded. Each recurrent TBI case was matched to a case sustaining one TBI based on age (±2 years), gender, and index TBI severity. Cognitive ability, disability, and postconcussion symptoms (PCS) were assessed 1 year after the index injury. Overall, 9.9% (n=72) of TBI cases experienced at least one recurrent TBI within the year after initial index injury. Males, people <35 years of age, and those who had experienced a TBI before their index injury were at highest risk of recurrent TBI. Recurrent TBI cases reported significantly increased PCS at 1 year, compared to the matched controls (n=72) sustaining one TBI. There was no difference in overall cognitive ability and disability between the two groups. People experiencing recurrent TBIs are more likely to experience increased frequency and severity of PCS. Greater public awareness of the potential effects of recurrent brain injury is needed.
本研究的目的是确定复发性创伤性脑损伤（TBI）在1年期间的发生频率、机制及影响。基于人群的TBI发病率及1年结局研究，并进行嵌套式病例对照分析。所有在首次损伤后12个月内经历过复发性TBI（不止一次）的参与者（成人和儿童）以及在同一时期内遭受一次TBI的匹配对照者，均纳入基于人群的TBI发病率及结局研究。记录了首次损伤后12个月内所有复发性TBI的详细情况。根据年龄（±2岁）、性别和首次TBI严重程度，将每例复发性TBI病例与遭受一次TBI的病例进行匹配。在首次损伤后1年评估认知能力、残疾情况和脑震荡后症状（PCS）。总体而言，9.9%（n = 72）的TBI病例在首次损伤后的1年内经历了至少一次复发性TBI。男性、年龄<35岁的人群以及在首次损伤前曾经历过TBI的人群，复发性TBI的风险最高。与遭受一次TBI的匹配对照者（n = 72）相比，复发性TBI病例在1年时报告的PCS显著增加。两组在总体认知能力和残疾情况方面没有差异。经历复发性TBI的人更有可能经历PCS频率和严重程度的增加。需要提高公众对复发性脑损伤潜在影响的认识。
