Feiss Robyn, Corrigan John D, Ding Kele, Beaulieu Cynthia L, Bogner Jennifer, Yang Jingzhen
Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Division of Rehabilitation Psychology, Department of Physical Medicine and Rehabilitation, The Ohio State University College of Medicine, Columbus, OH, USA.
Inj Epidemiol. 2022 Aug 15;9(1):25. doi: 10.1186/s40621-022-00390-w.
While lifetime history of traumatic brain injury (TBI) is associated with increased risk of disabilities, little is known about disability and TBI among Appalachian and other rural residents. This study aimed to examine if the relationship between lifetime history of TBI with loss of consciousness (LOC) and disability differs by location of living (Appalachian vs. non-Appalachian; rural vs. urban).
We obtained data on lifetime history of TBI with LOC, location of living, and six sources of disability (auditory, visual, cognitive, mobility, self-care related, and independent living-related impairments) from the 2016-2019 Ohio Behavioral Risk Factor Surveillance System. We modeled the disability outcomes with Appalachian living (or rural living), lifetime history of TBI with LOC, and their interaction as independent variables.
Of the 16,941 respondents included, 16.9% had a lifetime history of TBI with LOC, 19.5% were Appalachian residents and 22.9% were rural residents. Among Appalachian residents, 56.1% lived in a rural area. Appalachian (ARR = 1.92; 95%CI = 1.71-2.13) and rural residents (ARR = 1.87; 95%CI = 1.69-2.06) who had a lifetime history of TBI with LOC were at greater risk for having any disability compared to non-Appalachian and urban residents without lifetime history of TBI with LOC, respectively.
Appalachian and rural living and lifetime history of TBI with LOC are risk factors for disability. Future research and health policies should address mechanisms for this risk as well as access to healthcare services following a TBI among Appalachian and rural residents.
虽然创伤性脑损伤（TBI）的终生病史与残疾风险增加有关，但对于阿巴拉契亚及其他农村居民中的残疾与TBI情况却知之甚少。本研究旨在探讨有昏迷（LOC）的TBI终生病史与残疾之间的关系是否因居住地点（阿巴拉契亚地区与非阿巴拉契亚地区；农村与城市）而异。
我们从2016 - 2019年俄亥俄州行为风险因素监测系统获取了有关有LOC的TBI终生病史、居住地点以及六种残疾来源（听觉、视觉、认知、行动能力、自我护理相关和独立生活相关损伤）的数据。我们将阿巴拉契亚地区居住情况（或农村居住情况）、有LOC的TBI终生病史及其交互作用作为自变量，对残疾结果进行建模。
在纳入的16941名受访者中，16.9%有带LOC的TBI终生病史，19.5%是阿巴拉契亚地区居民，22.9%是农村居民。在阿巴拉契亚地区居民中，56.1%生活在农村地区。与没有带LOC的TBI终生病史的非阿巴拉契亚和城市居民相比，有带LOC的TBI终生病史的阿巴拉契亚居民（调整风险比[ARR] = 1.92；95%置信区间[CI] = 1.71 - 2.13）和农村居民（ARR = 1.87；95%CI = 1.69 - 2.06）患任何残疾的风险更高。
阿巴拉契亚地区和农村居住情况以及有LOC的TBI终生病史是残疾的风险因素。未来的研究和卫生政策应探讨这种风险的机制，以及阿巴拉契亚和农村居民TBI后获得医疗服务的途径。
