Article

OBJECTIVE: To assess and compare the effect of Pre-existing epilepsy/seizure
disorder and drug/alcohol problem on the hazard of repeat traumatic brain injury
(TBI) in persons with TBI who participated in a follow-up study. DESIGN:
Retrospective cohort. SETTING: Acute care hospitals in South Carolina.
PARTICIPANTS: Participants were from the South Carolina Traumatic Brain Injury
Follow-up Registry cohort of persons (N=2118) who were discharged from an acute
care hospital in South Carolina and who participated in a year-1 follow-up
interview. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Repeat TBI was
defined by 2 isolated events of TBI in the same person at least 72 hours apart
and recorded in hospital discharge or emergency department records from 1999
through 2005. RESULTS: A Cox proportional hazards model was used to assess the
associations of Pre-existing epilepsy/seizure disorder and drug/alcohol problem
with time to repeat TBI, controlling for other confounding factors. There were
2099 persons with information on both Pre-existing conditions. There were 147
(7%) persons who sustained repeat TBI after recruitment to the follow-up study,
and 82 (3.9%) had a previous TBI before recruitment for which they were seen in
the hospital discharge or emergency department since 1996. The hazard of repeat
TBI for persons with Pre-existing epilepsy/seizure disorder was 2.3 times the
hazard for those without (hazard ratio, 2.3; 95% confidence interval, 1.2-4.4;
P=.011). Pre-existing drug/alcohol problem was not associated with repeat TBI.
Other variables significantly associated with repeat TBI were having a prior TBI,
being insured under Medicaid, and having no insurance. CONCLUSIONS: Pre-existing
epilepsy/seizure disorder predisposes to repeat TBI. Appropriate management of
seizure control may be an important strategy to allay the occurrence of repeat
TBI.

Langue : ANGLAIS