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Assessing pre-injury health status of older adults who have sustained a traumatic brain injury compared to matched controls

Bulas, Ashlyn (2019) Assessing pre-injury health status of older adults who have sustained a traumatic brain injury compared to matched controls. Master Essay, University of Pittsburgh.

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Abstract

Traumatic brain injuries (TBI) are a major public health burden with approximately 2 million individuals receiving hospital treatment annually. Large heterogeneity exists among individuals who sustain a TBI concerning the clinical representation and post-TBI disease progression. Additionally, older adults tend to have worse post-injury outcomes compared to younger cohorts and research surrounding this difference in clinical prognoses is limited. It remains unknown whether the decline seen post-TBI in older adults can be attributed to a continuation of a pre-existing disease process or whether the TBI was the causal trigger for the cognitive and physical decline. We performed conditional logistic regression analyses that examined pre-index injury physical and behavioral risk factors in inpatient TBI cases from the TBI Health Study compared to matched, non-TBI controls from MIDUS Study populations. We found the odds of having prior year, pre-index injury depression was 3.98 times higher in TBI cases compared to matched controls (OR=3.98, 95% CI=1.71-9.27, p-value=0.001). Subgroup analyses found the odds of having prior year exposure of depression was significant in male TBI cases versus male controls (OR=6.92, 95% CI=2.19-21.90, p-value=<0.001). Additionally, the odds of having prior year exposure of depression was significant in >=65 years TBI cases versus >=65 years controls (OR=6.54, 95% CI=1.72-24.84, p-value=0.006). While most prior year risk factors reported insignificant differences between TBI cases and controls, the null findings suggest that post-TBI disease progression may not be a continuation of prior health conditions. In fact, traumatic brain injuries may be the causal agent for the cognitive and physical health decline experienced after injury. The public health significance is that these results will lead to better categorization of post-TBI disease progression, thus helping improve TBI prevention methods and traumatic brain injury clinical care.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Bulas, Ashlynamb358@pitt.eduamb358
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairRosso, Andreaalr143@pitt.edualr143UNSPECIFIED
Committee MemberDams-O'Connor, Kristenkristen.dams-o'connor@mountsinai.orgUNSPECIFIEDUNSPECIFIED
Committee MemberYouk, Adaayouk@pitt.eduayoukUNSPECIFIED
Date: 11 December 2019
Date Type: Completion
Number of Pages: 59
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: Traumatic Brain Injury, TBI, Head Injury
Date Deposited: 20 Aug 2020 17:08
Last Modified: 20 Aug 2020 17:08
URI: http://d-scholarship.pitt.edu/id/eprint/38009

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