Head injury linked to increased risk of death over long-term

Is head injury associated with long-term all-cause mortality risk? Findings from a 30-year follow-up study indicate such an association, researchers reported on Jan 25, 2023 in JAMA Neurology.

“Our data reveals that head injury is associated with increased mortality rates even long-term. This is particularly the case for individuals with multiple or severe head injuries,” said lead author, Holly Elser, MD, PhD, MPH,  Neurology Specialist in Philadelphia, PA. “This highlights the importance of safety measures, like wearing helmets and seatbelts, to prevent head injuries.”

Prior research has shown that increased short-term mortality is associated with head injuries. In this newly reported long-term study the researchers evaluated 30 years of data from over 13,000 community-dwelling participants (those not hospitalized or living in nursing home facilities).

The endpoint was the impact of head injury on mortality rates in adults over the 30-year period.

Of the 13, 037 subjects in the study, over half were female (57.7%), 27.9% were Black (72.1% White), and the median age at baseline was 54 years.

Median follow-up was 27 years.

During follow-up, head injuries were reported by 2,402 subjects (18.4%), mostly classified as mild, with 12.4% classified as moderate or severe.

Median period between a head injury and death was 4.7 years.

Death from all causes was recorded in 64.6 percent of subjects who reported a head injury, and in 54.6 percent of those with none.

Adjusting for demographic differences among the subjects, the researchers found that the mortality rate from all-causes among subjects with a head injury was twice (2.21) the mortality rate among those with no head injury.

They also reported that the mortality rate among subjects with more severe head injuries was almost triple (2.87 times) the mortality rate among those with no head injury.

“Study data doesn’t explain why the cause of death in individuals with head injuries is more likely to be from neurodegenerative diseases, which underscores the need for further research into the relationship between these disorders, head injury, and death,” said Andrea L.C. Schneider, MD, PhD, Assistant Professor of Neurology at the University of Pennsylvania in Philadelphia, PA.

The data used in this study was from extracted from the Atherosclerosis Risk in Communities (ARIC) Study, an ongoing community-based study of 15,792 subjects aged 45-65 years enrolled from the suburbs of Minneapolis, Minnesota, Washington County, Maryland, Forsyth County, North Carolina, and Jackson, Mississippi in 1987-1989.