The Journal of Head Trauma Rehabilitation最新文献_第7页

A Clinical Trial Investigating Telehealth and In-Person Social Communication Skills Training for People With Traumatic Brain Injury: Participant-Reported Communication Outcomes. 一项研究外伤性脑损伤患者远程医疗和面对面社会沟通技能培训的临床试验:参与者报告的沟通结果。

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-07-01 DOI: 10.1097/HTR.0000000000000554

Rachael Rietdijk, Emma Power, Michelle Attard, Robert Heard, Leanne Togher

{"title":"A Clinical Trial Investigating Telehealth and In-Person Social Communication Skills Training for People With Traumatic Brain Injury: Participant-Reported Communication Outcomes.","authors":"Rachael Rietdijk, Emma Power, Michelle Attard, Robert Heard, Leanne Togher","doi":"10.1097/HTR.0000000000000554","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000554","url":null,"abstract":"Objective: To investigate the efficacy of telehealth-based and in-person social communication skills training (TBIconneCT) for people with moderate to severe traumatic brain injury (TBI) based on outcomes reported by the survivor and a close communication partner.Setting: Australia. Two telehealth dyads were located outside Australia.Participants: Adults (n = 51) at least 6 months after moderate-severe TBI with social communication skills deficits, and their usual communication partners (family members, friends, or paid carers).Design: Partially randomized controlled trial, with a telehealth intervention group, in-person intervention group, and a historical control group.Main measures: La Trobe Communication Questionnaire (LCQ) (total score, and number of items with perceived positive change). Both self- and other-reports.Results: Trained participants had significantly more items with perceived positive change than did historical controls. A medium effect size in the sample was observed for improvements in total score reported by trained communication partners after treatment. Comparisons between telehealth and in-person groups found medium to large effect sizes in the sample, favoring the telehealth group on some LCQ variables.Conclusions: Whether delivered via telehealth or in-person, social communication skills training led to perceived positive change in communication skills. It was unexpected that outcomes for the telehealth group were better than for the in-person group on some variables.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"241-253"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000554","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37591732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 14

The Association Between Community Participation and Social Internet Use Among Adults With Traumatic Brain Injury. 创伤性脑损伤成人社区参与与社交网络使用之间的关系。

The Journal of Head Trauma Rehabilitation Pub Date : 2020-07-01 DOI: 10.1097/HTR.0000000000000566

Jessica M Ketchum, Mitch Sevigny, Tessa Hart, Therese M O'Neil-Pirozzi, Angelle M Sander, Shannon B Juengst, Thomas F Bergquist, Laura E Dreer, Gale G Whiteneck

{"title":"The Association Between Community Participation and Social Internet Use Among Adults With Traumatic Brain Injury.","authors":"Jessica M Ketchum, Mitch Sevigny, Tessa Hart, Therese M O'Neil-Pirozzi, Angelle M Sander, Shannon B Juengst, Thomas F Bergquist, Laura E Dreer, Gale G Whiteneck","doi":"10.1097/HTR.0000000000000566","DOIUrl":"10.1097/HTR.0000000000000566","url":null,"abstract":"Objective: To examine the association between social Internet use and real-world societal participation in survivors of moderate-severe traumatic brain injury.Design: Prospective cross-sectional observational study.Setting: Ten Traumatic Brain Injury Model Systems Centers.Participants: A total of 331 participants in the Traumatic Brain Injury Model Systems, interviewed at any follow-up year between April 2014 and March 2015.Main measures: Survey on Internet use, including social media and other online socialization; Participation Assessment with Recombined Tools-Objective with separate analyses of Productivity, Social Relations, Out and About subscales; covariates included demographics, injury variables, and functional and emotional status at follow-up.Results: Participants were classified as social Internet users (N = 232) or nonusers (N = 99). Users had significantly higher Participation Assessment with Recombined Tools-Objective Social Relations scores than nonusers. A similar finding pertained to Out and About scores, with the between-group difference significantly greater for those with greater depressive symptoms severity. Users and nonusers did not differ significantly on Productivity subscale.Conclusions: The positive association between social Internet use and real-world social participation suggests that people with traumatic brain injury do not use social media as an alternative to real-world socialization. Rather, it is likely that similar barriers and facilitators affect both online and real-world social participation following traumatic brain injury. Emotional function should be considered as a moderating factor in further studies.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"254-261"},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8594140/pdf/nihms-1747486.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37686478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Discrepancy Between Cognitive Complaints and Neuropsychological Test Findings in Persons With Traumatic Brain Injury. 外伤性脑损伤患者认知主诉与神经心理测试结果的差异。

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-07-01 DOI: 10.1097/HTR.0000000000000557

Leia Vos, Michael W Williams, Julia M P Poritz, Esther Ngan, Luis Leon-Novelo, Mark Sherer

{"title":"The Discrepancy Between Cognitive Complaints and Neuropsychological Test Findings in Persons With Traumatic Brain Injury.","authors":"Leia Vos, Michael W Williams, Julia M P Poritz, Esther Ngan, Luis Leon-Novelo, Mark Sherer","doi":"10.1097/HTR.0000000000000557","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000557","url":null,"abstract":"Objective: To better identify variables related to discrepancies between subjective cognitive complaints and objective neuropsychological findings in persons with traumatic brain injury (TBI).Setting: Three rehabilitation centers in the United States.Participants: In total, 504 community-dwelling adult survivors of TBI following discharge from inpatient rehabilitation.Design: Prospective cohort observation study.Main measures: Wechsler Adult Intelligence Scale, Fourth Edition, Digit Span; Rey Auditory Verbal Learning Test; Trail Making Test, Part B; Word Memory Test; Patient Health Questionnaire-9; Neurobehavioral Symptom Inventory; TBI-Quality of Life item bank.Results: Statistical analyses revealed multiple factors associated with subjective-objective discrepancies in attention, memory, and executive functions. Depression was consistently associated with underestimation of cognitive abilities. However, subjective-objective discrepancies varied by cognitive domains in regard to other factors related to underestimation and overestimation of abilities.Conclusions: Reconciling and interpreting subjective-objective discrepancies regarding cognitive functions following TBI are important tasks for case conceptualization and treatment planning. Depression is an important patient characteristic to consider when discrepancy patterns indicate underestimation of cognitive abilities. This study highlights the importance of assessing mood, a modifiable patient characteristic, with self-report symptom inventories. Future studies are needed to connect these findings with TBI outcomes.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E382-E392"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000557","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37685599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

Concussion Symptoms Among Athletes: Preinjury Factors Predict Postinjury Factors. 运动员脑震荡症状:损伤前因素预测损伤后因素

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-07-01 DOI: 10.1097/HTR.0000000000000562

Aaron M Sinnott, Anthony P Kontos, Michael W Collins, Justus Ortega

{"title":"Concussion Symptoms Among Athletes: Preinjury Factors Predict Postinjury Factors.","authors":"Aaron M Sinnott, Anthony P Kontos, Michael W Collins, Justus Ortega","doi":"10.1097/HTR.0000000000000562","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000562","url":null,"abstract":"Objective: Determine whether preinjury concussion symptom factors predict postinjury concussion symptom factors.Setting: Community concussion surveillance program between 2008 and 2017.Participants: A total of 290 high school and collegiate-aged athletes (n = 168, aged 14-17 years; n = 122, aged 18-21 years, respectively).Design: Retrospective analysis.Main measures: Post-Concussion Symptom Scale scores prior to and within 7 days of sustaining a sport-related concussion.Methods: Post-Concussion Symptom Scale scores were aggregated into cognitive-sensory, sleep-arousal, vestibular-somatic, and affective preinjury symptom factors. These preinjury symptom factors, in conjunction with sex and previous concussion history, underwent linear regressions to predict cognitive-migraine-fatigue, somatic, sleep, and affective postinjury symptom factors.Results: The cognitive-sensory factor (P = .002) and female sex (P = .002) predicted the postinjury cognitive-migraine-fatigue factor in combined age group but not stratified age group models. Among the 14 to 17 years age group, and not the 18 to 21 years age group, the preinjury sleep-arousal symptom factor predicted postinjury somatic (P = .003) and sleep factors (P = .005). The affective preinjury factor predicted the affective factor (P = .001) and somatic factor (P = .008) in the 18 to 21 years age group. A history of previous concussions also predicted the postinjury somatic symptom factor (P = .005).Conclusion: Preinjury symptom factors predicted postinjury symptom factors and age-associated differences in symptom factors may provide clinical value in prognostic models for subsequent postinjury clinical outcomes.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E361-E371"},"PeriodicalIF":2.4,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37685604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

From Early Childhood to Adolescence: Lessons About Traumatic Brain Injury From the Ohio Head Injury Outcomes Study. 从幼儿到青少年:来自俄亥俄州头部损伤结果研究的关于创伤性脑损伤的教训。

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-05-01 DOI: 10.1097/HTR.0000000000000555

Christine L Petranovich, Julia Smith-Paine, Shari L Wade, Keith Owen Yeates, H Gerry Taylor, Terry Stancin, Brad G Kurowski

{"title":"From Early Childhood to Adolescence: Lessons About Traumatic Brain Injury From the Ohio Head Injury Outcomes Study.","authors":"Christine L Petranovich, Julia Smith-Paine, Shari L Wade, Keith Owen Yeates, H Gerry Taylor, Terry Stancin, Brad G Kurowski","doi":"10.1097/HTR.0000000000000555","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000555","url":null,"abstract":"Objective: The Ohio Head Injury Outcomes study was a 12-year longitudinal study of early childhood traumatic brain injury (TBI). This article reviewed the findings pertaining to caregiver and family functioning and child cognition, behavior, social competence, emotional functioning, and academics. We further considered individual and social-environmental influences on recovery and interventions.Setting: Recruitment was completed at 3 children's hospitals and 1 general hospital.Participants: Children aged 3 to 7 years at the time of injury with complicated mild to moderate and severe TBI or orthopedic injury requiring hospitalization were included.Design: A concurrent cohort/prospective research design was used. A baseline assessment was completed shortly after the injury. Follow-up assessments were completed at 6, 12, and 18 months and at an average of 38 and 82 months postinjury.Main measures: At baseline, parents/guardians completed retrospective ratings of their child's behavioral, emotional, and social functioning preinjury. At the subsequent assessments, ratings reflected current functioning. Information about current family and caregiver functioning was collected at each time point and cognitive testing was completed at selected time points.Results and conclusions: Recovery after TBI is complex, varies over time, and involves injury-related and premorbid influences, cognition, genetics, and caregiver and family functioning. A sizable number of children with TBI have persisting unmet clinical needs.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"226-239"},"PeriodicalIF":2.4,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37591674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 16

The Relationship Between Fighting Style, Cognition, and Regional Brain Volume in Professional Combatants: A Preliminary Examination Using Brief Neurocognitive Measures. 职业格斗者搏击方式、认知和区域脑容量之间的关系:使用简短神经认知测量的初步检验。

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-05-01 DOI: 10.1097/HTR.0000000000000540

Steve J Stephen, Guogen Shan, Sarah J Banks, Charles Bernick, Lauren L Bennett

{"title":"The Relationship Between Fighting Style, Cognition, and Regional Brain Volume in Professional Combatants: A Preliminary Examination Using Brief Neurocognitive Measures.","authors":"Steve J Stephen, Guogen Shan, Sarah J Banks, Charles Bernick, Lauren L Bennett","doi":"10.1097/HTR.0000000000000540","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000540","url":null,"abstract":"Objective: Repetitive head impacts (RHIs) in combat sports are associated with cognitive decline and brain volume reduction. While fighting style differences between boxers, mixed martial artists (MMAs), and martial artists (MAs) have resulted in a broader spectrum of injury, the effects of RHIs on MAs relative to other fighters have not yet been explored. This study aimed to determine a differential effect of fighting style on cognition and brain.Setting: A large outpatient medical center specializing in neurological care.Participants, design, and main measures: In total, 40 MAs, 188 boxers, and 279 MMAs were compared on baseline measures of subcortical regional brain volumes, after controlling for total brain volumes, and cognitive performance.Results: Significant differences between MAs, MMAs, and boxers were observed in subcortical brain structure volumes and cognitive measures. MMAs and MAs consistently had larger volumes and higher scores than boxers. Fighting style significantly moderated the relationship between the number of professional fights and the volumes of various subcortical brain structures and performance on a measure of processing speed at baseline.Conclusions: Differences in RHIs across fighting styles may be of clinical significance. Exploring changes over time within the MA, boxer, and MMA cohorts may provide insight into longer-term discrepancies in subcortical regional brain volumes and cognitive functioning across fighting styles.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E280-E287"},"PeriodicalIF":2.4,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000540","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37455126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 8

An International Exploration of the Effect of Media Portrayals of Postconcussion Management on Concussion Identification in the General Public. 媒体对脑震荡后管理的描述对公众脑震荡识别影响的国际探索。

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-05-01 DOI: 10.1097/HTR.0000000000000547

Cindy Ku, Audrey McKinlay, Randolph C Grace, Mark Linden, Tracey McLellan

{"title":"An International Exploration of the Effect of Media Portrayals of Postconcussion Management on Concussion Identification in the General Public.","authors":"Cindy Ku, Audrey McKinlay, Randolph C Grace, Mark Linden, Tracey McLellan","doi":"10.1097/HTR.0000000000000547","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000547","url":null,"abstract":"Background: Concussion portrayal in media broadcasts of sporting events may contribute to lack of public understanding regarding concussion.Methods: In total, 828 participants from Australia, New Zealand, and the United Kingdom completed a questionnaire assessing concussion knowledge. Participants were randomly assigned to either receive sports return-to-play (RTP) guideline information (RTP group) or not (no-RTP group). Participants viewed 12 short clips from televised rugby games and indicated whether they believed the player in each clip had sustained a concussion. Participants were then informed whether the player was removed, returned, or stayed in the game and again asked whether they thought a concussion had occurred.Results: Probability of reporting a likely concussion over all videos was 65.6%. When told a player's possible concussion was managed by removal from the game, participants were more likely to change their response from \"no\" (no concussion) to \"yes\" (concussion) than from \"yes\" to \"no.\" When told the player stayed or returned to the game, participants were more likely to change their response from \"yes\" (concussion) to \"no\" (no concussion) than from \"no\" to \"yes.\" There was no significant main effect for RTP guideline manipulation or interaction effect with RTP information.Conclusion: Additional player's injury management information influenced participants' judgments of concussion occurrence. Results show that information provided via sports media broadcasts influenced viewers' perceptions of concussion and appropriate concussion management.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"218-225"},"PeriodicalIF":2.4,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000547","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37455130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Association Between Traumatic Brain Injury and Dementia in Veterans: A Rapid Systematic Review. 退伍军人创伤性脑损伤与痴呆之间的关系:一项快速系统综述。

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-05-01 DOI: 10.1097/HTR.0000000000000549

Kimberly Peterson, Stephanie Veazie, Donald Bourne, Johanna Anderson

{"title":"Association Between Traumatic Brain Injury and Dementia in Veterans: A Rapid Systematic Review.","authors":"Kimberly Peterson, Stephanie Veazie, Donald Bourne, Johanna Anderson","doi":"10.1097/HTR.0000000000000549","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000549","url":null,"abstract":"Objective: To systematically review the prevalence of dementia in Veterans versus civilians and the association between previous traumatic brain injuries (TBIs) and the risk and timing of dementia onset in Veterans.Design: We systematically searched MEDLINE, PsycINFO, and Cochrane Central Register of Controlled Trials from database inception to October 2018. One reviewer assessed articles for inclusion, evaluated study quality, graded strength of evidence, and extracted data, with second reviewer checking.Results: Forty articles were included, among which 10 presented the best evidence. Evidence suggests that dementia rates are likely similar between Veterans and civilians (10.7% vs 8.8%-11.6%, respectively). Dementia prevalence is likely higher in those with TBI (6%-16%) than in those without (3%-10%), with a possible dose-response relationship between the two. There may also be an association between TBI and early-onset dementia, although this evidence has important limitations. No studies evaluated whether dementia prevalence varied on the basis of combat deployment history or era of conflict.Conclusion: Dementia prevalence is likely similar in Veteran and civilian populations, and the risk of dementia is likely increased by TBI. To inform development of screening, prevention, and rehabilitation efforts, research is still needed addressing the mechanism of association and timing of dementia onset.Protocol: PROSPERO; CRD42018107926.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"198-208"},"PeriodicalIF":2.4,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000549","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37591733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Increased Risk of Stroke Among Young Adults With Serious Traumatic Brain Injury. 严重创伤性脑损伤的年轻人中风风险增加。

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-05-01 DOI: 10.1097/HTR.0000000000000539

Timothy D McFarlane, Josh Love, Shane Hanley, Brian E Dixon, Flora M Hammond

{"title":"Increased Risk of Stroke Among Young Adults With Serious Traumatic Brain Injury.","authors":"Timothy D McFarlane, Josh Love, Shane Hanley, Brian E Dixon, Flora M Hammond","doi":"10.1097/HTR.0000000000000539","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000539","url":null,"abstract":"Objective: To quantify the risk of acute ischemic stroke (AIS) following traumatic brain injury (TBI) according to severity.Setting: Indiana Network for Patient Care, including medical records from more than 100 Indiana hospitals and affiliated practices.Participants: Individuals 18 years and older with TBI from 2005 to 2014.Design: Retrospective cohort.Main measures: AIS incidence in the first 30, 31 to 180, and 181 days after TBI. Time to AIS using a stratified Cox proportional hazards model.Results: Among 58 294 patients with TBI, AIS risk was greatest in the first 30 days (incidence rate = 23.3 per 1000 person-months), declining to 3.1 and 1.3 per 1000 person-months after 31 to 180 and 181 days or more, respectively. Cervical artery dissection increased the risk of AIS in the first 30 days (incidence rate = 170.9 per 1000 person-months). In the first 30 days, serious TBI increased risk for all age groups, with the largest effect observed among those aged 18 to 24 years. Over time, serious TBI modified the effect of age on AIS only for those aged 18 to 24 years.Conclusions: These findings add to a growing body of work demonstrating that the acute and postacute stages of TBI play an accelerative role in AIS risk, particularly among younger patients, cervical artery dissection, and serious TBI.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"E310-E319"},"PeriodicalIF":2.4,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000539","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37455125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 10

Traumatic Brain Injury and Opioid Overdose Among Post-9/11 Veterans With Long-Term Opioid Treatment of Chronic Pain. 长期阿片类药物治疗慢性疼痛的9/11后退伍军人的创伤性脑损伤和阿片类药物过量

IF 2.4

The Journal of Head Trauma Rehabilitation Pub Date : 2020-05-01 DOI: 10.1097/HTR.0000000000000546

Jennifer R Fonda, Jaimie L Gradus, Susan B Brogly, Regina E McGlinchey, William P Milberg, Lisa Fredman

{"title":"Traumatic Brain Injury and Opioid Overdose Among Post-9/11 Veterans With Long-Term Opioid Treatment of Chronic Pain.","authors":"Jennifer R Fonda, Jaimie L Gradus, Susan B Brogly, Regina E McGlinchey, William P Milberg, Lisa Fredman","doi":"10.1097/HTR.0000000000000546","DOIUrl":"https://doi.org/10.1097/HTR.0000000000000546","url":null,"abstract":"Objective: To evaluate the association between traumatic brain injury (TBI) and nonfatal opioid overdose, and the role of psychiatric conditions as mediators of this association.Setting: Post-9/11 veterans receiving care at national Department of Veterans Affairs (VA) facilities from 2007 to 2012.Participants: In total, 49 014 veterans aged 18 to 40 years receiving long-term opioid treatment of chronic noncancer pain.Design: Longitudinal cohort study using VA registry data.Main measures: TBI was defined as a confirmed diagnosis (28%) according to VA comprehensive TBI evaluation; no TBI was defined as a negative primary VA TBI screen (ie, no head injury). Nonfatal opioid overdose was defined using ICD-9 (International Classification of Diseases, Ninth Revision) codes. We performed demographic-adjusted Cox proportional hazards regression. We quantified the impact of co-occurring and individual psychiatric conditions (mood, anxiety, substance use, and posttraumatic stress disorder) on this association using mediation analyses.Results: Veterans with TBI had more than a 3-fold increased risk of opioid overdose compared with those without (adjusted hazards ratio [aHR] = 3.22; 95% confidence interval [CI], 2.13-4.89). This association was attenuated in mediation analyses of any co-occurring psychiatric condition (aHR = 1.77; 95% CI, 1.25-2.52) and individual conditions (aHR range, 1.52-2.95).Conclusion: TBI status, especially in the context of comorbid conditions, should be considered in clinical decisions regarding long-term use of opioids in patients with chronic pain.","PeriodicalId":519229,"journal":{"name":"The Journal of Head Trauma Rehabilitation","volume":" ","pages":"209-217"},"PeriodicalIF":2.4,"publicationDate":"2020-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HTR.0000000000000546","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37455129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9