Dorji Harnod1,2, Yu-Shu Yen3,4, Cheng-Li Lin5,6, Tomor Harnod7,8, Chia-Hung Kao9,10,11. 1. Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City. 2. School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City. 3. Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei. 4. School of Medicine, National Yang-Ming University, Taipei. 5. Management Office for Health Data, China Medical University Hospital, Taichung. 6. College of Medicine, China Medical University, Taichung. 7. Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien. 8. College of Medicine, Tzu Chi University, Hualien. 9. Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung. 10. Department of Nuclear Medicine and PET Center, and Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung. 11. Department of Bioinformatics and Medical Engineering, Asia University, Taichung.
Abstract
BACKGROUND: We used data from the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients who develop posttraumatic parkinsonism (PTP) after traumatic brain injury (TBI) have an increased mortality risk. METHODS: We analyzed data from the NHIRD of patients aged ≥20 years who had received a diagnosis of and admitted for head injury with TBI (ICD-9-CM 850-854, 959.01) from 2000 to 2012. The TBI cohort was further divided into PTP and posttraumatic non-parkinsonism (PTN) cohorts and compared against a sex-, age-, comorbidity-, and index-date-matched comparison cohort. We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of all-cause mortality risk in these cohorts after adjustment for age, sex, and comorbidities. RESULTS: There were 23,504 and 744 patients enrolled in the PTN cohort and the PTP cohort. Subsequent parkinsonism happened with an incidence of 3.07% in patients with TBI, and 11.59% in those aged over 65 years. The PTP cohort (aHR =1.67, 95% CI: 1.47-1.90) other than PTN (aHR =1.37, 95% CI: 1.29-1.45) cohort had a higher risk of mortality. In ones aged 65-74 years (aHR =2.08, 95% CI: 1.41-3.07), there was a more increased mortality risk in patients with PTP when compared to the PTN cohort. CONCLUSIONS: PTP would increase the long-term mortality risk of patients with TBI, especially in whom aged 65-74 years. Our findings provide vital information for clinicians and the government to improve the long-term prognosis of TBI. 2019 Annals of Translational Medicine. All rights reserved.
BACKGROUND: We used data from the National Health Insurance Research Database (NHIRD) of Taiwan to determine whether patients who develop posttraumatic parkinsonism (PTP) after traumatic brain injury (TBI) have an increased mortality risk. METHODS: We analyzed data from the NHIRD of patients aged ≥20 years who had received a diagnosis of and admitted for head injury with TBI (ICD-9-CM 850-854, 959.01) from 2000 to 2012. The TBI cohort was further divided into PTP and posttraumatic non-parkinsonism (PTN) cohorts and compared against a sex-, age-, comorbidity-, and index-date-matched comparison cohort. We calculated the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of all-cause mortality risk in these cohorts after adjustment for age, sex, and comorbidities. RESULTS: There were 23,504 and 744 patients enrolled in the PTN cohort and the PTP cohort. Subsequent parkinsonism happened with an incidence of 3.07% in patients with TBI, and 11.59% in those aged over 65 years. The PTP cohort (aHR =1.67, 95% CI: 1.47-1.90) other than PTN (aHR =1.37, 95% CI: 1.29-1.45) cohort had a higher risk of mortality. In ones aged 65-74 years (aHR =2.08, 95% CI: 1.41-3.07), there was a more increased mortality risk in patients with PTP when compared to the PTN cohort. CONCLUSIONS: PTP would increase the long-term mortality risk of patients with TBI, especially in whom aged 65-74 years. Our findings provide vital information for clinicians and the government to improve the long-term prognosis of TBI. 2019 Annals of Translational Medicine. All rights reserved.
Entities:
Keywords:
Cohort study; National Health Insurance; mortality; parkinsonism; traumatic brain injury (TBI)
Authors: Marina Frantseva; Jose Luis Perez Velazquez; Alexandre Tonkikh; Yana Adamchik; Peter L Carlen Journal: Prog Brain Res Date: 2002 Impact factor: 2.453
Authors: David C Perry; Virginia E Sturm; Matthew J Peterson; Carl F Pieper; Thomas Bullock; Bradley F Boeve; Bruce L Miller; Kevin M Guskiewicz; Mitchel S Berger; Joel H Kramer; Kathleen A Welsh-Bohmer Journal: J Neurosurg Date: 2015-08-28 Impact factor: 5.115
Authors: Douglas H Smith; Kunihiro Uryu; Kathryn E Saatman; John Q Trojanowski; Tracy K McIntosh Journal: Neuromolecular Med Date: 2003 Impact factor: 3.843