Long-term causes of death after traumatic brain injury.
OBJECTIVE
To determine which causes of death are more frequent in persons with traumatic brain injury (TBI), and by how much, compared with the general population. Our focus was the period beginning 1 yr after injury.


METHODS
Subjects were 2320 Californians with long-term mental disability after a TBI at age 10 yr or more, followed up between 1988 and 1997. The units of study were person-years, each linked to the subject's age, gender, level of ambulation, time since injury, and cause of death (if any) for the specific year. Observed numbers of cause-specific deaths were compared with numbers expected according to general population mortality rates.


RESULTS
Mortality was higher between 1.0 and 5.0 yr postinjury than after 5.0 yr and was strongly related to reduced mobility. Death rates were elevated for circulatory diseases, respiratory diseases, choking/suffocation, and seizures, with seizure deaths being relatively frequent, even among the most ambulatory.


CONCLUSIONS
Death rates for several causes are elevated in persons with long-term sequelae of TBI. The increased risk of choking/suffocation should be of interest to caregivers. Life expectancy seems to be reduced, even for patients who are fully ambulatory.
Shavelle
R M
RM
Department of Statistics, University of California, Riverside, USA.
Strauss
D
D
Whyte
J
J
Day
S M
SM
Yu
Y L
YL
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000402:Airway Obstruction / Q000209:etiology; D001237:Asphyxia / Q000209:etiology; D001930:Brain Injuries / Q000150:complications / Q000401:mortality*; D002140:California / Q000453:epidemiology; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D016208:Databases, Factual; D005500:Follow-Up Studies; D006801:Humans; D008017:Life Expectancy; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D013997:Time Factors