title: Pre-existing health conditions and repeat traumatic brain injury.
abstract: OBJECTIVE
  To assess and compare the effect of Pre-existing epilepsy/seizure disorder and drug/alcohol problem on the hazard of repeat traumatic brain injury (TBI) in persons with TBI who participated in a follow-up study.
  
  
  METHODS
  Retrospective cohort.
  
  
  METHODS
  Acute care hospitals in South Carolina.
  
  
  METHODS
  Participants were from the South Carolina Traumatic Brain Injury Follow-up Registry cohort of persons (N=2118) who were discharged from an acute care hospital in South Carolina and who participated in a year-1 follow-up interview.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Repeat TBI was defined by 2 isolated events of TBI in the same person at least 72 hours apart and recorded in hospital discharge or emergency department records from 1999 through 2005.
  
  
  RESULTS
  A Cox proportional hazards model was used to assess the associations of Pre-existing epilepsy/seizure disorder and drug/alcohol problem with time to repeat TBI, controlling for other confounding factors. There were 2099 persons with information on both Pre-existing conditions. There were 147 (7%) persons who sustained repeat TBI after recruitment to the follow-up study, and 82 (3.9%) had a previous TBI before recruitment for which they were seen in the hospital discharge or emergency department since 1996. The hazard of repeat TBI for persons with Pre-existing epilepsy/seizure disorder was 2.3 times the hazard for those without (hazard ratio, 2.3; 95% confidence interval, 1.2-4.4; P=.011). Pre-existing drug/alcohol problem was not associated with repeat TBI. Other variables significantly associated with repeat TBI were having a prior TBI, being insured under Medicaid, and having no insurance.
  
  
  CONCLUSIONS
  Pre-existing epilepsy/seizure disorder predisposes to repeat TBI. Appropriate management of seizure control may be an important strategy to allay the occurrence of repeat TBI.
authors.affiliation: Department of Health Sciences and Research, Medical University of South Carolina, Charleston, 77 President St, Ste 117, MSC 700, Charleston, SC 29425, USA. saundel@musc.edu
authors.forename: Lee L
authors.initials: LL
authors.lastname: Saunders
authors.forename: Anbesaw W
authors.initials: AW
authors.lastname: Selassie
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Hill
authors.forename: Michael D
authors.initials: MD
authors.lastname: Horner
authors.forename: Joyce S
authors.initials: JS
authors.lastname: Nicholas
authors.forename: Daniel T
authors.initials: DT
authors.lastname: Lackland
authors.forename: John D
authors.initials: JD
authors.lastname: Corrigan
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology*; D016009:Chi-Square Distribution; D004827:Epilepsy / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013022:South Carolina / Q000453:epidemiology; D019966:Substance-Related Disorders / Q000150:complications*