title: Airmen with mild traumatic brain injury (mTBI) at increased risk for subsequent mishaps.
abstract: BACKGROUND
  Little is known regarding long-term performance decrements associated with mild Traumatic Brain Injury (mTBI). The goal of this study was to determine if individuals with an mTBI may be at increased risk for subsequent mishaps.
  
  
  METHODS
  Cox proportional hazards modeling was utilized to calculate hazard ratios for 518,958 active duty U.S. Air Force service members (Airmen) while controlling for varying lengths of follow-up and potentially confounding variables. Two non-mTBI comparison groups were used; the second being a subset of the original, both without head injuries two years prior to study entrance.
  
  
  RESULTS
  Hazard ratios indicate that the causes of increased risk associated with mTBI do not resolve quickly. Additionally, outpatient mTBI injuries do not differ from other outpatient bodily injuries in terms of subsequent injury risk.
  
  
  CONCLUSIONS
  These findings suggest that increased risk for subsequent mishaps are likely due to differences shared among individuals with any type of injury, including risk-taking behaviors, occupations, and differential participation in sports activities. Therefore, individuals who sustain an mTBI or injury have a long-term risk of additional mishaps.
  
  
  CONCLUSIONS
  Differences shared among those who seek medical care for injuries may include risk-taking behaviors (Cherpitel, 1999; Turner & McClure, 2004; Turner, McClure, & Pirozzo, 2004), occupations, and differential participation in sports activities, among others. Individuals with an mTBI should be educated that they are at risk for subsequent injury. Historical data supported no lingering effects of mTBI, but more recent data suggest longer lasting effects. This study further adds that one of the longer term sequelae of mTBI may be an increased risk for subsequent mishap.
authors: Infoscitex Corporation, Dayton, OH, USA. Electronic address: Casserly.Whitehead.ctr@WPAFB.AF.MIL.
authors: Casserly R
authors: CR
authors: Whitehead
authors: Vulnerability Analysis Branch, AFMC 711 Human Performance Wing, Air Force Research Laboratory, Wright-Patterson AFB, OH, USA. Electronic address: Timothy.Webb@WPAFB.AF.MIL.
authors: Timothy S
authors: TS
authors: Webb
authors: Vulnerability Analysis Branch, AFMC 711 Human Performance Wing, Air Force Research Laboratory, Wright-Patterson AFB, OH, USA. Electronic address: tmlbwells@wowway.com.
authors: Timothy S
authors: TS
authors: Wells
authors: U.S. Air Force Safety Center, Kirtland AFB, NM, USA. Electronic address: Kari.Hunter@Kirtland.AF.MIL.
authors: Kari L
authors: KL
authors: Hunter
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data*; D000328:Adult; D001359:Aviation; D001930:Brain Injuries / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D002487:Centers for Disease Control and Prevention, U.S.; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D016272:Occupational Health / Q000592:standards; D017063:Outcome Assessment, Health Care / Q000592:standards; D010561:Personnel Staffing and Scheduling / Q000145:classification; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology
keywords: Accidents; Concussion; Long-term risk; Occupational safety; Performance decrements