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Analyzing Mortality Risk and Medical Burden among Patients with Traumatic Brain Injury and Subsequent Dementia

1,2, 3,4,*, 5,6 and 7,8,9,*
1
Department of Emergency and Critical Care Medicine, Fu Jen Catholic University Hospital, New Taipei City 243, Taiwan
2
School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 243, Taiwan
3
Department of Neurosurgery, Hualien Tzu Chi General Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
4
College of Medicine, Tzu Chi University, Hualien 970, Taiwan
5
Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
6
College of Medicine, China Medical University, Taichung 404, Taiwan
7
Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung 404, Taiwan
8
Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404, Taiwan
9
Department of Bioinformatics and Medical Engineering, Asia University, Taichung 413, Taiwan
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(5), 686; https://doi.org/10.3390/jcm8050686
Received: 12 April 2019 / Revised: 9 May 2019 / Accepted: 12 May 2019 / Published: 15 May 2019
(This article belongs to the Section Neuroscience)
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PDF [414 KB, uploaded 15 May 2019]
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Abstract

We used the National Health Insurance Research Database of Taiwan to determine whether patients with posttraumatic dementia (PTD) exhibit increased mortality and medical burden than those without it. Patients ≥20 years of age having head injury admission (per the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 850–854, 959.01) between 2000 and 2012 were enrolled as traumatic brain injury (TBI) cohort. A PTD cohort (with ICD-9-CM codes 290, 294.1, 331.0) and a posttraumatic nondementia (PTN) cohort were established and compared in terms of age, sex, and comorbidities. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of all-cause mortality risk, number of hospital days, and frequency of medical visits in these cohorts. Patients with PTD had a higher mortality rate than did patients with TBI alone (rate per 1000 person-years: 12.00 vs. 6.32), with an aHR of 1.54 (95% CI: 1.32–1.80). Patients with PTD who were aged ≥65 years (aHR = 1.54, 95% CI: 1.31–1.80) or male (aHR = 1.78, 95% CI: 1.45–2.18) exhibited greatly increased risks of mortality. Furthermore, patients with PTD had 19.9 more hospital days and required medical visits 4.49 times more frequently compared with the PTN cohort. Taiwanese patients with PTD had increased mortality risk and medical burden compared with patients who had TBI only. Our findings provide crucial information for clinicians and the government to improve TBI and PTD outcomes. View Full-Text
Keywords: cohort study; mortality; national health insurance; posttraumatic dementia; traumatic brain injury cohort study; mortality; national health insurance; posttraumatic dementia; traumatic brain injury
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Harnod, D.; Harnod, T.; Lin, C.-L.; Kao, C.-H. Analyzing Mortality Risk and Medical Burden among Patients with Traumatic Brain Injury and Subsequent Dementia. J. Clin. Med. 2019, 8, 686.

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