HealthDay News — The odds of poor long-term outcome trajectories are very high for U.S. military who sustained a concussion in combat, according to a study published in the March/April issue of the Journal of Head Trauma Rehabilitation.

Christine L. MacDonald, Ph.D., from the University of Washington School of Medicine in Seattle, and colleagues examined global disability trajectories in U.S. military with and without traumatic brain injury (TBI) during the first decade following deployment. Patients were followed every six months for 10 years after injury. Participants were in four main groups: 143 combat-deployed controls without a history of blast exposure (nonblast control), 236 concussive blast TBI (blast TBI), 54 combat-deployed controls with a history of blast exposure (blast control), and 42 with combat concussion not from a blast (nonblast TBI).

The researchers identified four main trajectories of global outcome; compared with nonblast controls, those sustaining combat concussion were 37 to 49 times more likely to be in the worse disability trajectories (odds ratios, 49.33 and 37.50 for blast TBI and nonblast TBI, respectively). Compared with nonblast controls, blast-exposed controls were five times more likely to be in the worse disability categories (odds ratio, 5.00). These odds ratios were not altered substantially after adjustment for demographic factors and subsequent head injury exposure.


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“Taken together, we believe these findings help inform targeting of more aggressive treatment strategies in service members meeting this profile of greatest risk following deployment to [aid] in reducing the extremely high public health burden identified with prior conflict,” the authors write.

Abstract/Full Text