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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2005 Mar;76(3):395–400. doi: 10.1136/jnnp.2004.037861

Late mortality after head injury

B Pentland 1, L Hutton 1, P Jones 1
PMCID: PMC1739527  PMID: 15716535

Abstract

Objectives: To investigate mortality trends in a cohort of people admitted to a regional head injury unit with all severities of injury in the calendar year 1981.

Methods: A computerised database with details of 1919 admissions was compared with deaths registered by the NHS Central Register, Scotland for the years 1981 to mid-2002. Death certificate information for matches was analysed.

Results: The 1919 admissions referred to 1871 individuals, comprising 93 severe, 205 moderate, and 1573 minor injuries according to Glasgow coma scale criteria. There were 57 deaths (42 severe head injuries, eight moderate, seven minor) during the initial admission, and 340 (six severe, 33 moderate, 301 minor) in the subsequent years. Substance abuse, principally alcohol, was a factor in 37 deaths, suicide accounted for 20, and accidents for 25. The great majority of these latter deaths were in people under the age of 70 years.

Conclusion: Premature deaths after predominantly minor head injury are commonly alcohol related or the result of suicide or accidents.

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Selected References

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  1. Adams J. H., Graham D. I., Jennett B. The structural basis of moderate disability after traumatic brain damage. J Neurol Neurosurg Psychiatry. 2001 Oct;71(4):521–524. doi: 10.1136/jnnp.71.4.521. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Annegers J. F., Grabow J. D., Groover R. V., Laws E. R., Jr, Elveback L. R., Kurland L. T. Seizures after head trauma: a population study. Neurology. 1980 Jul;30(7 Pt 1):683–689. doi: 10.1212/wnl.30.7.683. [DOI] [PubMed] [Google Scholar]
  3. Baguley I., Slewa-Younan S., Lazarus R., Green A. Long-term mortality trends in patients with traumatic brain injury. Brain Inj. 2000 Jun;14(6):505–512. doi: 10.1080/026990500120420. [DOI] [PubMed] [Google Scholar]
  4. Bombardier Charles H., Rimmele Carl T., Zintel Heather. The magnitude and correlates of alcohol and drug use before traumatic brain injury. Arch Phys Med Rehabil. 2002 Dec;83(12):1765–1773. doi: 10.1053/apmr.2002.36085. [DOI] [PubMed] [Google Scholar]
  5. Bombardier Charles H., Temkin Nancy R., Machamer Joan, Dikmen Sureyya S. The natural history of drinking and alcohol-related problems after traumatic brain injury. Arch Phys Med Rehabil. 2003 Feb;84(2):185–191. doi: 10.1053/apmr.2003.50002. [DOI] [PubMed] [Google Scholar]
  6. Brooks N., Symington C., Beattie A., Campsie L., Bryden J., McKinlay W. Alcohol and other predictors of cognitive recovery after severe head injury. Brain Inj. 1989 Jul-Sep;3(3):235–246. doi: 10.3109/02699058909029638. [DOI] [PubMed] [Google Scholar]
  7. Deb S., Lyons I., Koutzoukis C., Ali I., McCarthy G. Rate of psychiatric illness 1 year after traumatic brain injury. Am J Psychiatry. 1999 Mar;156(3):374–378. doi: 10.1176/ajp.156.3.374. [DOI] [PubMed] [Google Scholar]
  8. Dikmen S. S., Machamer J. E., Donovan D. M., Winn H. R., Temkin N. R. Alcohol use before and after traumatic head injury. Ann Emerg Med. 1995 Aug;26(2):167–176. doi: 10.1016/s0196-0644(95)70147-8. [DOI] [PubMed] [Google Scholar]
  9. Dischinger P. C., Mitchell K. A., Kufera J. A., Soderstrom C. A., Lowenfels A. B. A longitudinal study of former trauma center patients: the association between toxicology status and subsequent injury mortality. J Trauma. 2001 Nov;51(5):877–886. doi: 10.1097/00005373-200111000-00009. [DOI] [PubMed] [Google Scholar]
  10. Harris E. C., Barraclough B. Suicide as an outcome for mental disorders. A meta-analysis. Br J Psychiatry. 1997 Mar;170:205–228. doi: 10.1192/bjp.170.3.205. [DOI] [PubMed] [Google Scholar]
  11. Hibbard M. R., Uysal S., Kepler K., Bogdany J., Silver J. Axis I psychopathology in individuals with traumatic brain injury. J Head Trauma Rehabil. 1998 Aug;13(4):24–39. doi: 10.1097/00001199-199808000-00003. [DOI] [PubMed] [Google Scholar]
  12. Jennett B., MacMillan R. Epidemiology of head injury. Br Med J (Clin Res Ed) 1981 Jan 10;282(6258):101–104. doi: 10.1136/bmj.282.6258.101. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kelly D. F. Alcohol and head injury: an issue revisited. J Neurotrauma. 1995 Oct;12(5):883–890. doi: 10.1089/neu.1995.12.883. [DOI] [PubMed] [Google Scholar]
  14. Kolakowsky-Hayner Stephanie A., Gourley Eugene V., 3rd, Kreutzer Jeffrey S., Marwitz Jennifer H., Meade Michelle A., Cifu David X. Post-injury substance abuse among persons with brain injury and persons with spinal cord injury. Brain Inj. 2002 Jul;16(7):583–592. doi: 10.1080/02699050110119475. [DOI] [PubMed] [Google Scholar]
  15. Lewin W., Marshall T. F., Roberts A. H. Long-term outcome after severe head injury. Br Med J. 1979 Dec 15;2(6204):1533–1538. doi: 10.1136/bmj.2.6204.1533. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Miller J. D., Jones P. A. The work of a regional head injury service. Lancet. 1985 May 18;1(8438):1141–1144. doi: 10.1016/s0140-6736(85)92442-0. [DOI] [PubMed] [Google Scholar]
  17. RUSSELL W. R. Disability caused by brain wounds; a review of 1,166 cases. J Neurol Neurosurg Psychiatry. 1951 Feb;14(1):35–39. doi: 10.1136/jnnp.14.1.35. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Rish B. L., Dillon J. D., Weiss G. H. Mortality following penetrating craniocerebral injuries. An analysis of the deaths in the Vietnam Head Injury Registry population. J Neurosurg. 1983 Nov;59(5):775–780. doi: 10.3171/jns.1983.59.5.0775. [DOI] [PubMed] [Google Scholar]
  19. Seel Ronald T., Kreutzer Jeffrey S., Rosenthal Mitchell, Hammond Flora M., Corrigan John D., Black Kertia. Depression after traumatic brain injury: a National Institute on Disability and Rehabilitation Research Model Systems multicenter investigation. Arch Phys Med Rehabil. 2003 Feb;84(2):177–184. doi: 10.1053/apmr.2003.50106. [DOI] [PubMed] [Google Scholar]
  20. Shavelle R. M., Strauss D., Whyte J., Day S. M., Yu Y. L. Long-term causes of death after traumatic brain injury. Am J Phys Med Rehabil. 2001 Jul;80(7):510–519. doi: 10.1097/00002060-200107000-00009. [DOI] [PubMed] [Google Scholar]
  21. Simpson Grahame, Tate Robyn. Suicidality after traumatic brain injury: demographic, injury and clinical correlates. Psychol Med. 2002 May;32(4):687–697. doi: 10.1017/s0033291702005561. [DOI] [PubMed] [Google Scholar]
  22. Strauss D. J., Shavelle R. M., Anderson T. W. Long-term survival of children and adolescents after traumatic brain injury. Arch Phys Med Rehabil. 1998 Sep;79(9):1095–1100. doi: 10.1016/s0003-9993(98)90177-0. [DOI] [PubMed] [Google Scholar]
  23. Teasdale T. W., Engberg A. W. Suicide after traumatic brain injury: a population study. J Neurol Neurosurg Psychiatry. 2001 Oct;71(4):436–440. doi: 10.1136/jnnp.71.4.436. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Thornhill S., Teasdale G. M., Murray G. D., McEwen J., Roy C. W., Penny K. I. Disability in young people and adults one year after head injury: prospective cohort study. BMJ. 2000 Jun 17;320(7250):1631–1635. doi: 10.1136/bmj.320.7250.1631. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Walker A. E., Leuchs H. K., Lechtape-Grüter H., Caveness W. F., Kretschman C. Life expectancy of head injured men with and without epilepsy. Arch Neurol. 1971 Feb;24(2):95–100. doi: 10.1001/archneur.1971.00480320023001. [DOI] [PubMed] [Google Scholar]

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