• Preventive medicine · Aug 2024

    Traumatic brain injury and long-term associations with work, divorce and academic achievement.

    • Hana Malá Rytter, Carsten Hjorthøj, Heidi Jeannet Graff, Lene Falgaard Eplov, Merete Nordentoft, Michael E Benros, Annette Erlangsen, and Trine Madsen.
    • The Danish Concussion Center, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark; University Hospital Bispebjerg - Frederiksberg, Department of Neurology, Copenhagen, Denmark. Electronic address: hana.mala@psy.ku.dk.
    • Prev Med. 2024 Aug 1; 185: 108062108062.

    ObjectiveTraumatic brain injuries (TBI), irrespective of severity, may have long-term social implications. This study explores the relationships between TBI severity and outcomes related to work stability, divorce, and academic achievement.MethodsUsing a Danish nationwide sample of persons with and without TBI, we employed case-control and longitudinal cohort designs. The case-control design utilized individuals aged 18 to 60 years and examined work stability. Each case, employed at time of TBI, was compared with 10 matched controls. The cohort design utilized individuals alive from 1980 to 2016 with and without TBI and assessed the likelihood of 1) divorce and 2) higher-level education. TBI exposures included concussion, skull fractures, or confirmed TBI.ResultsTBI cases exhibited higher odds ratios (OR) for work instability at all follow-ups compared to controls. Increased TBI severity was associated with a higher risk of work instability at 2-year follow-up (concussion: OR = 1.83; skull fracture: OR = 2.22; confirmed TBI: OR = 4.55), and with a higher risk of not working at 10-year follow-up (confirmed TBI: OR = 2.82; concussion: OR = 1.63). The divorce incidence rate ratio (IRR) was elevated in individuals with TBI (males: IRR = 1.52; females: IRR = 1.48) compared to those without TBI. Individuals with childhood TBI had reduced chances of attaining high school degree or higher (males: IRR = 0.79; females: IRR = 0.85) compared to those without TBI.ConclusionTBI is associated with an increased long-term risk of social consequences, including work instability, divorce, and diminished chances of higher education, even in cases with concussion.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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