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首页> 外文期刊>Journal of neurotrauma >Risk of Depression after Traumatic Brain Injury in a Large National Sample
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Risk of Depression after Traumatic Brain Injury in a Large National Sample

机译：在大型国家样本中创伤性脑损伤后抑郁症

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Depression is associated with poorer recovery after traumatic brain injury (TBI), yet awareness of depression risk post-TBI among providers and patients is low. The aim of this study was to estimate risk of depression post-TBI among adults 18 years of age and older and to identify risk factors associated with developing depression post-TBI. We conducted a retrospective, matched cohort study using claims data for privately insured and Medicare Advantage enrollees in a large U.S. health plan. Adults 18 years of age diagnosed with TBI (n=207,354) with 12 months continuous insurance coverage pre-TBI and 24 months post-TBI were matched to controls without TBI (n=414,708). We identified the presence of depression on any in- or outpatient claim occurring during the study period (both before and after TBI). Of the initial 622,062 individuals, 62,963 (10%) had depression pre-TBI and were excluded from incidence calculations. Incidence of depression post-TBI was 79.5 (95% confidence interval [CI], 78.5,80.5) per 1,000 person-years compared to 33.5 (95% CI, 33.1,34.0) per 1,000 person-years for those without TBI. The adjusted hazard ratio for depression post-TBI was 1.83 (95% CI, 1.79,1.86). We observed effect modification by sex and age, with males and older adults at increased risk. History of neuropsychiatric disturbances pre-TBI was the strongest predictor of depression post-TBI. Risk of depression increases substantially post-TBI. Groups at increased risk include those with a history of neuropsychiatric disturbances, older adults, and men. This study highlights the importance of long-term monitoring for depression post-TBI.
机译：创伤性脑损伤（TBI）后抑郁症与较差的恢复有关，但在提供者和患者中，TBI后抑郁风险的认识性低。本研究的目的是在18岁及以上的成年人中估算抑郁症后TBI的风险，并确定与TBI后抑郁症相关的危险因素。我们在大型美国健康计划中进行了一个追溯，匹配的队列研究，用于私人保险和Medicare Advantage登记者。 18岁的成年人诊断为TBI（n = 207,354），连续12个月连续保险覆盖预TBI和24个月与没有TBI的对照匹配（n = 414,708）。我们确定了在研究期间发生的任何内外权利要求的抑郁症（TBI之前和之后）。在最初的622,062个个体中，62,963（10％）具有凹陷前TBI，并且被排除在发生率计算之外。抑郁症后TBI的发病率为79.5（95％置信区间[CI]，78.5,80.5），与33.5（95％CI，33.1,34.0）相比，每1000人为没有TBI的年龄。 TBI后抑郁症的调整后危险比为1.83（95％CI，1.79,1.86）。我们观察了性别和年龄的效果修饰，雄性和老年人的风险增加。神经精神障碍的历史前TBI是TBI后抑郁症的最强预测因子。抑郁症的风险显着增加了TBI后。风险增加的群体包括那些具有神经精神障碍，老年人和男性的历史的人。本研究突出了TBI后长期监测的重要性。

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