Long-Term Health Outcomes of Traumatic Brain Injury in Veterans
Menée à partir de données américaines 2004-2019 portant sur près de 2 millions de vétérans (âge médian : 31 ans ; durée médiane de suivi : 7,2 ans ; 80,2 % d'hommes), cette étude analyse l'association entre des lésions cérébrales traumatiques et le risque de cancer du cerveau (398 cas)
Traumatic brain injury (TBI) has become one of the most prevalent battle wounds among veterans of the Iraq and Afghanistan wars. According to the Defense and Veterans Brain Injury Center, nearly 414 000 service members worldwide sustained TBI between 2000 and late 2019. More than 185 000 veterans receiving Veterans Affairs (VA) health care have received at least 1 diagnosis of TBI, mostly mild cases. The impact of TBI and related conditions substantially burdens service members, families, clinicians, and health systems.Numerous psychiatric and medical consequences arise after TBI, including posttraumatic stress disorder, depression, suicidal thoughts, cognitive deficits, chronic pain, and unemployment. TBI severity appears to be linked to certain outcomes. Given this backdrop, the analysis by Stewart et al provides a timely probe of associations between TBI severity and subsequent risk of brain cancer in this vulnerable patient cohort. This retrospective cohort study analyzed records of more than 1.9 million post-9/11 veterans. Notable findings indicate that moderate, severe, and penetrating TBI were associated with elevated brain cancer risk, but mild TBI was not. This finding suggests that severe TBI may predispose veterans to brain cancer, whereas mild TBI likely is not associated with heightened risk. Crude incidence rates per 100 000 person-years were 3.06 for no TBI, 2.85 for mild TBI, 4.88 for moderate/severe TBI, and 10.34 for penetrating TBI (P < .001), displaying a stepwise increase in brain cancer incidence corresponding to worse TBI severity.
JAMA Network Open , éditorial en libre accès, 2023