While chronic neurological effects from concussion have been studied widely, little is known about possible links between concussion and long-term medical and behavioral comorbidities. We performed a retrospective cohort study of 9205 adult patients with concussion, matched to non-concussion controls from a hospital-based electronic medical registry. Patients with comorbidities before the index visit were excluded. Behavioral and medical comorbidities were defined by International Classification of Diseases, Ninth and Tenth Revision codes. Groups were followed for up to 10 years to identify comorbidity incidence after a concussion. Cox proportional hazards models were used to calculate associations between concussion and comorbidities after multi-variable adjustment. Patients with concussion were 57% male (median age: 31; interquartile range [IQR] = 23–48 years) at enrollment with a median follow-up time of 6.1 years (IQR = 4.2–9.1) and well-matched to healthy controls. Most (83%) concussions were evaluated in outpatient settings (5% inpatient). During follow-up, we found significantly higher risks of cardiovascular risks developing including hypertension (hazard ratio [HR] = 1.7, 95% confidence interval [CI]: 1.5–1.9), obesity (HR = 1.7, 95% CI: 1.3–2.0), and diabetes mellitus (HR = 1.8, 95% CI: 1.4–2.3) in the concussion group compared with controls. Similarly, psychiatric and neurological disorders such as depression (HR = 3.0, 95% CI: 2.6–3.5), psychosis (HR = 6.0, 95% CI: 4.2–8.6), stroke (HR = 2.1 95% CI: 1.5–2.9), and epilepsy (HR = 4.4, 95% CI: 3.2–5.9) were higher in the concussion group. Most comorbidities developed less than five years post-concussion. The risks for post-concussion comorbidities were also higher in patients under 40 years old compared with controls. Patients with concussion demonstrated an increased risk of development of medical and behavioral health comorbidities. Prospective studies are warranted to better describe the burden of long-term comorbidities in patients with concussion.

中文翻译：

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慢性医学和行为健康合并症的脑震荡和风险

虽然脑震荡对慢性神经系统的影响已被广泛研究，但人们对脑震荡与长期医学和行为合并症之间可能存在的联系知之甚少。我们对 9205 名脑震荡成年患者进行了一项回顾性队列研究，与来自基于医院的电子医疗登记处的非脑震荡对照相匹配。首次就诊前有合并症的患者被排除在外。行为和医学合并症由国际疾病分类第九和第十版定义代码。对各组进行长达 10 年的随访，以确定脑震荡后的合并症发生率。Cox比例风险模型用于计算多变量调整后脑震荡和合并症之间的关联。脑震荡患者在入组时为 57% 的男性（中位年龄：31；四分位距 [IQR] = 23-48 岁），中位随访时间为 6.1 年（IQR = 4.2-9.1），并且与健康对照组非常匹配. 大多数（83%）脑震荡是在门诊（5% 住院）中评估的。在随访期间，我们发现发生心血管风险的风险显着增加，包括高血压（风险比 [HR] = 1.7，95% 置信区间 [CI]：1.5–1.9）、肥胖（HR = 1.7，95% CI：1.3– 2.0），与对照组相比，脑震荡组的糖尿病（HR = 1.8, 95% CI：1.4-2.3）。相似地，精神和神经系统疾病，例如抑郁症 (HR = 3.0, 95% CI: 2.6–3.5)、精神病 (HR = 6.0, 95% CI: 4.2–8.6)、中风 (HR = 2.1 95% CI: 1.5–2.9)、脑震荡组的癫痫（HR = 4.4, 95% CI: 3.2-5.9）较高。大多数合并症在脑震荡后不到五年内发展。与对照组相比，40 岁以下患者的脑震荡合并症风险也更高。脑震荡患者出现医学和行为健康合并症的风险增加。前瞻性研究有必要更好地描述脑震荡患者长期合并症的负担。9）在脑震荡组中较高。大多数合并症在脑震荡后不到五年内发展。与对照组相比，40 岁以下患者的脑震荡合并症风险也更高。脑震荡患者出现医学和行为健康合并症的风险增加。前瞻性研究有必要更好地描述脑震荡患者长期合并症的负担。9）在脑震荡组中较高。大多数合并症在脑震荡后不到五年内发展。与对照组相比，40 岁以下患者的脑震荡合并症风险也更高。脑震荡患者出现医学和行为健康合并症的风险增加。前瞻性研究有必要更好地描述脑震荡患者长期合并症的负担。