Brain injuries shorten young lives

With freewheeling summer months behind children and school and organized sports ahead, new research offers some sobering news about the potential for long-term cost when a child’s brain is injured.

In a study that tracked the life trajectories of more than one million Swedes, young people who sustained a brain injury — including a concussion — before 25 were more likely to have a tougher, and shorter, life than were their uninjured siblings.

Compared with a broad population of their unhurt peers, young people who were treated in the hospital for a single traumatic brain injury before the age of 25 were nearly twice as likely, by their mid-30s or so, to be admitted to hospital for a psychiatric illness. They were 76 per cent more likely to be unable to work and require disability benefits and 72 per cent more likely to die before the age of 36.

To ensure that the different outcomes weren’t the product of socioeconomic circumstances or family situations, the researchers compared the outcomes of individuals who sustained a brain injury before 25 directly with those of a sibling who did not.

That direct comparison only marginally diluted the divergent outcomes of the brain-injured and those who were not. Compared with his or her unharmed sibling, a person who had at least one brain injury before 25 was 57 per cent more likely to have an inpatient psychiatric episode, 49 per cent more likely to receive disability benefits, and 40 per cent more likely to die by his or her mid-30s.

Failing to complete high school and receiving welfare payments were also more common among those with an early brain injury, even after family circumstances were taken into account.

The study, published this week in the journal PLoS Medicine, comes against the backdrop of growing concern about brain injuries in young people, particularly those related to organized sports. In 2009, nearly 250,000 Americans age 19 and under were treated in U.S. hospitals for sports- and recreation-related injuries or had them diagnosed, a 57 per cent rise over an eight-year period. In a population of 1,143,470 youngsters born between 1973 and 1985, the new study identified 104,290 Swedes who were diagnosed and treated in a hospital for traumatic brain injury before they were 25. While the severity of those injuries varied, 77.4 per cent were diagnosed as concussion.

The vast majority of the young Swedes in the study — including the 9.1 per cent treated in the hospital for a brain injury while young — turned out fine. In both groups, it was rare to develop serious psychiatric illness or require disability payments by 41, or to die before 36. But among those who had sustained a significant blow to the head, such poor adult outcomes were notably less rare.

Having such a low rate of poor outcomes can magnify small differences between two groups. When the “base number” of those who die early or experience hardships is tiny, even a numerically small increase in such people can appear as a stark difference.

But it is a difference, and the design of the new research suggests that brain trauma likely contributed to an increased risk of hardship.