Patients with traumatic brain injury (TBI) have a higher risk of premature death, particularly from suicides, injuries and assaults, according to a study by Seena Fazel, M.D., of the University of Oxford, United Kingdom, and colleagues.

TBI is a substantial cause of disability, according to the study background. Researchers studied all patients born in 1954 or later in Sweden who were diagnosed with TBI from 1969 to 2009 (n=218,300). Among 11,053 patients with premature death after TBI, 2,378 (21.5 percent) died six months or later after diagnosis. The authors compared mortality rates six months or more after TBI with controls (n=2,163,190) and unaffected siblings of patients with TBI (n=150,513).

Researchers found an increased risk of dying among patients who survived six months after TBI compared to those without TBI. The risk remained for years after the TBI. Patients' risk of death from external causes, including suicide, injury and assault, also was higher. Patients with TBI also were at risk for premature death if they had psychiatric or substance abuse conditions, with 61 percent of premature deaths in TBI patients with a psychiatric or substance abuse diagnosis.

"Current clinical guidelines may need revision to reduce mortality risks beyond the first few months after injury and address high rates of psychiatric comorbidity and substance abuse," the authors conclude.