Evidence map›Paper›PMID 38716662›Full record

ArticleStroke2024

Head Injury and Risk of Incident Ischemic Stroke in Community-Dwelling Adults.

Holly Elser, Laura W Pappalardo, Rebecca F Gottesman, Josef Coresh, Ramon Diaz-Arrastia, Thomas H Mosley, Scott E Kasner, Silvia Koton, Andrea L C Schneider

Erratum issuedAbstract read
In one paragraph

Article in Stroke, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Holly ElserDepartment of Neurology (H.E., L.W.P., R.D.-A., S.E.K., A.L.C.S.), University of Pennsylvania, Philadelphia.ORCID 0000-0003-1781-904X
Laura W PappalardoDepartment of Neurology (H.E., L.W.P., R.D.-A., S.E.K., A.L.C.S.), University of Pennsylvania, Philadelphia.
Rebecca F GottesmanNational Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (R.F.G.).ORCID 0000-0002-9504-1256
Josef CoreshDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.C., S.K.).ORCID 0000-0002-4598-0669
Ramon Diaz-ArrastiaDepartment of Neurology (H.E., L.W.P., R.D.-A., S.E.K., A.L.C.S.), University of Pennsylvania, Philadelphia.ORCID 0000-0001-6051-3594
Thomas H MosleyThe Memory Impairment and Neurodegenerative Dementia Center, University of Mississippi Medical Center, Jackson (T.H.M.).ORCID 0000-0003-3343-1352
Scott E KasnerDepartment of Neurology (H.E., L.W.P., R.D.-A., S.E.K., A.L.C.S.), University of Pennsylvania, Philadelphia.ORCID 0000-0003-0418-6917
Silvia Koton *Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.C., S.K.).ORCID 0000-0002-9327-7505
Andrea L C Schneider *Department of Neurology (H.E., L.W.P., R.D.-A., S.E.K., A.L.C.S.), University of Pennsylvania, Philadelphia.ORCID 0000-0003-0026-5052

Funding

ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028U01HL096812 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, THOMAS H MOSLEY · 2010 to 2026
$65.7M
THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY - COORDINATING CENTER - TASK AREA B.2 AND B.375N92022D00001 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI COUPER, DAVID · 2022 to 2025
$13.7M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5U01HL096917 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI MOSLEY, THOMAS H · 2010 to 2018
$11.9M
Stroke, Cognition and Neuroepidemiology SectionZIANS009435 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI GOTTESMAN, REBECCA F · 2022 to 2025
$8.2M
ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5U01HL096899 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI COUPER, DAVID J · 2010 to 2018
$7.5M
ARIC Neurocognitive Study (ARIC-NCS)U01HL096902 · NHLBI · UNIVERSITY OF MINNESOTA · PI LUTSEY, PAMELA L. · 2010 to 2018
$7.4M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 4 of 5U01HL096814 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HUGHES, TIMOTHY M., WAGENKNECHT, LYNNE E · 2010 to 2018
$6.5M
THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY - FIELD CENTER - TASK ORDER 01, TASK AREA A75N92022D00003 · NHLBI · UNIVERSITY OF MINNESOTA · PI LUTSEY, PAMELA L. · 2022 to 2025
$5.1M
THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY - FIELD CENTER - TASK ORDER 01, TASK AREA A75N92022D00005 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI WAGENKNECHT, LYNNE E · 2022 to 2025
$5.0M
THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY - FIELD CENTER - TASK ORDER 01, TASK AREA A75N92022D00004 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI WINDHAM, BEVERLY GWEN · 2022 to 2025
$4.8M
THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY - FIELD CENTER - TASK ORDER 01, TASK AREA A75N92022D00002 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI CORESH, JOSEF · 2022 to 2025
$4.7M
Research Training Program in Disease Oriented Neuroscience (R25)R25NS065745 · NINDS · UNIVERSITY OF PENNSYLVANIA · PI DETRE, JOHN A · 2009 to 2023
$3.0M
NHLBI NIH HHS 75N92022D00001NHLBI NIH HHS 75N92022D00002NHLBI NIH HHS 75N92022D00003NHLBI NIH HHS 75N92022D00004NHLBI NIH HHS 75N92022D00005NHLBI NIH HHS U01 HL096812NHLBI NIH HHS U01 HL096814NHLBI NIH HHS U01 HL096899NHLBI NIH HHS U01 HL096902NHLBI NIH HHS U01 HL096917NINDS NIH HHS K23 NS123340NINDS NIH HHS R25 NS065745
6 · The paper itself

Abstract

backgroundWhile stroke is a recognized short-term sequela of traumatic brain injury, evidence about long-term ischemic stroke risk after traumatic brain injury remains limited.

methodsThe Atherosclerosis Risk in Communities Study is an ongoing prospective cohort comprised of US community-dwelling adults enrolled in 1987 to 1989 followed through 2019. Head injury was defined using self-report and hospital-based diagnostic codes and was analyzed as a time-varying exposure. Incident ischemic stroke events were physician-adjudicated. We used Cox regression adjusted for sociodemographic and cardiovascular risk factors to estimate the hazard of ischemic stroke as a function of head injury. Secondary analyses explored the number and severity of head injuries; the mechanism and severity of incident ischemic stroke; and heterogeneity within subgroups defined by race, sex, and age.

resultsOur analysis included 12 813 participants with no prior head injury or stroke. The median follow-up age was 27.1 years (25th-75th percentile=21.1-30.5). Participants were of median age 54 years (25th-75th percentile=49-59) at baseline; 57.7% were female and 27.8% were Black. There were 2158 (16.8%) participants with at least 1 head injury and 1141 (8.9%) participants with an incident ischemic stroke during follow-up. For those with head injuries, the median age to ischemic stroke was 7.5 years (25th-75th percentile=2.2-14.0). In adjusted models, head injury was associated with an increased hazard of incident ischemic stroke (hazard ratio [HR], 1.34 [95% CI, 1.12-1.60]). We observed evidence of dose-response for the number of head injuries (1: HR, 1.16 [95% CI, 0.97-1.40]; ≥2: HR, 1.94 [95% CI, 1.39-2.71]) but not for injury severity. We observed evidence of stronger associations between head injury and more severe stroke (National Institutes of Health Stroke Scale score ≤5: HR, 1.31 [95% CI, 1.04-1.64]; National Institutes of Health Stroke Scale score 6-10: HR, 1.64 [95% CI, 1.06-2.52]; National Institutes of Health Stroke Scale score ≥11: HR, 1.80 [95% CI, 1.18-2.76]). Results were similar across stroke mechanism and within strata of race, sex, and age.

conclusionsIn this community-based cohort, head injury was associated with subsequent ischemic stroke. These results suggest the importance of public health interventions aimed at preventing head injuries and primary stroke prevention among individuals with prior traumatic brain injuries.

Indexed as

Craniocerebral TraumaIndependent LivingIschemic StrokeAdultAgedCohort StudiesFemaleHumansIncidenceMaleMiddle AgedProspective StudiesRisk Factorsbrain injuries, traumaticcraniocerebral traumaheart disease risk factorsischemic strokestroke

Identifiers

PMID38716662
PMCPMC11126353

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