Association of Trauma With Long-Term Risk of Death and Immune-Mediated or Cancer Disease in Same-Sex Twins

Area of Science:

• Trauma and Injury Research
• Immunology
• Oncology
• Epidemiology

Background:

• Trauma triggers immediate immune system activation.
• Long-term consequences of trauma include premature death, disability, and reduced workability.

Purpose of the Study:

• To investigate the long-term association between moderate to severe trauma and increased risk of death.
• To examine the long-term association between trauma and immune-mediated or cancer diseases.

Main Methods:

• Registry-based, matched, co-twin control cohort study.
• Linked Danish Twin and National Patient Registries (1994-2018).
• Used Cox proportional hazards regression for intrapair analyses.

Main Results:

• 3776 twin pairs included; 2290 eligible for primary outcome analysis.
• Twins exposed to trauma had a 33% increased hazard ratio for death or immune-mediated/cancer disease (HR, 1.33; 95% CI, 1.19-1.49).
• Significantly increased hazard ratios for death (HR, 1.91) and immune-mediated/cancer diseases (HR, 1.28) were observed separately.

Conclusions:

• Moderate to severe trauma is associated with a significantly increased long-term risk of death.
• Trauma survivors face a higher risk of developing immune-mediated or cancer diseases years after the event.
• The co-twin control design strengthens the evidence by accounting for shared genetic and environmental factors.