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Published on: February 16, 2011
Self-Perceived Health Status Among Patients With and Without TBI: An All of Us Analysis
Richard Cook1, Kathleen R Ran, Vikas N Vattipally
1Author Affiliations: Department of Neurosurgery, McGovern Medical School at UTHealth Houston (Mr Cook, Dr Jowah, Mr Gundapaneni, Dr Dharnipragada, and Dr Williams), Houston, Texas; and Department of Neurosurgery, Johns Hopkins Hospital (Ms Ran, Mr Vattipally, Dr Suarez, and Dr Azad), Baltimore, Maryland.
Background:
Self-perceived health status, defined as one's overall perception of their health, is associated with adherence to medical care, morbidity, and mortality. However, little is known about the dynamics of self-perceived health status following traumatic brain injury (TBI).
Methods:
Using the NIH All of Us Research Program, participants with TBI (N = 5,055) were matched with respondents without TBI (N = 14,983) through propensity score matching. Multivariable ordinal logistic regression modeled the relationship between TBI and survey questions pertinent to self-perceived health status. Race/ethnicity and income were assessed for effect modification of the association between TBI and the self-perceived health. Among the subgroup of respondents with TBI, univariate chi-squared analysis assessed the association of race/ethnicity and income with survey questions related to self-perceived health status.
Results:
Traumatic brain injury was significantly associated with worse self-reported fatigue (OR 1.40, 95% CI: 1.32-1.48, P < .001), pain (OR 1.59, 95% CI: 1.50-1.69, P < .001), emotional problems (OR 1.27, 95% CI: 1.19-1.34, P < .001), and ability to complete everyday activities (OR 0.70, 95% CI: 0.66-0.75, P < .001). Also, TBI was associated with worse self-reported general health (OR 0.77, 95% CI: 0.72-0.81, P < .001), mental health (OR 0.70, 95% CI: 0.66-0.74, P < .001), physical health (OR 0.78, 95% CI: 0.73-0.82, P < .001), and general quality of life (OR 0.80, 95% CI: 0.76-0.85, P < .001). Among those with TBI, respondents of more vulnerable socioeconomic status also reported worse overall health, mental health, physical health, and general quality of life. Association of TBI with self-perceived health varied by race/ethnicity, with significantly stronger effects among non-Hispanic Black respondents.
Conclusion:
Participants with TBI reported significantly poorer self-perceived health status, even after adjustment for potentially confounding variables. Self-perceived health status is associated with clinically meaningful outcomes, so this finding, particularly among vulnerable socioeconomic groups, is concerning and warrants further investigation into ways to improve patient quality of life.
