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Migraine and traumatic brain injury: a cohort study in Taiwan

Wang QR, Lu YY, Su YJ, Qin H, Zhang L, Wu MK, Zhang CL, Wu CH

BMJ open, 2019

7,267 participants · 11 citations

Abstract

OBJECTIVE: Traumatic brain injury is now a major contributor to the global healthcare burden. Migraine is another debilitating disease with a global health impact. While most researchers agree that traumatic brain injury is a risk factor for migraine, whether migraine is a risk factor for traumatic brain injury still remains under debate. We therefore aimed to investigate whether migraine was a risk factor for developing traumatic brain injury.

STUDY DESIGN: Retrospective population-based cohort study.

SETTING: Data for people who had been diagnosed with migraine were retrieved from Taiwan's National Health Insurance Research Database.

PARTICIPANTS: We identified 7267 patients with newly diagnosed migraine during 1996-2010. The migraineurs to non-migraineurs ratio was set at 1:4 to enhance the power of statistical tests.

PRIMARY AND SECONDARY OUTCOME MEASURES: We used multivariate Cox proportional hazard regression models to assess the effects of migraines on the risk of traumatic brain injury after adjusting for potential confounders.

RESULTS: The overall traumatic brain injury risk was 1.78 times greater in the migraine group compared with the non-migraine group after controlling for covariates. Additionally, patients with previous diagnoses of alcohol-attributed disease, mental disorders and diabetes mellitus had a significantly higher traumatic brain injury risk compared with those with no history of these diagnoses.

CONCLUSIONS: This study of a population-based database…

How strong is the evidence?

Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 7,267 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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