Article Figures & Tables
Tables
- Table 1: Participant characteristics at baseline, by traumatic brain injury status (n = 1 479 406)
Characteristic No. (%) of participants with at least 1 TBI§§,¶¶
n = 77519No. (%) of participants without TBI
n = 1401887Incarcerated over follow-up No 77117 (99.5) 1398556 (99.8) Yes 402 (0.5) 3331 (0.2) Age, yr; mean ± SD 22.8 ± 3.2 23.1 ± 3.2 Age group, yr 18-21 32235 (41.6) 489801 (34.9) 22-24 19779 (25.5) 372714 (26.6) 25-28 25505 (32.9) 539372 (38.5) Sex Female 28410 (36.6) 702603 (50.1) Male 49109 (63.4) 699284 (49.9) Rural residence No 65596 (84.6) 1207066 (86.1) Yes 11657 (15.0) 171652 (12.2) Missing 266 (0.3) 23169 (1.7) Material deprivation* Q1 (least deprived) 15248 (19.7) 328137 (23.4) Q2 16063 (20.7) 307752 (22.0) Q3 15825 (20.4) 277083 (19.8) Q4 14342 (18.5) 235336 (16.8) Q5 (most deprived) 13057 (16.8) 195222 (13.9) Missing 2984 (3.8) 58357 (4.2) Ethnic concentration* Q1 (least) 11669 (15.0) 188437 (13.4) Q2 15008 (19.4) 251657 (18.0) Q3 13577 (17.5) 239193 (17.1) Q4 14968 (19.3) 279384 (19.9) Q5 (most) 19313 (24.9) 384859 (27.5) Missing 2984 (3.8) 58357 (4.2) Residential instability* Q1 (least unstable) 15491 (20.0) 312087 (22.3) Q2 15296 (19.7) 285173 (20.3) Q3 14741 (19.0) 255428 (18.2) Q4 17437 (22.5) 288167 (20.6) Q5 (most unstable) 11570 (14.9) 202675 (14.5) Missing 2984 (3.8) 58357 (4.2) Previous TBI†,‡ No 68639 (88.5) 1326647 (94.6) Yes 8880 (11.5) 75240 (5.4) Psychotic mood disorder†,§,¶ No 76368 (98.5) 1 390308 (99.2) Yes 1151 (1.5) 11579 (0.8) Nonpsychotic mood disorder†,§,** No 57909 (74.7) 1119044 (79.8) Yes 19610 (25.3) 282843 (20.2) Substance use disorder†,§,†† No 74869 (96.6) 1381839 (98.6) Yes 2650 (3.4) 20048 (1.4) Social problems†,§,††,‡‡ No 74721 (96.4) 1365949 (97.4) Yes 2798 (3.6) 35938 (2.6) Note: ICD-9 = International Classification of Diseases, 9th Revision, [Clinical Modification], Q = quintile, SD = standard deviation, TBI = traumatic brain injury.
*As per the Ontario Marginalization Index42 by quintile.
†Medical records from physician visits, including primary care providers.
‡History of TBI between Apr. 1, 1993, and June 30, 1997.
§History of diagnosis between Jan. 1, 1995, and June 30, 1997.
¶Defined as hospital visit for ICD-9 diagnostic codes 295-298.
**Defined as hospital visit for ICD-9 diagnostic codes 300-302, 306, 309 and 3011.
††Defined as hospital visit for ICD-9 diagnostic codes 291-292 and 303-304.
‡‡Defined as hospital visit for ICD-9 diagnostic codes 897-906 and 909.
§§At least 1 TBI between Apr. 1, 1997, and December 2011.
¶¶Unless specified otherwise.
- Table 2: Incidence rate (IR), and unadjusted and adjusted hazard ratios (HRs) for incarceration among men in Ontario from 1997 to 2011, by traumatic brain injury, sociodemographic characteristics and medical history (n = 716 585)
Characteristics No. of incarcerations Person-years Incidence rate per 100 000 person-years Unadjusted model Adjusted model IR (95% CI) HR (95% CI) HR (95% CI) Overall 3321 9 238 892 35.9 (34.7-37.2) TBI* No 2965 8891856 33.5 (32.1-34.5) 1.00 1.00 Yes 356 347126 102.6 (91.9-113.2) 3.26 (2.91-3.64) 2.47 (2.21-2.77) Age, yr 18-21 1297 3262825 39.8 (37.6-42.0) 1.00 (1.00) 22-24 873 2449332 35.6 (33.3-38.1) 0.90 (0.82-0.98) 0.87 (0.80-0.95) 25-28 1151 3526825 32.6 (30.8-34.6) 0.82 (0.76-0.89) 0.77 (0.71-0.83) Rural residence No 2966 8115993 36.5 (35.2-37.9) 1.00 1.00 Yes 355 1123388 31.6 (28.1-35.1) 0.87 (0.77-0.97) 1.03 (0.91-1.17) Material deprivation† Q1 (least deprived) 439 2204177 19.9 (18.1-21.9) 1.00 1.00 Q2 569 2129505 26.7 (24.6-29.0) 1.34 (1.19-1.52) 1.29 (1.14-1.47) Q3 639 1933271 33.0 (30.6-35.7) 1.66 (1.47-1.88) 1.48 (1.30-1.68) Q4 704 1627296 43.3 (40.2-46.6) 2.17 (1.93-2.45) 1.76 (1.55-2.00) Q5 (most deprived) 970 1344731 72.1 (67.7-76.8) 3.62 (3.24-4.06) 2.54 (2.23-2.89) Ethnic concentration† Q1 (least) 416 1344374 29.8 (27.1-32.8) 1.00 1.00 Q2 563 1773547 30.5 (28.1-33.2) 1.03 (0.90-1.16) 1.03 (0.91-1.17) Q3 531 1656420 30.8 (28.3-33.6) 1.04 (0.91-1.18) 1.00 (0.87-1.14) Q4 662 1883787 33.8 (33.1-36.5) 1.14 (1.00-1.28) 1.04 (0.91-1.18) Q5 (most) 1149 2580852 42.8 (40.4-45.3) 1.44 (1.29-1.61) 1.06 (0.94-1.20) Residential instability† Q1 (least unstable) 485 2189635 22.3 (20.2-24.2) 1.00 1.00 Q2 492 2012090 24.4 (22.4-26.7) 1.10 (0.97-1.25) 1.01 (0.89-1.15) Q3 611 1783041 34.3 (31.6-37.1) 1.55 (1.37-1.75) 1.20 (1.06-1.37) Q4 919 1952207 47.1 (44.1-50.2) 2.12 (1.90-2.37) 1.38 (1.22-1.56) Q5 (most unstable) 814 1301008 62.5 (58.4-67.0) 2.82 (2.52-3.16) 1.74 (1.53-1.97) Previous TBI‡,§ No 2801 8570118 32.7 (31.5-33.9) 1.00 1.00 Yes 520 668864 77.7 71.3-84.7 2.38 (2.17-2.61) 1.88 (1.71-2.07) Psychotic mood disorder‡,¶,** No 3233 9159856 35.3 (34.1-36.5) 1.00 1.00 Yes 88 79126 111.2 (90.2-137.1) 3.15 (2.55-3.89) 1.02 (0.82-1.27) Nonpsychotic mood disorder‡,¶,†† No 2255 7957300 28.3 (27.2-29.5) 1.00 1.00 Yes 1066 1281682 83.2 (78.3-88.3) 2.93 (2.72-3.16) 2.25 (2.09-2.44) Substance use disorder‡,¶,‡‡ No 2988 9081002 32.9 (31.7-34.1) 1.00 1.00 Yes 333 157980 210.8 (189.3-234.7) 6.40 (5.72-7.17) 3.67 (3.25-4.13) Social problems‡,¶,§§ No 3169 9099282 34.8 (33.6-36.1) 1.00 1.00 Yes 152 139700 108.9 (92.8-127.6) 3.12 (2.66-3.68) 1.71 (1.45-2.02) Note: CI = confidence interval, HR = hazard ratio, ICD-9 = International Classification of Diseases, 9th Revision, [Clinical Modification], IR = incidence rate, Q = quintile, TBI = traumatic brain injury. Values in boldface type represent confidence limits that do not cross 1.
*At least 1 TBI between June 30, 1997, and Mar. 31, 2011.
†As per the Ontario Marginalization Index,42 by quintile.
‡Based on medical records from physician visits, including primary care providers.
§History of TBI between Apr. 1, 1993, and June 30, 1997.
¶History of diagnosis between Jan. 1, 1995, and June 30, 1997.
**Defined as hospital visit for ICD-9 diagnostic codes 295-298.
††Defined as hospital visit for ICD-9 diagnostic codes 300-302, 306, 309 and 301.
‡‡Defined as hospital visit for ICD-9 diagnostic codes 291-292 and 303-304.
§§Defined as hospital visit for ICD-9 diagnostic codes 897-906 and 909.
- Table 3: Incidence rate (IR), and unadjusted and adjusted hazard ratios (HRs) for incarceration among women in Ontario from 1997 to 2011, by traumatic brain injury, sociodemographic characteristics and medical history (n = 701 480)
Characteristics No. of incarcerations Total
person-yearsIR (per 100000 person-years) Unadjusted model Adjusted model IR (95% CI) HR (95% CI) HR (95% CI) Overall 210 9 058 616 2.3 (2.0-2.6) TBI* No 193 8875705 2.2 (1.9-2.5) 1.00 (1.00) 1.00 (1.00) Yes 17 182912 9.3 (4.9-13.7) 4.15 (2.15-6.86) 2.76 (1.65-4.60) Age, yr 18-21 77 3141869 2.4 (2.0-3.1) 1.00 1.00 22-24 47 2369277 1.9 (1.5-2.6) 0.81 (0.56-1.16) 0.77 (0.54-1.11) 25-28 86 3547472 2.4 (2.0-3.0) 0.99 (0.73-1.34) 0.90 (0.66-1.23) Rural residence No 190 8151021 2.3 (2.0-2.7) 1.00 1.00 Yes 23 1139914 2.0 (1.3-3.0) 0.82 (0.52-1.30) 1.37 (0.81-2.31) Material deprivation† Q1 (least deprived) 29 2181375 1.3 (0.9-1.9) 1.00 1.00 Q2 26 2048689 1.3 (0.9-1.9) 0.95 (0.56-1.62) 0.92 (0.54-1.56) Q3 47 1861048 2.5 (1.9-3.4) 1.90 (1.19-3.02) 1.61 (0.99-2.61) Q4 41 1614514 2.5 (1.9-3.7) 1.91 (1.19-3.07) 1.37 (0.82-2.30) Q5 (most deprived) 67 1352988 5.0 (3.9-6.3) 3.72 (2.41-5.75) 2.17 (1.31-3.57) Ethnic concentration† Q1 (least concentrated) 13 1242374 1.0 (0.6-1.8) 1.00 1.00 Q2 32 1669734 1.9 (1.3-2.7) 1.83 (0.96-3.49) 1.89 (0.99-3.61) Q3 32 1598383 2.0 (1.4-2.8) 1.91 (1.00-3.65) 1.98 (1.02-3.83) Q4 45 1915808 2.3 (1.8-3.1) 2.24 (1.21-4.16) 2.24 (1.17-4.30) Q5 (most concentrated) 88 2632316 3.3 (2.7-4.1) 3.20 (1.78-5.72) 2.71 (1.44-5.09) Residential instability† Q1 (least unstable) 28 2051860 1.4 (0.9-2.0) 1.00 1.00 Q2 24 1881424 1.3 (0.8-1.9) 0.93 (0.54-1.61) 0.91 (0.52-1.58) Q3 39 1718755 2.3 (1.6-3.1) 1.66 (1.02-2.70) 1.34 (0.80-2.25) Q4 56 1992259 2.8 (2.2-3.6) 2.06 (1.31-3.24) 1.30 (0.79-2.16) Q5 (most unstable) 63 1414316 4.4 (3.5-5.7) 3.27 (2.09-5.10) 1.88 (1.14-3.09) Previous TBI‡,§ No 185 8690013 2.1 (1.8-2.4) 1.00 1.00 Yes 25 368602 6.8 (4.6-10.0) 3.18 (2.10-4.84) 2.25 (1.47-3.45) Psychotic mood disorder‡,¶,** No 198 8983104 2.2 (1.9-2.5) 1.00 1.00 Yes 12 75512 15.9 (9.0-28.0) 7.21 (4.03-12.91) 2.54 (1.37-4.70) Nonpsychotic mood disorder‡,¶,†† No 111 6592676 1.7 (1.4-2.0) 1.00 1.00 Yes 99 2465939 4.0 (3.3-4.9) 2.38 (1.82-3.12) 1.60 (1.20-2.14) Substance use disorder‡,¶,‡‡ No 182 9212901 2.0 (1.7-2.3) 1.00 1.00 Yes 32 114994 27.8 (19.7-39.3) 14.69 (10.08-21.40) 8.65 (5.78-12.95) Social problems‡,¶,§§ No 186 8717397 2.1 (1.8-2.5) 1.00 1.00 Yes 24 341219 7.0 (4.7-10.5) 3.30 (2.15-5.04) 1.98 (1.28-3.08) Note: CI = confidence interval, HR = hazard ratio, ICD-9 = International Classification of Diseases, 9th Revision, [Clinical Modification], IR = incidence rate, Q = quintile, TBI = traumatic brain injury. Values in boldface type represent confidence limits that do not cross 1.
*At least 1 TBI between June 30, 1997, and Mar. 31, 2011.
†As per the Ontario Marginalization Index,42 by quintile.
‡Based on medical records from physician visits, including primary care providers.
§History of TBI between Apr. 1, 1993, and June 30, 1997.
¶History of diagnosis between Jan. 1, 1995, and June 30, 1997.
**Defined as hospital visit for ICD-9 diagnostic codes 295-298.
††Defined as hospital visit for ICD-9 diagnostic codes 300-302, 306, 309 and 301.
‡‡Defined as hospital visit for ICD-9 diagnostic codes 291-292 and 303-304.
§§Defined as hospital visit for ICD-9 diagnostic codes 897-906 and 909.
- Table 4: Sensitivity analyses: unadjusted and adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for traumatic brain injury and incarceration among men and women in Ontario from 1997 to 2011
Sensitivity analysis Men Women Unadjusted model Adjusted model Unadjusted model Adjusted model HR (95% CI) HR (95% CI) HR (95% CI) HR (95% CI) Final model 3.26 (2.91-3.64) 2.47 (2.21-2.77) 4.15 (2.15-6.86) 2.76 (1.65-4.60) Exclude participants with TBI before baseline 3.84 (3.23-4.57) 3.08 (2.59-3.67) 2.90 (1.18-7.13) 2.12 (0.86-5.23) Exclude records probabilistically linked 4.43 (3.76-5.28) 3.14 (2.66-3.71) 3.23 (1.42-7.38) 2.08 (0.91-4.79) Year-lagged TBI exposure 3.70 (3.14-4.36) 2.71 (2.30-3.20) 2.60 (1.06-6.38) 1.66 (0.67-4.11) No lagged TBI exposure 4.16 (3.60-4.82) 3.06 (2.64-3.54) 4.51 (2.35-8.62) 2.93 (1.52-5.65) Include TBI-related visits to primary care providers 3.92 (3.57-4.30) 3.02 (2.75-3.32) 4.79 (3.22-7.12) 3.78 (2.25-5.06) Diagnosis code type Hospital admission 4.89 (3.55-6.73) 3.41 (2.47-4.71) 10.19 (2.53-41.09) 7.12 (1.76-28.86 ED visit 3.13 (2.78-3.52) 2.40 (2.13-2.70) 4.15 (2.51-6.86) 2.55 (1.48-4.38) TBI count 0 1.00 1.00 1.00 1.00 1 3.67 (3.12-4.31) 2.77 (2.35-3.26) 4.02 (1.96-8.25) 2.70 (1.30-5.57) ≥ 2 9.13 (5.92-14.05) 4.50 (2.92-6.95) -* -* Note: CI = confidence interval, ED = emergency department, HR = hazard ratio, TBI = traumatic brain injury. Values in boldface type represent confidence limits that do not cross 1.
*Estimate not provided. No women had more than 1 TBI and went on to be incarcerated.