Abstract
Objective
To describe Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans
who underwent the Comprehensive Traumatic Brain Injury Evaluation (CTBIE), differences
between the traumatic brain injury (TBI) and non-TBI subgroups, and factors associated
with return to productivity (RTP).
Design
Retrospective medical record review.
Setting
Medical center.
Participants
Medical records of OEF/OIF veterans (N=236) who underwent the CTBIE between 2009 and 2013.
Interventions
Not applicable.
Main Outcome Measures
Demographic characteristics, injury history, clinical presentation, and factors associated
with RTP.
Results
Veteran sample included 90.7% men, was 45.3% white and 34.7% black, with half of Hispanic
origin, and had a mean age of 33 years. The mean time since injury was approximately
4 years. Reported symptoms were high, with >90% reporting anxiousness, irritability,
sleep difficulty, forgetfulness, and headaches. TBI diagnosis was found in 163 veterans
(69%). The TBI subgroup was younger (TBI: 32.5y vs non-TBI: 34.9y; P=.02), reported a greater number of injuries (P<.001), and had significantly higher rates of half of the reported symptoms. Greatest
differences were noted with forgetfulness (TBI: 95.7% vs non-TBI: 79.5%; P<.001), poor concentration (TBI: 90.2% vs non-TBI: 76.7%; P=.007), and headaches (TBI: 93.9% vs non-TBI: 83.6%; P=.014). RTP was 60.6% for the total veteran population. Factors associated with RTP
were race (white) (odds ratio [OR], 2.00; 95% confidence interval [CI], 1.13–3.55;
P=.018), sensitivity to light (OR, 2.58; 95% CI, 1.17–5.66; P=.018), and fatigue (OR, 3.68; 95% CI, 1.51–8.95; P=.004). Veterans that did RTP were 3 times less likely to report depression (OR, .32;
95% CI, .12–.85; P=.022).
Conclusions
Veterans reported a substantial number of lingering symptoms, with a higher prevalence
in veterans with TBI. Veterans with reported depression were less likely to RTP. Future
research should focus on the relation between depression and non-RTP and the effectiveness
of Department of Veterans Affairs services.
Keywords
List of abbreviations:
CI (confidence interval), CTBIE (Comprehensive Traumatic Brain Injury Evaluation), mTBI (mild traumatic brain injury), NSI (Neurobehavioral Symptom Inventory), OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom), OR (odds ratio), PTSD (posttraumatic stress disorder), RTP (return to productivity), TBI (traumatic brain injury), VA (Department of Veterans Affairs)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 13, 2017
Footnotes
Supported with resources and the use of facilities at the Department of Rehabilitation Medicine, James J. Peters Veterans Affairs Medical Center, Bronx, NY; and by the National Center for Advancing Translational Sciences, National Institutes for Health (grant no. UL1 TR000040).
The contents do not represent the views of the U.S. Department of Veterans Affairs or the U.S. Government.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This funding source had no involvement in study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
