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Descriptive Findings of the VA Polytrauma Rehabilitation Centers TBI Model Systems National Database

Published:February 06, 2018DOI:https://doi.org/10.1016/j.apmr.2017.12.035

      Abstract

      Objectives

      To present initial descriptive findings from the Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRC) Traumatic Brain Injury (TBI) Model Systems (MS) National Database.

      Design

      Prospective cohort study.

      Setting

      VA PRC TBIMS National Database.

      Participants

      712 service members and veterans with TBI who consented to participate between January 2010 and June 2015.

      Interventions

      Not applicable.

      Main Outcome Measures

      Demographics, preinjury characteristics, injury characteristics, rehabilitation course, functional outcomes, and discharge disposition by TBI severity level.

      Results

      The study cohort was predominantly male with moderate to severe TBI secondary to vehicular accident or blast injury. Sixty-five percent were active duty service members; one-third had been injured during deployment. One-third reported mental health treatment and/or alcohol use problems in the year predating the index TBI. The median number of days between injury and PRC admission was 42.5. Nearly 25% reported clinical levels of posttraumatic stress disorder; 75% reported mild to moderate neurobehavioral symptomatology. The median length of stay in the PRC was 36 days; those with severe TBI had the longest lengths of stay. Functional independence ratings improved from admission to discharge across all TBI severity levels. A majority were discharged to urban areas to reside with spouses or other residents in private residences or adult homes, with some variability by injury severity.

      Conclusions

      The VA PRC TBIMS national database is a rich source of information on a unique group of individuals with TBI and promises to complement existing knowledge on TBI in the civilian population.

      Keywords

      List of abbreviations:

      DRS (Disability Rating Scale), GCS (Glasgow Coma Scale), GOAT (Galveston Orientation and Amnesia), mTBI (mild traumatic brain injury), NIDRR (National Institute on Disability and Rehabilitation Research), NSI (Neurobehavioral Symptom Inventory), PCL-C (Posttraumatic Stress Checklist–Civilian), PRC (polytrauma rehabilitation center), PSC (polytrauma system of care), PTA (posttraumatic amnesia), PTSD (posttraumatic stress disorder), TBI (traumatic brain injury), TBIMS (Traumatic Brain Injury Model Systems), TFC (time to follow commands), VA (Veterans Affairs)
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