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Intentional versus Unintentional Traumatic Brain Injury: Risk Factors and Outcomes

Purpose: This study examined potential differences between people who have experienced intentional vs unintentional traumatic brain injury (TBI). Subjects: Subjects with unintentional injury (N=194), obtained mostly in crashes, were compared to 44 people with intentional injuries, obtained mostly in assaults, in terms of demographic information, injury factors, and outcome. Setting: Large medical center with acute rehabilitation. Measures: Functional Independence Measure (FIM), Disability Rating Scale (DRS), Community Integration Questionnaire. Results: T-tests did not reveal differences between the groups in age, education, Glasgow Coma Score, total Functional Independence Measure (FIM) scores at rehabilitation admission and discharge, or DRS or CIQ scores at 6 and 12 months post-injury. The only significant difference was in acute care length of stay, which was shorter for those with intentional injuries (17 vs. 25 days). A similar, non-significant pattern was evident for rehabilitation length of stay. Neuropsychological evaluation of a sub-sample obtained at 6 months post-injury did not differentiate the groups. Based on chi-square analysis, those with intentional injury were significantly more likely to have experienced pre-morbid drug abuse and social problems (school and legal problems, suicide attempts), to be African-American, or to be indigent. There were no differences in duration of post-traumatic amnesia, history of alcohol abuse, marital status, or living arrangements at the time of injury. At 6 and 12 months follow-up, those with intentional injuries were more likely to be residing with a significant other or institutionalized. Males were more likely to sustain intentional injury, but the difference was not significant. Conclusion: Despite significant differences in background for the intentionally vs. unintentionally injured, it does not appear that there are significant differences in functional or neuropsychological outcome based on this sample.

Registry Project Number: 157
Lead Investigator: Novack, T
Lead Center for Project: University of Alabama
Collaborating Investigators: Bush, B, Meythaler, J, Canupp, K, Alderson, A
Collaborating Institutions: Methodist Rehabilitation Center
Keywords: agitation, medication, medical management
Date of Completion: 02/15/2000
Type: Local
Status of Project: Latest Information Shown

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