Abstract:
Abstract from Project Phase I - Objective: To investigate mortality, life expectancy, risk factors for death, and causes of death in individuals with traumatic brain injury (TBI). Methods: Retrospective cohort study utilizing data from the TBI Model Systems National Database, the Social Security Death Index and death certificates. Participants: 2,178 individuals with TBI completing inpatient rehabilitation in one of 15 National Institute on Disability and Rehabilitation Research-funded TBI Model Systems of care between 1988 and 2001. Results: Individuals with TBI were twice as likely to die compared to individuals in the general population of similar age, gender and race, resulting in an estimated average life expectancy reduction of 7 years for individuals with TBI. After 1 year post-injury, individuals with TBI were 37 times more likely to die of seizures, 12 times more likely to die of septicemia, 4 times more likely to die of pneumonia, and 3 times more likely to die of other respiratory conditions (excluding pneumonia), digestive conditions, and all external causes of injury/poisoning compared to individuals in the general population of similar age, gender and race. Within the TBI population, the strongest independent risk factors for death after 1 year post-injury were older age and not being employed at injury, and greater disability at rehabilitation discharge. Conclusion: This information is important to guide decision-making for treatment, utilization of limited medical resources, and planning for ongoing health care needs and lifetime planning.
Phase II of the project involves a feasibility study to determine if the TBI Model Systems mortality study can be productively expanded to include all TBI cases rehabilitated in TBI Model System facilities, even before Model System designation occurred. Phase III of the project involves Craig Hospital determining the survival status of 3000 individuals with TBI who were rehabilitated at its own facility over the last four decades before Craig was designated a TBI Model System. Products thus far from this project can be found at http://www.craighospital.org.