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Projects of the TBINDC Registry by Research Center
Pre-injury crime, substance abuse, and neurobehavioral functioning after traumatic brain injury
Abstract: There is limited information regarding the effects of preinjury history of arrest or history of substance use on neurobehavioral functioning after brain injury. The current study included 211 patients with traumatic brain injury, who were seen for a follow-up neuropsychological evaluation in an outpatient setting. An effort was made to distinguish between (1) patients with a history of preinjury arrests and patients without a preinjury history of arrests, (2) patients classified as substance abusers and non-abusers and (3) patients with and without a history of preinjury illicit drug use on the basis of demographic characteristics, injury characteristics, and neurobehavioral functioning. Results indicate significant differences between... more
Investigators: Kreutzer J, Kolakowsky-Hayner S view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Etiology and incidence of rehospitalizations
Abstract: Objective: To investigate incidence and etiology of rehospitalizations at one and five years post traumatic brain injury.

Design: Prospective study of etiology and incidence of rehospitalizations at years 1 and 5 years postinjury. Analysis of variance and chi-square were used to identify factors relating to rehospitalization; factors included length of stay, admission and discharge functional status, payor source, medical complications, injury severity, and demographics.

Setting: Seventeen medical centers in the federally sponsored Traumatic Brain Injury Model Systems. In each setting, the continuum of care includes emergency medical services, intensive and acute medical care, inpatient rehabilitation, and a spectrum of community... more
Investigators: Kreutzer J, Marwitz J, High Jr. W, Englander J, Cifu D view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Collaborating Centers: The Institute for Rehabilitation and Research, Santa Clara Valley Medical Center
Consumer education and self-advocacy project
Abstract: In partnership with consumers and professionals, Virginia Commonwealth University implemented a statewide series of workshops with the ultimate goal of promoting self-directed learning, locally based consumer-centered programs, empowerment, and self-advocacy. Workshops consisted of a one day, 4 . 6 hour course of instruction, provided in the form of discussion groups and lectures with emphasis placed on interactive learning. A total of 12 workshops were implemented. Information regarding workshop quality was solicited from participants. After each workshop was completed participants: (a) rated relevance of information presented in each course; (b) rated the quality of presentation format and/or speakers; (c) described the most and... more
Investigators: Kreutzer J, Marwitz J view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Return to work after traumatic brain injury: A self-directed approach
Abstract: Despite the development and proliferation of rehabilitation programs in the last decade, successful return to work remains as a formidable challenge to many persons with brain injury. Professionals are beginning to recognize the value of consumer input as a guide to development of more effective employment services. Unfortunately, there is a scarcity of practical information to guide implementation of effective employment services for persons with TBI. Development of new resources which integrate and incorporate guidance from consumers offers a promising opportunity to improve employment outcomes. This project was intended to provide a more accurate description of the obstacles to employment, vocational needs, and employment outcomes... more
Investigators: Kreutzer J, Kolakowsky-Hayner S view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
The prevalence and symptom rates of depression after traumatic brain injury: A comprehensive examination
Abstract: Objective: Differing definitions of depression, limited sample sizes, and variability in methodologies have contributed to equivocal findings about the prevalence of depression among persons with traumatic brain injury. The present investigation used standardized diagnostic criteria and a large sample to identify the manifestations of depression after TBI.

Design and Setting: 722 outpatients with brain injury referred for comprehensive assessment at a regional Level I trauma center were studied. Depressive symptoms were characterized utilizing standard DSM-IV criteria and the Neurobehavioral Functioning Inventory.

Results: Forty-two percent of patients with brain injury met the prerequisite number of symptoms for a DSM-IV diagnosis... more
Investigators: Kreutzer J, Seel R, Gourley E view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Incidence, risk factors, and outcomes of fecal incontinence after acute brain injury: Findings from the traumatic brain injury model systems national database
Abstract: Objective: To investigate the incidence, risk factors, and outcome in patients with fecal incontinence after acute brain injury.

Design: A retrospective study of the incidence of and risk factors contributing to fecal incontinence, and outcomes at admission to and discharge from inpatient rehabilitation and at 1-year follow-up. Setting: Medical centers in the federally sponsored Traumatic Brain Injury Model Systems (TBIMS). Participants: A total of 1013 consecutively enrolled ehabilitation inpatients from 17 TBIMS centers who were admitted to acute care within 24 hours of traumatic brain injury and seen at 1-year
postinjury between 1990 and 2000.

Main Outcome Measures: Incidence of fecal incontinence, length of coma, length of... more
Investigators: Foxx-Orenstein A, Kolakowsky-Hayner S, Marwitz J, Cifu D, Dunbar A, Englander J, Francisco G view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Collaborating Centers: Santa Clara Valley Medical Center, The Institute for Rehabilitation and Research
Charges and Lengths of Stay for Acute and Inpatient Rehabilitation Treatment of TBI 1990-1996
Abstract: Acute care daily charges showed almost routine increases, averaging nearly $550 per year. Conversely, lengths of stay generally showed a downward trend, with annual reductions averaging 2.25 days. Between 1990 and 1996, average daily rehabilitation charges increased each year, with the rise averaging $83 or 7%. The rise in daily rehabilitation charges was offset by corresponding decreases in lengths of stay averaging 3.65 days or 8% annually. Increases in daily charges for brain injury rehabilitation care were roughly comparable to those for general medical care prices. However, the rate of change in acute care charges was substantially greater, with annual increases averaging 10% more than national medical care prices... more
Investigators: Kreutzer J, Kolakowsky-Hayner S, Ripley D, Cifu D, Rosenthal M, Bushnik T, Zafonte R, Englander J, High Jr. W view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Collaborating Centers: Santa Clara Valley Medical Center, Emory University/Shepherd Center, Rehabilitation Institute of Michigan, Kessler Medical Rehabilitation Research and Education Corporation, The Institute for Rehabilitation and Research
Depression after traumatic brain injury: A NIDRR model systems multi-center investigation.
Abstract: Objective: To identify the frequency and manifestations of depression after traumatic brain injury (TBI) and the factors that contribute to developing this mood disorder.

Design: A prospective, nationwide, multicenter study; 17 centers supplied data from medical records and patient responses on a standardized criterion instrument.

Setting: Traumatic Brain Injury Model Systems programs.

Participants: A demographically diverse sample of 666 outpatients with TBI was evaluated 10 to 126 months after injury.

Main Outcome Measures: Depressive symptoms were characterized with the Neurobehavioral Functioning Inventory by using the Diagnostic and Statistical Manual of Mental Disorders (4th ed; DSM-IV) diagnostic framework. Analysis of... more
Investigators: Seel R, Kreutzer J, Rosenthal M, Hammond F, Corrigan J, Black K view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Collaborating Centers: Rehabilitation Institute of Michigan, Kessler Medical Rehabilitation Research and Education Corporation, Carolinas Rehabilitation, Ohio State University
Family Members' and Caregivers' Emotional Well Being
Abstract: Objectives for this collaborative project include: (1) to examine the frequency and magnitude of emotional distress and depressive symptoms and the level of life satisfaction of family members and non-family caregivers as compared to clinical and non-clinical populations, and (2) to identify the relationships between caregivers' well-being and survivors' injury severity and level of functioning. Six TBI Model System centers are collecting data from family members, significant others, and friends of individuals in the National Database at either 1, 2, or 5 year follow-up. Data is collected from each caregiver only once. Measures include the Neurobehavioral Functioning Inventory (NFI) Depression subscale, the Brief Symptom Inventory-18... more
Investigators: Kreutzer J, Marwitz J, Rapport L, Koviak C, Hammond F, Morita C, Hart T, Selleck E, Glenn M, Harrison-Felix C view full
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Lead Center: Virginia Commonwealth University/Medical College of Virginia
Collaborating Centers: Spaulding Rehabilitation Hospital, Rehabilitation Institute of Michigan, Carolinas Rehabilitation, Moss Rehabilitation Research Institute, Craig Hospital
Illicit Drug Use Over Time Following Traumatic Brain Injury
Abstract: Reported drug use at Years 1 and 2 following traumatic brain injury (TBI) is 6 to 8%, compared to 29% premorbidly. How drug use responses change over time in the same group is not known. This study investigates patterns of reported drug use and follow-up for individuals with TBI who received inpatient rehabilitation, and who were questioned annually about illicit drug use. The TBI Model System Database (n=1160) was used to perform a cross-sectional analysis on all successfully contacted and screened over a 10 year period. Responses to drug use at Year 1 were 37 yes, and 333 no, with no significant difference in yes/no responses across the years. However, analysis of the positive responses revealed those reporting drug use in Year 1 had... more
Investigators: Hammond F, Grattan K, Sasser H, Corrigan J, Bogner J, Kreutzer J, Weintraub R, Berry J view full
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Lead Center: Carolinas Rehabilitation
Collaborating Centers: Ohio State University, Virginia Commonwealth University/Medical College of Virginia
Subjective Well-being in the First Two Years Following Traumatic Brain Injury
Abstract: Purpose: Examine predictors of life satisfaction one and two years post-injury.

Design: Prospective, longitudinal study of patients with TBI followed at one and two years post-injury. Replication of a single center study using data from the TBI Model Systems dataset. Univariate regression models will be calculated first. Those variables
that account for at least 1% of variance will be included in subsequent stepwise linear regression models.

Current status: Data has been compiled.... more
Investigators: Corrigan J, Bogner J, Hammond F, Sander A, Whiteneck G, Kreutzer J view full
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Lead Center: Ohio State University
Collaborating Centers: Carolinas Rehabilitation, The Institute for Rehabilitation and Research, Virginia Commonwealth University/Medical College of Virginia
Post-traumatic Depression as a Complication of Violence Induced TBI Versus Non-violence Induced TBI: Implications on treatment, interventions, cost, and long-term outcomes.
Abstract: Depression is a well-established complication of TBI, with reported incidence of less than 10% to 77%. However, previous studies have been limited by small, unrepresentative samples. This study investigates the incidence, time-course, outcome, and measurement of post-traumatic depression in those with TBI who survive and are admitted to acute inpatient rehabilitation.... more
Investigators: Hammond F, Babin P, Grattan K, Norton H, Johnston M, Miller M, Kreutzer J, Black K view full
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Lead Center: Carolinas Rehabilitation
Collaborating Centers: Rehabilitation Institute of Michigan, Kessler Medical Rehabilitation Research and Education Corporation, Emory University/Shepherd Center, Virginia Commonwealth University/Medical College of Virginia
Effect of blood alcohol level on neurpsych outcome from TBI
Abstract: 1) To resolve contradictory reports in the literature regarding adverse effects of acute blood alcohol level (BAL) on neuropsychological outcome from traumatic brain injury (TBI). 2) 459 adults with nonpenetrating TBI who were inpatients at one of 6 rehabilitation centers in the TBI Model Systems project, whose BAL had been measured at hospital arrival, and who emerged from post-traumatic amnesia (PTA) and underwent neuropsychological testing before rehabilitation discharge. 3)15 neuropsychological tests were administered after resolution of post-traumatic amnesia and at one year post-injury. 4) BAL was classified as 1) negative vs. positive and 2) intoxicated (BAL > 100 mg/dl) vs. non-intoxicated. The effect of BAL on neuropsychological... more
Investigators: Boake C, High Jr. W, Sander A, Kreutzer J, Macciocchi S, Stringer A, Hammond F, Rosenthal M, Bogner J, Hanks R view full
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Lead Center: The Institute for Rehabilitation and Research
Collaborating Centers: Emory University/Shepherd Center, Ohio State University, Rehabilitation Institute of Michigan, Carolinas Rehabilitation, Kessler Medical Rehabilitation Research and Education Corporation, Virginia Commonwealth University/Medical College of Virginia
A Collaborative National Information Center on Outcome Measurement in Brain Injury
Abstract: In order to better serve the rehabilitation community, the Center on Outcome Measurement in Brain Injury (COMBI) website and newsletter are proposed. The COMBI provides information on measures in a format that is easily accessed and understood, free of charge, objective, and comprehensive. Each measure will have online syllabi, training and testing materials (including the measure's rating form), information on scale properties, a reference listing of published studies using the measure, and a section for "Frequently Asked Questions."... more
Investigators: Bushnik T, Wright J, Mellick D, Harrison-Felix C, Boake C, Sander A, Malec J, Sherer M, Thompson R, Novack T, Dijkers M, Bogner J, Corrigan J, Hammond F, Kreutzer J, Marwitz J, Millis S, O'Neil-Pirozzi T view full
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Lead Center: Santa Clara Valley Medical Center
Collaborating Centers: Craig Hospital, The Institute for Rehabilitation and Research, Mayo Medical Center, Methodist Rehabilitation Center, University of Alabama, Rehabilitation Institute of Michigan, Ohio State University, Carolinas Rehabilitation, Virginia Commonwealth University/Medical College of Virginia, Moss Rehabilitation Research Institute, Kessler Medical Rehabilitation Research and Education Corporation, Spaulding Rehabilitation Hospital, Mount Sinai School of Medicine
Mortality and Life Expectancy After TBI Rehabilitation
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... more
Investigators: Harrison-Felix C, Whiteneck G, Devivo M, Hammond F, Jha A view full
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Lead Center: Craig Hospital
Collaborating Centers: Carolinas Rehabilitation, Emory University/Shepherd Center, Mayo Medical Center, Ohio State University, University of Alabama, Oregon Health Sciences University, University of Missouri, Moss Rehabilitation Research Institute, Rehabilitation Institute of Michigan, Spaulding Rehabilitation Hospital, Virginia Commonwealth University/Medical College of Virginia, Santa Clara Valley Medical Center, University of Washington


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Registry Dataset accessed Monday, September 25, 2006 5:52am
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