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Projects of the TBINDC Registry by Research Center
Five to Eleven Years Post-Injury: Impact of Late Post-Traumatic Seizures
Abstract: The impact of late post-traumatic seizures (LPTS) in addition to a traumatic brain injury (TBI) has not been well examined. This study will characterize, describe, and highlight the particular issues that individuals with TBI and LPTS may face in their daily lives. The participant pool will be drawn from individuals who participated in an earlier NIDRR-funded study examining the risk factors for the development of LPTS. These individuals are now more than seven years post-injury. It is hypothesized that individuals with TBI and LPTS will report increased disability (physical and cognitive), increased utilization of medical services, and increased supervision needs over those without LPTS. Individuals with TBI and LPTS may report higher... more
Investigators: Duong T, Bushnik T, Englander J, Wright J view full
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Lead Center: Santa Clara Valley Medical Center
Comparisons among outcome measures: which to use
Abstract: The objective of this study is to determine the outcome measures that are best and least suited for use in assessing long-term functional outcome of individuals with TBI in the community. Conclusions: Measures that appeared to contribute little to assessing functional status of a TBI sample years postinjury were the FIM, FIM+FAM, SRS, GOS, and LCFS. Measures that showed a range of deficits across participants were the DRS employability, the NFI, PCRS, and the R-CHART cognition subscale.
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Investigators: Hall K, Wright J, Bushnik T view full
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Lead Center: Santa Clara Valley Medical Center
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
Association between Fatigue, Severity of Injury, Duration of Injury, and Underlying Factors
Abstract: The consequences of fatigue are many-fold and can present significant barriers to recovery. Estimates of the prevalence of fatigue among individuals with traumatic brain injury living in the community are estimated to range between 50% and 80%. This study will expand upon the current literature and correlate the fatigue experienced by individuals at least one year post-TBI, with potential contributing factors: concurrent medications, sleep patterns, endocrine findings, affective symptomatology, activity patterns and limitations, and substance use.... more
Investigators: Bushnik T, Englander J, Wright J view full
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Lead Center: Santa Clara Valley Medical Center
Assessing the Pattern of Fatigue, and Its Correlates During the First Two Years Post-TBI
Abstract: The prevalence of fatigue among individuals with traumatic brain injury living in the community is estimated to range between 50% and 80%. The need to clarify the contributing factors to fatigue is driven by the availability of different treatments. This longitudinal study will examine the dynamic nature of fatigue experienced by individuals with TBI in the first two years post-injury and will document whether the nature of fatigue changes within that time frame. It will assess whether factors such as concurrent medications, sleep findings, affective symptomatology, activity patterns and limitations, substance use, and neuroendocrine profiles may contribute to the changes in fatigue dimensions within the first two years post-TBI.... more
Investigators: Englander J, Bushnik T, Wright J view full
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Lead Center: Santa Clara Valley Medical Center
Two to Four Years Post-Injury: Impact of Late Post-Traumatic Seizures
Abstract: Traumatic brain injuries account for 20% of symptomatic epilepsy in the general population and 5% of all epilepsy. The risk factors associated with the development of late post-traumatic seizures, which are defined as occurring after the first week of injury and within 2 years of injury, include age, penetrating injuries, multiple
neurosurgical procedures, severity of injury, locations of lesions, depressed skull fracture, intracranial hemorrhage, and occurrence of early PTS. This study will utilize the power of the TBI Model Systems National Database to compare and contrast the levels of impairment, disability, and participation of those who develop late post-traumatic seizures and those who do not. The two groups will be compared at... more
Investigators: Bushnik T, Wright J, Englander J view full
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Lead Center: Santa Clara Valley Medical Center
Development of Participation Measures for People with Traumatic Brain Injury
Abstract: There is no general agreement in the field regarding a reliable and valid objective measure of community participation after TBI. This study will use a multi-center, prospective, cohort design to evaluate participation items pooled from four currently used tools: the Craig Handicap Assessment and Reporting Technique Short Form (CHART-SF); the Community Integration Questionnaire Version 2 (CIQ-2); the Participation Objective-Participation Subjective (PO-PS) section of the Living Life After TBI (LLATBI); and the Mayo-Portland Participation Index (M2PI). The primary objectives of this study are to: 1) evaluate internal consistency, concurrent validity, and item/scale structure of current measures of community participation after TBI; and 2)... more
Investigators: Whiteneck G, Bushnik T, Cicerone K, Corrigan J, Bogner J, Dijkers M, Gordon W, Hart T, Malec J, Novack T view full
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Lead Center: Craig Hospital
Collaborating Centers: University of Alabama, Santa Clara Valley Medical Center, Mayo Medical Center, Kessler Medical Rehabilitation Research and Education Corporation, Mount Sinai School of Medicine, Ohio State University, Moss Rehabilitation Research Institute
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
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
A Prospective Observational Study of Screening and Prophylaxis for Deep Vein Thrombosis in Survivors of Traumatic Brain Injury During Inpatient Rehabilitation
Abstract: During the period of acute rehabilitation for traumatic brain injury (TBI), the development of deep vein thrombosis (DVT) is a significant complication that increases morbidity and mortality. Pulmonary embolism (PE) is one of the most ominous, and frequently life-threatening, complications that occur during TBI rehabilitation. TBI patients often sustain concomitant multiple trauma and have cumulative risk factors for DVT. Because these TBI patients are usually maintained at bed rest during their acute hospitalization, they are at increased risk for existing DVT to embolize when they enter the rehabilitation setting and resume mobility. Prior to initiating this study, a practice survey was distributed to the 16 rehabilitation centers of... more
Investigators: Carlile M, Diaz-Arrastia R, Mysiw W view full
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Lead Center: North Texas Traumatic Brain Injury Model System
Collaborating Centers: Carolinas Rehabilitation, JFK Johnson Rehabilitation Institute, Mayo Medical Center, Mount Sinai School of Medicine, Santa Clara Valley Medical Center, Methodist Rehabilitation Center, Ohio State University, University of Alabama, University of Pittsburgh
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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National Traumatic Brain Injury Live Syllabus v2.00.00
Registry Dataset accessed Monday, September 25, 2006 5:50am
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