Monday, September 25, 2006 5:59am
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Live Syllabus Variables
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Display Form I variables
Display Form II variables
Variable ID
Variable Title
Form Type
01
VERSION OF FORM I BEING ENTERED
I
100
SYSTEM/SUBJECT ID
I
101a
DATES (AND TIMES)
I
102
SHORT TERM REHABILITATION INTERRUPTION
I
103
PATIENT BIRTHDATE
I
104
SEX
I
105
RACE
I
107
MARITAL STATUS
I
108
PRIMARY PERSON LIVING WITH
I
109
RESIDENCE
I
109a
ZIP CODE
I
110a
YEARS OF EDUCATION
I
110b
GED
I
111a
EMPLOYMENT STATUS
I
111b
HOURS OF PAID COMPETITIVE EMPLOYMENT
I
111d
JOB STABILITY: WEEKS EMPLOYED
I
111i
ANNUAL EARNINGS
I
112
CENSUS OCCUPATIONAL CATEGORY
I
121
HISTORY OF TBI
I
122
PREMORBID CONDITIONS
I
123
PREMORBID LIMITATIONS
I
130a
DATE ABLE TO FOLLOW COMMANDS
I
131h
ASSOCIATED INJURY - Spinal Cord Injury
I
133a
CAUSE OF INJURY
I
133b
ICD-9-CM EXTERNAL CAUSE OF INJURY CODE
I
134
ETOH BLOOD LEVEL AT INJURY
I
135
INTRACRANIAL CT DIAGNOSIS
I
137
ICD-9-CM Diagnosis codes for brain injury
I
139
GLASGOW COMA SCALE
I
140
REVISED TRAUMA SCORE
I
144a
DATE EMERGED FROM PTA
I
144b
METHOD OF PTA DETERMINATION
I
146
CAUSE(S) OF DEATH
I
148h
CRANIAL COMPLICATIONS - Intracranial Hypertension
I
151
DISABILITY RATING SCALE
I
152
FUNCTIONAL INDEPENDENCE MEASURE (FIM)
I
170m1
CRANIAL SURGERY - CRANIOTOMY/CRANIECTOMY
I
176
CHARGES
I
178
PAYOR SOURCE
I
192a1
PREMORBID DRUG USE
I
192a2
PREMORBID ALCOHOL USE
I
192h
PREMORBID HISTORY OF PENAL INCARCERATIONS WITH CONVICTION FOR FELONY
I
192i
PREMORBID HISTORY OF LEARNING AND/OR BEHAVIOR PROBLEMS IN SCHOOL
I
Traumatic Brain Injury Model System National Database Live Syllabus V10.3
Monday, September 25, 2006 5:59am .
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