Variable IDVariable TitleForm 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  .   comments/questions?
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