Research Reports - US population estimates of health and social outcomes 5 years after rehabilitation for traumatic brain injury

J Head Trauma Rehabil. 2014 Feb 3

Corrigan JD(1), Cuthbert JP, Harrison-Felix C, Whiteneck GG, Bell JM, Miller AC, Coronado VG, Pretz CR

OBJECTIVE:: To estimate the number of adults in the United States from 2006 to
2012 who manifest selected health and social outcomes 5 years following a
traumatic brain injury (TBI) that required acute inpatient rehabilitation.
DESIGN:: Secondary data analysis.
SETTING:: Acute inpatient rehabilitation facilities.
PARTICIPANTS:: Patients 16 years and older receiving acute inpatient
rehabilitation for a primary diagnosis of TBI.
MAIN OUTCOME MEASURES:: Mortality, functional independence, societal
participation, subjective well-being, and global outcome.
RESULTS:: Annually from 2001 to 2007, an average of 13 700 patients aged 16 years
or older received acute inpatient rehabilitation in the United States with a
primary diagnosis of TBI. Approximately 1 in 5 patients had died by the 5-year
postinjury assessment. Among survivors, 12% were institutionalized and 50% had
been rehospitalized at least once. Approximately one-third of patients were not
independent in everyday activities. Twenty-nine percent were dissatisfied with
life, with 8% reporting markedly depressed mood. Fifty-seven percent were
moderately or severely disabled overall, with 39% having deteriorated from a
global outcome attained 1 or 2 years postinjury. Of those employed preinjury, 55%
were unemployed. Poorer medical, functional, and participation outcomes were
associated with, but not limited to, older age. Younger age groups had poorer
mental and emotional outcomes. Deterioration in global outcome was common and not
age-related.
CONCLUSIONS:: Significant mortality and morbidity were evident at 5 years
postinjury. The deterioration in global outcomes observed regardless of age
suggests that multiple influences contribute to poorer outcomes. Public health
interventions intended to reduce post-acute inpatient rehabilitation mortality
and morbidity rates will need to be multifaceted and age-specific.

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