Research Reports - Long-term survival after traumatic brain injury: Life expectancy

Arch Phys Med Rehabil. 2015 Jun;96(6):1000-5

Brooks JC(1), Shavelle RM(2), Strauss DJ(2), Hammond FM(3), Harrison-Felix CL(4)

OBJECTIVES: To compute the life expectancy of persons with traumatic brain injury
(TBI) based on validated prognostic models from 2 cohorts, to compare mortality
and life expectancy of persons with TBI with those of the U.S. general
population, and to investigate trends toward improved survival over the last 2
decades.
DESIGN: Survival analysis.
SETTING: Postdischarge from rehabilitation units and long-term follow-up at
regional centers.
PARTICIPANTS: Two cohorts of long-term survivors of TBI (N=12,481): the Traumatic
Brain Injury Model Systems (TBIMS) cohort comprised 7365 persons who were
admitted to a TBIMS facility with moderate to severe TBI and were assessed at ≥1
years postinjury, and the California Department of Developmental Services (CDDS)
cohort comprised 5116 persons who sustained a TBI and received long-term services
from the CDDS.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Life expectancy.
RESULTS: The estimates of age-, sex-, and disability-specific life expectancy of
persons with TBI derived from the CDDS and TBIMS were similar. The estimates of
age- and sex-specific life expectancy were lower than those of the U.S. general
population. Mortality rates of persons with TBI were higher than those of the
U.S. general population. Mortality rates did not improve and the standardized
mortality ratio increased over the study period from 1988 to 2010.
CONCLUSIONS: Life expectancy of persons with TBI is lower than that of the
general population and depends on age, sex, and severity of disability. When
compared, the survival outcomes in the TBIMS and CDDS cohorts are remarkably
similar. Because there have been no marked trends in the last 20 years, the life
expectancies presented in this article may remain valid in the future.

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