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Mortality following rehabilitation in the Traumatic Brain Injury Model Systems of Care

Issue title: Aging with a Neurodisability: Morbidity and Life Expectancy Issues

Guest editors: Michael J. DeVivo

Article type: Research Article

Authors: Harrison-Felix, Cynthiaa; * | Whiteneck, Galea | DeVivo, Michaelb | Hammond, Flora M.c | Jha, Amitabha; d

Affiliations: [a] Research Department, Craig Hospital, Englewood, CO, USA | [b] Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA | [c] Charlotte Institute of Rehabilitation, Charlotte, NC, USA | [d] Department of Rehabilitation Medicine, Denver Health Medical Center, University of Colorado, Denver, CO, USA | Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA

Correspondence: [*] Address for correspondence: C. Harrison-Felix, Ph.D., Craig Hospital, Research Department, 3425 South Clarkson Street, Englewood, CO 80113, USA. Tel.: +1 303 7898565; Fax: +1 303 7898441; E-mail: charrison-felix@craighospital.org

Keywords: traumatic brain injury, mortality, life expectancy

DOI: 10.3233/NRE-2004-19106

Journal: NeuroRehabilitation, vol. 19, no. 1, pp. 45-54, 2004

Published: 17 February 2004
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Abstract

While many outcomes after traumatic brain injury (TBI) have been systematically investigated, the most basic of all outcomes – survival – has been neglected. The purpose of this study was to investigate mortality in a cohort of 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. The study hypotheses were: (1) relative to the general population, TBI increases mortality and decreases life expectancy in individuals with TBI completing inpatient rehabilitation and surviving to one-year post-injury; and (2) within the TBI population, the risk of death is greater in certain TBI subgroups. Results indicate that 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 seven years for individuals with TBI. Within the TBI population, the strongest independent risk factors for death after one-year post-injury were older age and not being employed at injury, and greater disability at rehabilitation discharge. This information is important to guide decision-making for treatment, utilization of limited medical resources, and planning for ongoing health care needs and lifetime planning.

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