Research Reports - Prior history of traumatic brain injury among persons in the traumatic brain injury model systems national database

Arch Phys Med Rehabil. 2013 Oct;94(10):1940-50

Corrigan JD, Bogner J, Mellick D, Bushnik T, Dams-O'Connor K, Hammond FM, Hart T, Kolakowsky-Hayner S

OBJECTIVE: To determine the association between demographic, psychosocial, and
injury-related characteristics and traumatic brain injury (TBI) occurring prior
to a moderate or severe TBI requiring rehabilitation.
DESIGN: Secondary data analysis.
SETTING: TBI Model System inpatient rehabilitation facilities.
PARTICIPANTS: Persons (N=4464) 1, 2, 5, 10, 15, or 20 years after TBI resulting
in participation in the TBI Model System National Database.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: History of TBI prior to the TBI Model System Index injury,
pre-Index injury demographic and behavioral characteristics, Index injury
characteristics, post-Index injury behavioral health and global outcome.
RESULTS: Twenty percent of the cohort experienced TBIs preceding the TBI Model
System Index injury-80% of these were mild and 40% occurred before age 16. Pre-
and post-Index injury behavioral issues, especially substance abuse, were highly
associated with having had a prior TBI. Greater severity of the pre-Index injury
as well as occurrence before age 6 often showed stronger associations.
Unexpectedly, pre-Index TBI was associated with less severe Index injuries and
better functioning on admission and discharge from rehabilitation.
CONCLUSIONS: Findings suggest that earlier life TBI may have important
implications for rehabilitation after subsequent TBI, especially for anticipating
behavioral health issues in the chronic stage of recovery. Results provide
additional evidence for the potential consequences of early life TBI, even if
mild.

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