TY - JOUR
T1 - Life expectancy following rehabilitation
T2 - A NIDRR traumatic brain injury model systems study
AU - Harrison-Felix, Cynthia
AU - Kreider, Scott E.D.
AU - Arango-Lasprilla, Juan C.
AU - Brown, Allen W.
AU - Dijkers, Marcel P.
AU - Hammond, Flora M.
AU - Kolakowsky-Hayner, Stephanie A.
AU - Hirshson, Chari
AU - Whiteneck, Gale
AU - Zasler, Nathan D.
N1 - Copyright:
Copyright 2013 Elsevier B.V., All rights reserved.
PY - 2012/11
Y1 - 2012/11
N2 - OBJECTIVE: To characterize overall and cause-specific mortality and life expectancy among persons who have completed inpatient traumatic brain injury rehabilitation and to assess risk factors for mortality. DESIGN: Prospective cohort study. SETTING: The Traumatic Brain Injury Model Systems. PARTICIPANTS: A total of 8573 individuals injured between 1988 and 2009, with survival status per December 31, 2009, determined. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Standardized mortality ratio (SMR), life expectancy, cause of death. RESULTS: SMR was 2.25 overall and was significantly elevated for all age groups, both sexes, all race/ethnic groups (except Native Americans), and all injury severity groups. SMR decreased as survival time increased but remained elevated even after 10 years postinjury. SMR was elevated for all cause-of-death categories but especially so for seizures, aspiration pneumonia, sepsis, accidental poisonings, and falls. Life expectancy was shortened an average of 6.7 years. Multivariate Cox regression showed age at injury, sex, race/ethnic group, marital status and employment status at the time of injury year of injury, preinjury drug use, days unconscious, functional independence and disability on rehabilitation discharge, and comorbid spinal cord injury to be independent risk factors for death. CONCLUSION: There is an increased risk of death after moderate or severe traumatic brain injury. Risk factors and causes of death have been identified that may be amenable to intervention.
AB - OBJECTIVE: To characterize overall and cause-specific mortality and life expectancy among persons who have completed inpatient traumatic brain injury rehabilitation and to assess risk factors for mortality. DESIGN: Prospective cohort study. SETTING: The Traumatic Brain Injury Model Systems. PARTICIPANTS: A total of 8573 individuals injured between 1988 and 2009, with survival status per December 31, 2009, determined. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Standardized mortality ratio (SMR), life expectancy, cause of death. RESULTS: SMR was 2.25 overall and was significantly elevated for all age groups, both sexes, all race/ethnic groups (except Native Americans), and all injury severity groups. SMR decreased as survival time increased but remained elevated even after 10 years postinjury. SMR was elevated for all cause-of-death categories but especially so for seizures, aspiration pneumonia, sepsis, accidental poisonings, and falls. Life expectancy was shortened an average of 6.7 years. Multivariate Cox regression showed age at injury, sex, race/ethnic group, marital status and employment status at the time of injury year of injury, preinjury drug use, days unconscious, functional independence and disability on rehabilitation discharge, and comorbid spinal cord injury to be independent risk factors for death. CONCLUSION: There is an increased risk of death after moderate or severe traumatic brain injury. Risk factors and causes of death have been identified that may be amenable to intervention.
KW - brain injury
KW - chronic
KW - epidemiology
KW - life expectancy
KW - mortality
KW - rehabilitation
KW - vital statistics
UR - http://www.scopus.com/inward/record.url?scp=84870018665&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84870018665&partnerID=8YFLogxK
U2 - 10.1097/HTR.0b013e3182738010
DO - 10.1097/HTR.0b013e3182738010
M3 - Article
C2 - 23131972
AN - SCOPUS:84870018665
SN - 0885-9701
VL - 27
SP - E69-E80
JO - Journal of Head Trauma Rehabilitation
JF - Journal of Head Trauma Rehabilitation
IS - 6
ER -