A comparison of substance abuse and violence in the prediction of long-term rehabilitation outcomes after traumatic brain injury.
OBJECTIVE
To determine the relative contributions of substance abuse history and violent etiology to the prediction of outcomes for individuals who sustained a traumatic brain injury (TBI) requiring inpatient rehabilitation.


METHODS
Longitudinal study of outcomes 1 year postdischarge from rehabilitation.


METHODS
Specialized TBI acute rehabilitation unit.


METHODS
Three hundred fifty-one individuals consecutively admitted for rehabilitation.


METHODS
Gathered data from patients' medical records (including etiology of injury, initial Glasgow Coma Scale scores, and FIMtrade mark instrument scores at discharge), demographic details, and history of substance abuse; phone and mail survey data from individuals (Satisfaction with Life Scale [SWLS]; Community Integration Questionnaire [CIQ]).


METHODS
CIQ and SWLS; relative contributions of injury etiology, demographic and injury-related dependent variables, and substance abuse history to predictive model.


RESULTS
Almost 80% of persons with injuries from violence-related causes had a history of substance abuse. Substance abuse was found to contribute to the prediction of life satisfacton and productivity, while violent etiology was not a significant contributor to predictive models.


CONCLUSIONS
Substance abuse history proved to be a strong predictor of long-term outcomes, while violent etiology of injury was less influential. The results of this study emphasize the need to include substance abuse history in all studies of outcomes after TBI, and to increase prevention efforts to limit the effects of such a history.
Bogner
J A
JA
Ohio Regional Traumatic Brain Injury Model System, Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH, USA. bogner.1@osu.edu
Corrigan
J D
JD
Mysiw
W J
WJ
Clinchot
D
D
Fugate
L
L
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019966:Substance-Related Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D013997:Time Factors; D014754:Violence / Q000706:statistics & numerical data