Five years after traumatic brain injury: a study of individual outcomes and predictors of change in function.
OBJECTIVE
Study functional changes between one and five years after traumatic brain injury (TBI).


METHODS
Prospective cohort.


METHODS
TBI Model Systems National Database subjects using cohort with complete one and five year data (n = 301).


METHODS
Disability Rating Scale (DRS) Level of Functioning and Employability Items.


RESULTS
On Level of Functioning, 53 (18%) individuals improved, 228 (76%) stayed the same, and 20 (7%) worsened by more than one point from Year 1 to Year 5. On Employability, 50 (17%) individuals improved, 237 (79%) stayed the same, and 14 (5%) worsened by greater than one point. Level of Functioning improvement was predicted by FIM-Motor, FIM-Cognitive, Rey Auditory Verbal Learning Test, Symbol Digit Modalities Test (written and oral), and Wechsler Adult Intelligence Scale-Revised Block Design, and worsening predicted by Symbol Digit Modalities Test (written and oral). Improvement in Employability was predicted by race, while Glasgow Coma Scale Eye Opening was predictive of worsening.


CONCLUSIONS
Although the majority did not demonstrate meaningful change on the DRS items from year 1 to 5, some individuals made dramatic gains and a minority declined. There are demographic and functional indicators present at one-year post-injury that may be predictive of subsequent change.
Department of Physical Medicine and Rehabilitation, Charlotte Institute of Rehabilitation, Carolinas HealthCare System, Charlotte, NC 28203, USA. Flora.hammond@carolinashealthcare.org
Flora M
FM
Hammond
Karyn D
KD
Grattan
Howell
H
Sasser
John D
JD
Corrigan
Mitchell
M
Rosenthal
Tamara
T
Bushnik
William
W
Shull
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000503:physiopathology*; D015331:Cohort Studies; D004185:Disability Evaluation; D018450:Disease Progression; D004651:Employment; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D020127:Recovery of Function