title: Traumatic brain injury in veterans of the wars in Iraq and Afghanistan: communication disorders stratified by severity of brain injury.
abstract: OBJECTIVE
  To describe the prevalence of communication disorders in veterans of the wars in Iraq and Afghanistan with traumatic brain injury (TBI).
  
  
  METHODS
  Retrospective study of the prevalence of aphasia, fluency and voice disorders among veterans with different severity levels of TBI. Data was obtained from the VA National repository for OEF/OIF/OND veterans who received VA care in Fiscal Years 2010 and 2011.
  
  
  RESULTS
  Among the 303,716 veterans in this study, 1848 were diagnosed with a communication disorder; 40% of these were also diagnosed with a TBI. Voice disorders were the most prevalent diagnosis (3.5 per 1000) followed by aphasia (1.9 per 1000) and fluency disorder (0.7 per 1000). Individuals with a TBI diagnosis were more likely to have a diagnosis of aphasia, followed by fluency and then voice disorder. The odds ratio (OR) of aphasia with TBI was 11.09-252.75 (95% CI = 8.78-441.52, p < 0.01). OR for fluency disorders with TBI was 3.58-10.41 (95% CI = 2.56-42.40, p < 0.01) and association of voice disorders with TBI was significant for all levels of TBI severity (OR = 1.5-6.61, 95% CI = 1.24-14.05, p < 0.01).
  
  
  CONCLUSIONS
  Veterans who sustained a TBI were more likely to have a diagnosis of a communication disorder, regardless of TBI severity. Those with TBI, including mild TBI, should be screened and evaluated for communication disorders.
authors.affiliation: Polytrauma Rehabilitation Center, South Texas Veterans Health Care System (STVHCS) , San Antonio, TX , USA .
authors.forename: Rocío S
authors.initials: RS
authors.lastname: Norman
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Jaramillo
authors.forename: Megan
authors.initials: M
authors.lastname: Amuan
authors.forename: Margaret Ann
authors.initials: MA
authors.lastname: Wells
authors.forename: Blessen C
authors.initials: BC
authors.lastname: Eapen
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Pugh
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D001930:Brain Injuries / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D003147:Communication Disorders / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D054542:Iraq War, 2003-2011; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology