US population estimates of health and social outcomes 5 years after rehabilitation for traumatic brain injury.
OBJECTIVE
To estimate the number of adults in the United States from 2006 to 2012 who manifest selected health and social outcomes 5 years following a traumatic brain injury (TBI) that required acute inpatient rehabilitation.


METHODS
Secondary data analysis.


METHODS
Acute inpatient rehabilitation facilities.


METHODS
Patients 16 years and older receiving acute inpatient rehabilitation for a primary diagnosis of TBI.


METHODS
Mortality, functional independence, societal participation, subjective well-being, and global outcome.


RESULTS
Annually from 2001 to 2007, an average of 13 700 patients aged 16 years or older received acute inpatient rehabilitation in the United States with a primary diagnosis of TBI. Approximately 1 in 5 patients had died by the 5-year postinjury assessment. Among survivors, 12% were institutionalized and 50% had been rehospitalized at least once. Approximately one-third of patients were not independent in everyday activities. Twenty-nine percent were dissatisfied with life, with 8% reporting markedly depressed mood. Fifty-seven percent were moderately or severely disabled overall, with 39% having deteriorated from a global outcome attained 1 or 2 years postinjury. Of those employed preinjury, 55% were unemployed. Poorer medical, functional, and participation outcomes were associated with, but not limited to, older age. Younger age groups had poorer mental and emotional outcomes. Deterioration in global outcome was common and not age-related.


CONCLUSIONS
Significant mortality and morbidity were evident at 5 years postinjury. The deterioration in global outcomes observed regardless of age suggests that multiple influences contribute to poorer outcomes. Public health interventions intended to reduce post-acute inpatient rehabilitation mortality and morbidity rates will need to be multifaceted and age-specific.
Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus Ohio (Dr Corrigan); Research Department, Craig Hospital, Englewood, Colorado (Drs Cuthbert, Harrison-Felix, Whiteneck, and Pretz); National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Bell and Coronado); and Department of Education, National Institute on Disability and Rehabilitation Research, Washington, District of Columbia (Dr Miller).
John D
JD
Corrigan
Jeffrey P
JP
Cuthbert
Cynthia
C
Harrison-Felix
Gale G
GG
Whiteneck
Jeneita M
JM
Bell
A Cate
AC
Miller
Victor G
VG
Coronado
Christopher R
CR
Pretz
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001334:Automobile Driving / Q000706:statistics & numerical data; D001930:Brain Injuries / Q000453:epidemiology / Q000401:mortality / Q000523:psychology / Q000534:rehabilitation*; D003863:Depression / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D007326:Institutionalization / Q000706:statistics & numerical data; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D010549:Personal Satisfaction; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D055815:Young Adult