title: Global Outcome Trajectories After TBI Among Survivors and Nonsurvivors: A National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems Study.
abstract: OBJECTIVE
  To compare long-term functional outcome trajectories of individuals with traumatic brain injury (TBI) who survive with those who expire more than 5 years postinjury, using individual growth curve analysis.
  
  
  METHODS
  Secondary analysis of data from a multicenter longitudinal cohort study.
  
  
  METHODS
  Acute inpatient rehabilitation facilities that are current or former TBI Model Systems.
  
  
  METHODS
  Individuals 16 years and older with a primary diagnosis of TBI.
  
  
  METHODS
  Glasgow Outcome Scale-Extended; Disability Rating Scale.
  
  
  RESULTS
  Individuals in the TBI Model Systems who expire several years after injury demonstrate worse functional status at baseline and a steeper rate of decline over time as measured by both the Glasgow Outcome Scale-Extended and the Disability Rating Scale. There was significant variability in each growth parameter (P < .05) for both instruments. A reduced model was built for each outcome, including all covariates that related significantly to the growth parameters. An interactive tool was created for each outcome to generate individual-level trajectories based on various combinations of covariate values.
  
  
  CONCLUSIONS
  Individuals with TBI who die several years after injury demonstrate functional trajectories that differ markedly from those of survivors. Opportunities should be sought for health management interventions to improve health and longevity after TBI.
authors.affiliation: Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York (Dr Dams-O'Connor and Mr Billah); Research Department, Craig Hospital, Englewood, Colorado (Drs Pretz and Harrison-Felix); and Indiana University School of Medicine, Indianapolis (Dr Hammond).
authors.forename: Kristen
authors.initials: K
authors.lastname: Dams-OʼConnor
authors.forename: Christopher
authors.initials: C
authors.lastname: Pretz
authors.forename: Tausif
authors.initials: T
authors.lastname: Billah
authors.forename: Flora M
authors.initials: FM
authors.lastname: Hammond
authors.forename: Cynthia
authors.initials: C
authors.lastname: Harrison-Felix
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001930:Brain Injuries / Q000401:mortality* / Q000534:rehabilitation*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020127:Recovery of Function; D000066768:Rehabilitation Research; D016019:Survival Analysis; D055815:Young Adult