title: Three-year outcome following moderate-to-severe TBI in U.S. military service members: a descriptive cross-sectional study.
abstract: This study examined the prospective course of neurobehavioral symptom reporting and health-related quality of life within the first 3 years following moderate-to-severe traumatic brain injury (TBI). Participants were 52 U.S. service members who were evaluated following a moderate-to-severe TBI sustained in the combat theater during Operations Iraqi and Enduring Freedom (90.4%), or from other noncombat-related incidents. Participants completed the Neurobehavioral Symptom Inventory and Post-Traumatic Stress Disorder-Checklist within 3 months postinjury, and at least one follow-up telephone interview at 12 (n = 27), 24 (n = 31), or 36 months (n = 22) postinjury. Approximately half of the sample (41.9%-63.0%) reported "persistent" symptoms from baseline to follow-up. A substantial minority also "improved" (22.2%-31.8%) or "developed" new symptoms (3.7%-16.1%). Ongoing physical and mental health problems were also reported. The number of service members receiving mental health treatment significantly reduced between 12 and 36 months postinjury (48.1%-18.2%), while complaints of bodily pain significantly increased (40.7%-68.2%). Despite ongoing symptom reporting, few reported suicidal/homicidal ideation (6.5%-9.1%), and a substantial majority reported good/excellent health status (74.1%-90.9%) and satisfaction with their life (81.5%-90.9%). Continued support and care for all service members who sustain a combat-related moderate-to-severe TBI is recommended, regardless of the presence or absence of symptom reporting within the first few months postinjury.
authors.affiliation: Defense and Veterans Brain Injury Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600.
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Brickell
authors.affiliation: Defense and Veterans Brain Injury Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600.
authors.forename: Rael T
authors.initials: RT
authors.lastname: Lange
authors.affiliation: Defense and Veterans Brain Injury Center, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600.
authors.forename: Louis M
authors.initials: LM
authors.lastname: French
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications* / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008605:Mental Health Services / Q000706:statistics & numerical data; D008889:Military Personnel / Q000523:psychology*; D010146:Pain / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D059020:Suicidal Ideation; D015599:Trauma Severity Indices; D014481:United States; D055815:Young Adult