title: Racial/Ethnic Differences in Combat- and Non-Combat-Associated Traumatic Brain Injury Severity in the Veterans Health Administration: 2004-2010.
abstract: OBJECTIVE
  We examined the association between traumatic brain injury (TBI) severity and combat exposure by race/ethnicity.
  
  
  METHODS
  We estimated logit models of the fully adjusted association of combat exposure with TBI severity in separate race/ethnicity models for a national cohort of 132 995 veterans with TBI between 2004 and 2010.
  
  
  RESULTS
  Of veterans with TBI, 25.8% had served in a combat zone. Mild TBI increased from 11.5% to 40.3%, whereas moderate or severe TBI decreased from 88.5% to 59.7%. Moderate or severe TBI was higher in non-Hispanic Blacks (80.0%) and Hispanics (89.4%) than in non-Hispanic Whites (71.9%). In the fully adjusted all-race/ethnicity model, non-Hispanic Blacks (1.44; 95% confidence interval [CI] = 1.37, 1.52) and Hispanics (1.47; 95% CI = 1.26, 1.72) had higher odds of moderate or severe TBI than did non-Hispanic Whites. However, combat exposure was associated with higher odds of mild TBI in non-Hispanic Blacks (2.48; 95% CI = 2.22, 2.76) and Hispanics (3.42; 95% CI = 1.84, 6.35) than in non-Hispanic Whites (2.17; 95% CI = 2.09, 2.26).
  
  
  CONCLUSIONS
  Research is needed to understand racial differences in the effect of combat exposure on mild TBI and on interventions to prevent TBI across severity levels.
authors.affiliation: Clara E. Dismuke, Mulugeta Gebregziabher, Derik Yeager, and Leonard E. Egede are with the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC. Clara E. Dismuke and Leonard E. Egede are also with the Center for Health Disparities Research and Division of General Internal Medicine & Geriatrics, Medical University of South Carolina, Charleston. Mulugeta Gebregziabher is also with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Clara E
authors.initials: CE
authors.lastname: Dismuke
authors.affiliation: Clara E. Dismuke, Mulugeta Gebregziabher, Derik Yeager, and Leonard E. Egede are with the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC. Clara E. Dismuke and Leonard E. Egede are also with the Center for Health Disparities Research and Division of General Internal Medicine & Geriatrics, Medical University of South Carolina, Charleston. Mulugeta Gebregziabher is also with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Mulugeta
authors.initials: M
authors.lastname: Gebregziabher
authors.affiliation: Clara E. Dismuke, Mulugeta Gebregziabher, Derik Yeager, and Leonard E. Egede are with the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC. Clara E. Dismuke and Leonard E. Egede are also with the Center for Health Disparities Research and Division of General Internal Medicine & Geriatrics, Medical University of South Carolina, Charleston. Mulugeta Gebregziabher is also with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Derik
authors.initials: D
authors.lastname: Yeager
authors.affiliation: Clara E. Dismuke, Mulugeta Gebregziabher, Derik Yeager, and Leonard E. Egede are with the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC. Clara E. Dismuke and Leonard E. Egede are also with the Center for Health Disparities Research and Division of General Internal Medicine & Geriatrics, Medical University of South Carolina, Charleston. Mulugeta Gebregziabher is also with the Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D044469:Racial Groups / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D014857:Warfare; D055815:Young Adult