title: Traumatic brain injury in U.S. Veterans with traumatic spinal cord injury.
abstract: Patients with both a spinal cord injury (SCI) and traumatic brain injury (TBI) are often very difficult to manage and can strain the resources of clinical units specialized in treating either diagnosis. However, a wide range of estimates exists on the extent of this problem. The aim of this study was to describe the scope of the problem in a well-defined population attending a comprehensive SCI unit. Electronic medical records of all patients with SCI being followed by the SCI unit in a U.S. Veterans' hospital were searched to identify those with concurrent TBI. The data were analyzed for age, sex, cause of injury, level and completeness of SCI, cognitive impairment, relationship with Active Duty military, and date of injury. Of 409 Veterans with a traumatic SCI, 99 (24.2%) were identified as having had a concurrent TBI. The occurrence did not appear to be closely related to military conflict. Reports of TBI were much more common in the last 20 yr than in previous decades. Documentation of TBI in patients with SCI was inconsistent. Improved screening and documentation could identify all patients with this dual diagnosis and facilitate appropriate management.
authors.affiliation: Spinal Cord Injury and Disorders Center, Department of Veterans Affairs Palo Alto Health Care System, Palo Alto, CA;
authors.forename: Graham H
authors.initials: GH
authors.lastname: Creasey
authors.forename: Zoia C
authors.initials: ZC
authors.lastname: Lateva
authors.forename: Sophia Miryam
authors.initials: SM
authors.lastname: Schüssler-Fiorenza Rose
authors.forename: Jon
authors.initials: J
authors.lastname: Rose
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000453:epidemiology*; D002574:Cervical Vertebrae; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity / Q000639:trends; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000209:etiology; D013904:Thoracic Vertebrae; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Active Duty military; Veterans; Veterans Health Administration; cognitive impairment; electronic medical records; military trauma; polytrauma; retrospective study; spinal cord injury; traumatic brain injury