title: Long-term outcomes after moderate-to-severe traumatic brain injury among military veterans: Successes and challenges.
abstract: OBJECTIVE
  To assess long-term outcomes after traumatic brain injury (TBI) among veterans and service members.
  
  
  METHODS
  Regional Veterans Affairs medical centre.
  
  
  METHODS
  One hundred and eighteen veterans and military personnel, aged 23-70 years (median = 35 years), 90% male, had moderate-to-severe TBI (82% in coma > 1 day, 85% amnesic > 7 days), followed by acute interdisciplinary rehabilitation 5-16 years ago (median = 8 years).
  
  
  METHODS
  Cross-sectional analysis of live interviews conducted via telephone.
  
  
  METHODS
  TBI follow-up interview (occupational, social, cognitive, neurologic and psychiatric ratings), Community Integration Questionnaire, Disability Rating Scale (four indices of independent function) and Satisfaction with Life Scale.
  
  
  RESULTS
  At follow-up, 52% of participants were working or attending school; 34% ended or began marriages after TBI, but the overall proportion married changed little. Finally, 22% were still moderately-to-severely disabled. However, 62% of participants judged themselves to be as satisfied or more satisfied with life than before injury. Injury severity, especially post-traumatic amnesia, was correlated with poorer outcomes in all functional domains.
  
  
  CONCLUSIONS
  After moderate-severe TBI, most veterans assume productive roles and are satisfied with life. However, widespread difficulties and functional limitations persist. These findings suggest that veteran and military healthcare systems should continue periodic, comprehensive follow-up evaluations long after moderate-to-severe TBI.
authors: a Defence and Veterans Brain Injury Center , Palo Alto , CA , USA.
authors: R Jay
authors: RJ
authors: Schulz-Heik
authors: a Defence and Veterans Brain Injury Center , Palo Alto , CA , USA.
authors: John H
authors: JH
authors: Poole
authors: b Baylor Regional Medical Center at Plano, Baylor Institute for Rehabilitation , Plano , TX , USA.
authors: Marie N
authors: MN
authors: Dahdah
authors: c Johns Hopkins School of Medicine , Baltimore , MD , USA.
authors: Campbell
authors: C
authors: Sullivan
authors: d Remedy Medical Group , Redwood City , CA , USA.
authors: Elaine S
authors: ES
authors: Date
authors: a Defence and Veterans Brain Injury Center , Palo Alto , CA , USA.
authors: Rose M
authors: RM
authors: Salerno
authors: e Defense and Veterans Brain Injury Center , Rockville , MD , USA.
authors: Karen
authors: K
authors: Schwab
authors: a Defence and Veterans Brain Injury Center , Palo Alto , CA , USA.
authors: Odette
authors: O
authors: Harris
mesh_terms: D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology / Q000534:rehabilitation*; D062309:Community Integration; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014728:Veterans
keywords: Outcome; rehabilitation; social reintegration; traumatic brain injury; work