Citation

Evans CT, St Andre JR, Pape TL, Steiner ML, Stroupe KT, Hogan TP, Weaver FM, Smith BM. PM R 2013; 5(3): 210-220.

Affiliation

Center for Management of Complex Chronic Care, Edward Hines Jr. Veterans Affairs (VA) Hospital, Department of VA, 5000 S. 5th Avenue, Hines, IL 60141; Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Department of VA, Hines, IL; Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, Chicago, IL . Electronic address: Charlesnika.Evans@va.gov.

Copyright

(Copyright © 2013, American Academy of Physical Medicine and Rehabilitation, Publisher Elsevier Publishing)

DOI

10.1016/j.pmrj.2012.12.004

PMID

23375630

Abstract

OBJECTIVE: The goal of this study was to describe the early results of the U.S. Department of Veterans Affairs (VA) screening program for traumatic brain injury (TBI) and to identify patient and facility characteristics associated with receiving a TBI screen and results of the screening. DESIGN: National retrospective cohort study. SETTING: VA Medical facilities. PATIENTS: A total of 170,681 Operation Enduring Freedom and/or Operation Iraqi Freedom (OEF/OIF) Veterans who sought care at VA medical facilities from April 2007 to September 30, 2008. METHODS: Data were abstracted from VA administrative and operational databases, including patient demographics, facility characteristics, and outcomes. MAIN OUTCOME MEASUREMENTS: The main outcomes were receipt of and results of the TBI screen. RESULTS: The majority of veterans eligible received the TBI screen (91.6%). Screening rates varied by patient and facility characteristics. In all, 25% of screened veterans had probable TBI exposure, in which the majority of the exposures were blasts (85.0%). The rate of a positive TBI screen was 20.5% for the screened cohort. Male gender, service in the army, multiple deployments, and mental health diagnoses in the previous year were associated with a positive screen. CONCLUSIONS: TBI screening rates are high in VA; concomitant mental health diagnoses were highly prevalent in individuals with positive TBI screens. These data indicate that there will be a significant need for long-term health care services for veterans with TBI symptomatology.

Language: en