Citation

Corrigan JD, Bogner JA, Mellick D, Bushnik T, Dams-O'connor K, Hammond FM, Hart T, Kolakowsky-Hayner S. Arch. Phys. Med. Rehabil. 2013; 94(10): 1940-1950.

Affiliation

Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus OH. Electronic address: corrigan.1@osu.edu.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.apmr.2013.05.018

PMID

23770276

Abstract

OBJECTIVE: To determine the association between demographic, psychosocial, and injury-related characteristics, and traumatic brain injury (TBI) occurring prior to a moderate or severe TBI requiring rehabilitation. DESIGN: Secondary data analysis. SETTING: TBI Model System inpatient rehabilitation facilities Participants: 4,464 persons 1, 2, 5, 10, 15 or 20 years after TBI resulting in participation in the TBI Model System National Database INTERVENTIONS: not applicable MAIN OUTCOME MEASURES: History of TBI prior to the TBI Model System Index injury, pre-Index injury demographic and behavioral characteristics, Index injury characteristics, post-Index injury behavioral health and global outcome. RESULTS: 20% of the cohort experienced TBIs preceding the TBI Model System Index injury--80% were mild and 40% occurred before age 16. Pre- and post-Index injury behavioral issues, especially substance abuse, were highly associated with having had a prior TBI. Greater severity of the pre-Index injury as well as occurrence before age 6 often showed stronger associations. Unexpectedly, pre-Index TBI was associated with less severe Index injuries and better functioning upon admission and discharge from rehabilitation. CONCLUSIONS: Findings suggest earlier life TBI may have important implications for rehabilitation after subsequent TBI, especially for anticipating behavioral health issues in the chronic stage of recovery. Results provide additional evidence for the potential consequences of early life TBI, even if mild.

Language: en