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Citation |
Pretz CR, Dams-O'connor K. Arch. Phys. Med. Rehabil. 2013; 94(12): 2486-2493. |
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Affiliation |
Traumatic Brain Injury National Data and Statistical Center, Craig Hospital, Englewood CO. Electronic address: cpretz@craighospital.org. |
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Copyright |
(Copyright © 2013, Elsevier Publishing) |
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DOI |
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PMID |
23838239 |
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Abstract |
OBJECTIVE: To comprehensively describe the temporal patterns of global outcome after Traumatic Brain Injury (TBI) in the TBI Model Systems National Database (TBIMS NDB). DESIGN: Longitudinal prospective cohort study. SETTING: TBI Model Systems Centers. PARTICIPANTS: Patients 16 years of age and older with moderate or severe TBI enrolled in the TBIMS NDB (N=3870). INTERVENTIONS: None MAIN OUTCOME MEASURE: Glasgow Outcome Scale - Extended (GOS-E). RESULTS: The trajectory of GOS-E scores is best described with a model of quadratic change, in which scores initially increase and peak approximately 10 years after first GOS-E assessment, and then decrease. Change occurs most rapidly in the initial and final years of the timeline. There was significant variability in each growth parameter (p<.05). A reduced multi-level model was built including all covariates (age at first GOS-E, FIM(TM) race, sex, and RLOS) that related significantly to the growth parameters. An interactive tool was created to generate individual level trajectories based on various combinations of covariate values. Results provide an individual level account of the chronological progression of TBI outcomes as measured by the GOS-E. CONCLUSIONS: IGC analysis is a statistically rigorous approach to describe temporal change with respect to the GOS-E at the individual level for participants within the TBIMS NDB. Additional research may be required to determine the generalizability of these findings and the usefulness of this tool for clinical applications. Language: en |