Reinjury After Moderate to Severe TBI: Rates and Risk Factors in the NIDILRR Traumatic Brain Injury Model Systems. Issue 1 (January 2021)

• Record Type: Journal Article
• Authors: Bannon, Sarah M.; Kumar, Raj G.; Bogner, Jennifer; O'Neil-Pirozzi, Therese M.; Spielman, Lisa; Watson, Eric M.; Dams-O'Connor, Kristen
• Is Part Of: Journal of head trauma rehabilitation. Volume 36:Issue 1(2021)
• Publication Date: 2021-01
• Subjects: injury prevention -- rehabilitation -- survival analysis -- traumatic brain injury; Brain damage -- Patients -- Rehabilitation -- Periodicals; Brain damage -- Periodicals; 617.4810443
• DOI: 10.1097/HTR.0000000000000586
• Languages: English
• ISSNs: 0885-9701

Abstract

Abstract : Objectives: To compare characteristics of those who do and do not sustain subsequent traumatic brain injuries (TBIs) following index TBI and to identify reinjury risk factors. Design: Secondary data analysis of an ongoing longitudinal cohort study. Setting: TBI Model Systems Centers. Participants: In total, 11 353 individuals aged 16+ years. Main Outcome Measures: Ohio State University TBI Identification Method. Results: In total, 7.9% of individuals reported sustaining a TBI post–index TBI. Twenty percent of reinjuries occurred within a year of the index TBI. Reinjury risk followed an approximate U-shaped distribution such that risk was higher in the first year, declined 2 to 10 years postinjury, and then increased after 10 years. A multivariable Weibull model identified predictors of reinjury: younger (<29 years) and middle-aged and older (50+ years) age at index TBI relative to middle age, pre–index TBI, pre–index alcohol and illicit drug use, incarceration history, and less severe index TBI. Conclusions: A subset of individuals who receive inpatient rehabilitation for TBI are at an increased risk for reinjury, and an injury-prone phenotype may be characterized by engagement in risk behaviors. Factors associated with reinjury risk may differ for younger versus middle-aged and older adults. Findings underscore the need for empirically informed risk stratification models to identify TBI survivors at risk for reinjury. Abstract : Supplemental Digital Content is Available in the Text.