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The Differential Contributions of Posttraumatic Amnesia Duration and Time Since Injury in Prediction of Functional Outcomes Following Moderate-to-Severe Traumatic Brain Injury

Eastvold, Angela D. PhD; Walker, William C. PhD; Curtiss, Glenn PhD; Schwab, Karen PhD; Vanderploeg, Rodney D. PhD

Journal of Head Trauma Rehabilitation: January/February 2013 - Volume 28 - Issue 1 - p 48–58
doi: 10.1097/HTR.0b013e31823c9317
Original Articles
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Objective: To examine the relative contributions of preinjury, injury severity, and acute postinjury variables in predicting outcomes at 1 year following moderate-severe traumatic brain injury (TBI).

Design: Secondary analysis of a prospective longitudinal cohort study.

Setting: Four Veterans Affairs Medical Center acute inpatient rehabilitation programs.

Participants: Active duty military or veterans with a nonpenetrating moderate-to-severe TBI.

Main outcome measures: Independent living status (N = 280) and work status (N = 248) at one year postinjury.

Results: Preinjury characteristics as a group accounted for the largest amount of variance in independent living status at 1 year; however, posttraumatic amnesia (PTA) uniquely explained the largest amount of variance (8.8%). Those with less than 60 days PTA were 9 times more likely to be independent; those with less than 30 days PTA were 3 times more likely to be independent. In contrast, acute postinjury characteristics accounted for the largest amount of variance in work status, with time to rehabilitation explaining the most unique variance (10.4%). Those with less than 48 days time to rehabilitation were 2.4 times more likely to be productive.

Conclusions: This study highlights the differential contribution of variables in the prediction of 2 specific functional outcomes in a military sample, adding to our current body of knowledge to assist clinicians, patients and their families following TBI.

James A. Haley Veterans Affairs Medical Center, Tampa, Florida (Drs Eastvold, Curtiss, and Vanderploeg); Hunter H. McGuire Veterans Affairs Medical Center, Richmond, Virginia (Dr Walker); Defense and Veteran's Brain Injury Center, Richmond, Virginia (Dr Walker); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University School of Medicine, Richmond, Virginia (Dr Walker); Defense and Veterans Brain Injury Center, Bethesda, Maryland (Dr Schwab); Uniformed Services University of the Health Sciences, Bethesda, Maryland (Dr Schwab); Departments of Psychiatry and Neurosciences, and Aging and Mental Health Disparities, University of South Florida, Tampa, Florida (Dr Curtiss); Defense and Veterans Brain Injury Center, Tampa, Florida (Dr Vanderploeg); Departments of Psychiatry and Neurosciences, and Psychology, University of South Florida, Tampa, Florida (Dr Vanderploeg)

Corresponding Author: Angela D. Eastvold, PhD, Department of Neurology, School of Medicine, University of Utah, 650 Komas Ave 106A, Salt Lake City, UT 84108 (angela.eastvold@hsc.utah.edu).

The research reported here was originally supported by the Department of Veterans Affairs, Veterans Health Administration (VHA), Defense and Veterans Brain Injury Center, Uniformed Services University of the Health Sciences, Bethesda, MD, and a Department of Defense award administered through the Henry Jackson Foundation (grant MDA 905-03-2-0003). Further support was provided by the VHA Medical Center in Tampa, Florida.

The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.

The authors declare no conflicts of interest.

© 2013 Lippincott Williams & Wilkins, Inc.