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Risk of Negative Outcomes After Traumatic Brain Injury: A Statewide Population-Based Survey

Whiteneck, Gale G. PhD; Cuthbert, Jeffery P. PhD, MPH, MS; Corrigan, John D. PhD; Bogner, Jennifer A. PhD

Journal of Head Trauma Rehabilitation: January/February 2016 - Volume 31 - Issue 1 - p E43–E54
doi: 10.1097/HTR.0000000000000141
Prevalence in the Civilian Population

Objective: To investigate the rates of negative outcomes associated with all severities of traumatic brain injury (TBI), treated in all settings or not treated at all, in comparison to the general population.

Participants: Coloradoans without injury, with injury but no TBI, with mild TBI but no loss of consciousness (LOC), mild TBI with LOC, moderate TBI, or severe TBI.

Design: Statewide population-based survey.

Main measures: Computer-assisted, modified Ohio State University TBI Identification Method; Behavioral Risk Factor Surveillance System and National Health Interview Survey questions; Satisfaction with Life Scale; and postconcussive symptoms.

Results: Up to 42.5% of participants reported a lifetime history of at least 1 TBI. Multiple negative outcomes were found to increase in prevalence in a stepwise fashion in association with greater TBI severity, with the clearest patterns observed for disability, poor life satisfaction, and impaired memory.

Conclusions: Traumatic brain injury was found to be associated with disability and other negative outcomes in a general population survey. This study does not allow us to examine the proximate causes of disability, but it suggests that TBI may serve to both cause disability directly and exacerbate the influence of other etiologies. These relations should be examined in subsequent studies.

Supplemental Digital Content is Available in the Text.

Research Department, Craig Hospital, Englewood, Colorado (Drs Whiteneck and Cuthbert); and Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, Ohio (Drs Corrigan and Bogner).

Corresponding Author: Gale G. Whiteneck, PhD, Research Department, Craig Hospital, 3425 S Clarkson St, Englewood, CO 80113 (

The authors thank Cynthia A. Brooks, MSHA at Craig Hospital for coordinating the survey subcontract with the University of Colorado Cancer Center Survey Research Shared Resource under the direction of Dr Alfred C. Marcus.

This publication was supported by the Colorado Injury Control Research Center through grant number R49 CE001168 from the Centers for Disease Control and Prevention and the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitative Services, US Department of Education, TBI Model System Centers grants to Ohio State University (H133A070029). The contents of this manuscript are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the National Institute on Disability and Rehabilitation Research.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

The authors declare no conflicts of interest.

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