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Physical, Cognitive, and Psychosocial Characteristics Associated With Mortality in Chronic TBI Survivors: A National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems Study

O'Neil-Pirozzi, Therese M., ScD; Ketchum, Jessica M., PhD; Hammond, Flora M., MD, FACRM, FAAPMR; Philippus, Angela, BA; Weber, Erica, PhD; Dams-O'Connor, Kristen, PhD

Section Editor(s): Bushnik, Tamara PhD

The Journal of Head Trauma Rehabilitation: July/August 2018 - Volume 33 - Issue 4 - p 237–245
doi: 10.1097/HTR.0000000000000365
Original Articles

Objective: To compare a group of individuals who died more than 1 year posttraumatic brain injury (TBI) with a matched group of survivors and to identify physical function, cognitive function, and/or psychosocial function variables associated with mortality.

Design: Secondary analysis of data from a multicenter longitudinal cohort study.

Setting: Acute inpatient rehabilitation facilities and community follow-up.

Participants: Individuals 16 years and older with a primary diagnosis of TBI.

Main Outcome Measures: Functional Independence Measure (FIM), Disability Rating Scale, Participation Assessment with Recombined Tools Objective, Extended Glasgow Outcome Scale, Satisfaction With Life Scale.

Results: Individuals who died were distinguishable from their surviving counterparts. They demonstrated significantly poorer global functioning on all physical, cognitive, and psychosocial functioning variables at their most recent study follow-up visit prior to death. FIM Motor demonstrated the largest difference between survival groups, suggesting that independence in mobility may be particularly indicative of likelihood of longer-term survival.

Conclusions: These findings may inform continued research to elucidate functional characteristics of individuals postchronic TBI prior to their death and to identify opportunities for prevention of accelerated death and interventions to improve health, longevity, and quality of life.

Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation, Hospital and Department of Communication Sciences and Disorders, Northeastern University, Boston (Dr O'Neil-Pirozzi); Research Department, Craig Hospital and Traumatic Brain Injury Model Systems National Data and Statistical Center, Englewood, Colorado (Dr Ketchum); Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis (Dr Hammond); Research Department, Craig Hospital, Englewood, Colorado (Ms Philippus); Kessler Foundation, East Hanover, New Jersey (Dr Weber); and Departments of Rehabilitation Medicine and Neurology, Icahn School of Medicine at Mount Sinai, New York (Dr Dams-O'Connor).

Corresponding Author: Therese M. O'Neil-Pirozzi, ScD, Department of Communication Sciences and Disorders, Northeastern University, 360 Huntington Ave, 70 Forsyth Bldg Room 103, Boston, MA 02115 (t.oneil-pirozzi@northeastern.edu).

This work was funded by grants from the National Institute on Disability, Independent Living, and Rehabilitation Research to the Spaulding-Harvard TBI Model System (grant number 2012P002490), Traumatic Brain Injury Model Systems National Data and Statistical Center (grant number 90DP0084-01-00), Indiana University/Rehabilitation Hospital of Indiana TBI Model System (grant number 90DP0036-01-00), Rocky Mountain Regional Brain Injury System (grant number 90DP0034-01-00), Northern New Jersey Traumatic Brain Injury Model System (grant number 90DP0032), and New York TBI Model System (grant number 90DP0038-02-00).

The authors declare no conflicts of interest.

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