Trajectories of Global Functioning over the 10 Years after Traumatic Brain Injury in Black Individuals: A Model System Study.

Abstract

Objective: This study examined: (a) longitudinal global functioning trajectories over the 10 years after traumatic brain injury (TBI) in a group of Black individuals, and (b) demographic and injury-related predictors of those trajectories.

Design: Participants completed follow-up data collections at 1, 2, 5, and 10 years after TBI and being discharged from acute rehabilitation.

Setting: TBI Model System (TBIMS) hospitals.

Participants: This study included a subsample of 2,523 Black individuals in the TBIMS National Database who had a completed global functioning scores at one or more follow-up time points.

Interventions: None MAIN OUTCOME MEASURE: Glasgow Outcome Scale-Extended (GOS-E).

Results: GOS-E scores across the full sample tended to increase slightly between years 1 and 2 and then plateaued for the successive years such that a quadratic, or U-shaped, trend that best fit the data. Younger age (p < .001), higher level of education (p < .001), private insurance (p = .007), and shorter posttraumatic amnesia (PTA) duration (p < .001) were significant predictors of higher GOS-E trajectories. There was also a significant time²*age effect (p < .001), such that younger adults improved slightly over the first 5 years and plateaued between years 5 and 10 relative to a general decline for older adults.

Conclusions: These findings suggest that age, education, insurance status, and PTA are important predictors of long-term global functional outcomes for Black individuals with TBI. Identifying baseline risk factors for Black individuals who may experience lower global functioning trajectories can inform development of targeted interventions and be a first step in working to reduce health disparities in functional outcomes in this group.