Journal of Head Trauma Rehabilitation最新文献

{"title":"Quantifying the Relationship Between Clinician-Administered Measures of Vestibulo-Ocular Reflex and Oculomotor Function and Patient-Reported Outcome After Pediatric Mild Traumatic Brain Injury.","authors":"Adrienne Crampton, Pierre Langevin, Kathryn J Schneider, Lisa Grilli, Mathilde Chevignard, Michal Katz-Leurer, Miriam H Beauchamp, Chantel Debert, Isabelle J Gagnon","doi":"10.1097/HTR.0000000000001021","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001021","url":null,"abstract":"<p><strong>Background: </strong>In pediatric mild traumatic brain injury (mTBI), high rates of abnormalities are observed in vestibulo-ocular reflex (VOR) and oculomotor (OM) function, but there is a lack of understanding of how these impairments may affect daily functioning.</p><p><strong>Objectives: </strong>To determine the extent to which clinician-administered measures of VOR and OM function are associated with patient-reported levels of activity limitations and participation restriction in children and adolescents within 31 days post-mTBI.</p><p><strong>Design: </strong>Cross-sectional design.</p><p><strong>Setting: </strong>Tertiary care pediatric hospital.</p><p><strong>Participants: </strong>Participants with mTBI aged 7 to 17.99 years.</p><p><strong>Procedures: </strong>Participants were assessed on a battery of VOR and OM tests within 31 days of injury.</p><p><strong>Outcome measures: </strong>The Dizziness Handicap Inventory (DHI) and Cardiff Visual Ability Questionnaire (CVAQ) measured patient-reported dizziness and visual disability. The vestibular/ocular motor screening tool (VOMS), Head Thrust Test, computerized Dynamic Visual Acuity (DVA) Test, and video Head Impulse Test were administered to assess VOR and OM function.</p><p><strong>Analysis: </strong>Linear regression examined the associations between clinician-administered measures of VOR and OM function and patient-reported functional outcomes.</p><p><strong>Results: </strong>The sample consisted of 100 youth (54.4% female; mean age 13.92 [2.63]; mean time since injury: 18.26 [6.16] days). Associations were found between (1) DHI score and age (1.773 [0.473-3.073], P = .01), VOR symptom provocation (18.499 [11.312-25.686], P ≤ .001), and DVA (-29.433 [-59.206 to -2.60], P = .03); and (2) CVAQ score and version symptom provocation (0.796 [0.185-1.406], P = .01). High abnormal proportions (up to 56.7%) were found in VOMS performance.</p><p><strong>Discussion: </strong>The symptom provocation induced by VOR and OM tasks was associated with patient-reported dizziness and visual disability outcomes, highlighting the detrimental impact of symptoms on daily functioning.</p><p><strong>Implications: </strong>The findings of this study will assist clinicians when interpreting patient-reported measures of activity limitation and participation restriction.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143070865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional Classification and Prediction of Outcome Following Traumatic Brain Injury.","authors":"Jennie L Ponsford, Gershon Spitz, Phillipa Pyman, Sarah Carrier, Amelia J Hicks, Jack V Nguyen, Angelle M Sander, Mark Sherer","doi":"10.1097/HTR.0000000000001018","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001018","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to identify outcome clusters among individuals with traumatic brain injury (TBI), 6 months to 10 years post-injury, in an Australian rehabilitation sample, and determine whether scores on 12 dimensions, combined with demographic and injury severity variables, could predict outcome cluster membership 1 to 3 years post-injury.</p><p><strong>Setting: </strong>Rehabilitation hospital.</p><p><strong>Participants: </strong>A total of 467 individuals with TBI, aged 17 to 87 (M = 44.2 years), 70% male, with mean post-traumatic amnesia 24 days (range 0.5-455 days), were assessed a mean of 3.4 years post-injury (range 0.5-10 years). A subgroup of 138 participants was also evaluated as rehabilitation inpatients and followed up 1 year post-injury.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Main measures: </strong>TBI Quality of Life subscales (Upper Extremity, Pain Interference, Headache Pain, Anxiety, Resilience, Emotional and Behavioral Dyscontrol, General Cognitive Concerns, Independence, and Economic Quality of Life Scale), Neurobehavioral Symptom Inventory, Family Assessment Device General Functioning Scale, Wechsler Adult Intelligence Scale-IV Letter-Number-Sequencing and Coding, Rey Auditory Verbal Learning Test, Trail Making Test Part A, Verbal Fluency Test, Word Memory Test, Participation Assessment with Recombined Tools-Objective, and Glasgow Outcome Scale-Extended.</p><p><strong>Results: </strong>K-means cluster analysis revealed 5 clusters across 12 dimensions: Good Outcome, High Cognition, Poor Cognition, Poor Outcome, and Poor Adjustment, aligning with Sherer and colleagues' clusters. Inpatient assessments (n = 138) identified profiles predictive of outcome group membership. Participants with Good Outcomes exhibited lower anxiety and higher independence, self-esteem, and resilience, despite some cognitive deficits. High Cognition correlated with robust Economic and Family Support. Poor Cognition aligned with impaired cognitive function but positive psychosocial ratings suggest limited self-awareness. Poor Outcome featured low initial cognitive scores and poor psychosocial adjustment. Poor Adjustment participants, without inpatient cognitive impairments, reported persistent pain, physical symptoms, and emotional distress.</p><p><strong>Conclusions: </strong>Findings support the evaluation of cognitive and psychosocial factors during rehabilitation to predict outcomes with potential to inform rehabilitative interventions to optimize outcomes.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobehavioral Symptoms Partially Mediate the Effects of Depression and PTSD on Participation for Veterans With Mild Traumatic Brain Injury: A Cross-Sectional Study.","authors":"Jordan M Wyrwa, Lisa A Brenner, Xiang-Dong Yan, Alexandra L Schneider, Lindsay Burke, Samuel E King, Jeri E Forster, Adam R Kinney","doi":"10.1097/HTR.0000000000001012","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001012","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether neurobehavioral symptoms mediate the relationship between comorbid mental health conditions (major depressive disorder [MDD] and/or posttraumatic stress disorder [PTSD]) and participation restriction among Veterans with mild traumatic brain injury (mTBI).</p><p><strong>Setting: </strong>Veterans Health Administration (VHA).</p><p><strong>Participants: </strong>National sample of Veterans with mTBI who received VHA outpatient care between 2012 and 2020.</p><p><strong>Design: </strong>Secondary data analysis of VHA clinical data. We specified a latent variable path model to estimate relationships between: (1) comorbid mental health conditions and 3 latent indicators of neurobehavioral symptoms (vestibular-sensory; mood-behavioral; cognitive); (2) latent indicators of neurobehavioral symptoms and 2 latent indicators of participation restriction (social and community participation; productivity); and (3) comorbid mental health conditions and participation restriction.</p><p><strong>Main measures: </strong>International Classification of Diseases codes, Neurobehavioral Symptom Inventory, and Mayo-Portland Adaptability Inventory Participation Index to measure mental health conditions, neurobehavioral symptoms, and participation restrictions, respectively.</p><p><strong>Results: </strong>Indirect effect estimates indicated that comorbid MDD and/or PTSD was associated with greater social and community participation restrictions, as mediated by mood-behavioral (β = .22-.33; 99% CI 0.18-0.4; small to medium effect) and cognitive symptoms (β = .08-.13; 99% CI 0.05-0.18; small effect), and with greater productivity restrictions, as mediated by vestibular-sensory (β = .06-.11; 99% CI 0.04-0.15; small effect) and cognitive symptoms (β = .08-.13; 99% CI 0.05-0.18; small effect). Direct effect estimates indicated that comorbid MDD and/or PTSD was associated with greater challenges with both social and community participation (β = .19-.40; 99% CI 0.12-0.49; small to medium effect) and productivity (β = .08-.44; 99% CI -0.02 to 0.55; small to medium effect).</p><p><strong>Conclusion: </strong>Neurobehavioral symptoms partially mediated the impact of MDD and/or PTSD on participation restrictions among Veterans with mTBI. These findings advance the understanding of explanatory mechanisms underlying participation challenges among Veterans with comorbid mTBI and mental health challenges, thereby informing the development of tailored intervention strategies.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Early/Unplanned Separation Among US Service Members With a History of Mild Traumatic Brain Injury.","authors":"Isabelle Wal, Peter Hoover, Rachel Sayko Adams, Jeri E Forster, Jesus J Caban, Mary B Engler","doi":"10.1097/HTR.0000000000001034","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001034","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence of early/unplanned (E/U) separations following mild traumatic brain injury (mTBI) and assess whether sex impacts the hazard of separation.</p><p><strong>Setting: </strong>Military Health System (MHS).</p><p><strong>Participants: </strong>Active duty service members (N = 75,730) with an initial mTBI diagnosis in military records between January 2011 and January 2018.</p><p><strong>Design: </strong>Retrospective cohort study of electronic health records in the MHS. Cause-specific Cox proportional hazards models were used with sex at birth as the primary predictor.</p><p><strong>Main measures: </strong>Early/unplanned (E/U) separation, defined as military separation attributed to disability, misconduct, poor performance, death, or other medical circumstances, within 2 years following the initial mTBI.</p><p><strong>Results: </strong>Incidence of E/U separation within 2 years following mTBI was 13.7% (11.0% in women and 14.2% in men). Disability and misconduct separations were most common. Female service members had lower adjusted hazards for any E/U separation (Hazard Ratio [HR] = 0.65; 95% Confidence Interval [CI]: 0.61,0.69), disability separation (HR = 0.71; 95% CI: 0.65, 0.78), misconduct separation (HR = 0.40; 95% CI: 0.36, 0.45), and poor performance separation (HR = 0.84; 95% CI: 0.72, 0.99), compared to males, but had higher adjusted hazards for separations due to other medical circumstances (HR = 1.24; 95% CI: 1.04, 1.48).</p><p><strong>Conclusion: </strong>Male and female service members had different hazards of E/U separation following mTBI. Separating early may increase the risk of adverse health and socioeconomic outcomes, so additional research is needed on why these separations occur and why they may be impacting men and women differently.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Traumatic Brain Injury in Refugees: Feasibility, Usability, and Prevalence Insights From a US-Based Clinical Sample.","authors":"Sofia Sherman Rosa, Rodrigo Nadal, Altaf Saadi","doi":"10.1097/HTR.0000000000001037","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001037","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed (1) the feasibility and usability of traumatic brain injury (TBI) assessment using the Ohio State University TBI Identification Method (OSU-TBI-ID) in a sample of English and Spanish-speaking refugees and asylum seekers (hereafter refugees), and (2) the prevalence and characteristics of TBI in this population.</p><p><strong>Setting and participants: </strong>Refugees seeking care from Massachusetts General Hospital (MGH) Asylum Clinic, the MGH Chelsea HealthCare Center, and other asylum programs in the Greater Boston Area.</p><p><strong>Design and main measures: </strong>Bilingual clinical research coordinators screened 158 English and Spanish-speaking refugees using the OSU-TBI-ID. A \"positive\" screen for TBI was made if a participant reported loss of consciousness (LOC) or being dazed or confused following a head injury, with determinations of mild, moderate, and severe TBI based on established metrics of TBI severity using duration of LOC. We conducted descriptive statistics of the sample demographics and screening outcomes, including group comparisons between those with and without TBI and associated demographic characteristics.</p><p><strong>Results: </strong>The mean age was 36.8 years (SD: 9.1), with participants predominantly from Latin America and the Caribbean (51%), followed by Sub-Saharan Africa (35%). Less than half (43%) identified as men. The majority (59%) screened positive for having experienced at least 1 TBI in their lifetime. Among those with a TBI history, nearly three-quarters (73%) had a mild TBI, and about a third (38%) had sustained a moderate-to-severe TBI. A majority (56%) had more than 1 TBI and about 40% had sustained a childhood TBI. The most common mechanisms of injury were interpersonal assault (55%) and blunt trauma by an object (46%). There were no significant statistical differences in demographics and TBI characteristics.</p><p><strong>Conclusion: </strong>Our findings demonstrate the feasibility and usability of the OSU-TBI-ID in a sample of refugees. We call for greater and improved detection of TBI among refugees to ensure they receive the optimal care they need.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143059258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Family Needs After a Traumatic Brain Injury: A VA TBI Model Systems Study.","authors":"Jonathan Tsen, Jacob A Finn, Farina A Klocksieben, Therese M O'Neil-Pirozzi, Angelle M Sander, Stephanie D Agtarap, Laura E Dreer, Bridget A Cotner, Tiffanie A Vargas, Mia E Dini, Paul B Perrin, Risa Nakase-Richardson","doi":"10.1097/HTR.0000000000001015","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001015","url":null,"abstract":"<p><strong>Objective: </strong>To describe the self-reported needs of family caregivers of service members and veterans (SMVs) with traumatic brain injury (TBI) at 10 to 15 years post-injury and to identify unique predictors of unmet family needs.</p><p><strong>Setting: </strong>Five Department of Veterans Affairs Polytrauma Rehabilitation Centers.</p><p><strong>Participants: </strong>A total of 209 family caregivers of SMVs with TBI from the VA TBI Model Systems national database who completed a 10- or 15-year follow-up assessment.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Main outcome measure: </strong>Family Needs Questionnaire-Revised (FNQ-R).</p><p><strong>Results: </strong>Item-, domain-, and total score-level descriptive analyses of FNQ-R responses were conducted. On average, 56.3% of the FNQ-R family caregiver needs were reported as met. Health information and involvement in care needs were the most often met, and emotional support and instrumental support needs were the least often met. Adjusted multivariable regression models demonstrated that urban-dwelling SMVs (compared to suburban) and spouses/significant others (compared to parents) were associated with more unmet family needs. Distinct associations were identified between the 6 FNQ-R domains and SMV environmental factors (ie, urbanicity, rurality, and being active duty at follow-up), SMV comorbidities (ie, receiving mental health treatment in the year prior to the follow-up), and caregiver factors (ie, spouses/significant others).</p><p><strong>Conclusion: </strong>Family caregivers of SMVs with TBI reported multiple unmet needs at 10 to 15 years post-injury, emphasizing the importance of ongoing caregiver support after TBI. Policy and programming to support military caregivers should consider the current findings to direct resources to address the identified unmet needs.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On-TRACC Pilot Study: A Novel Intervention for Persistent Post-Concussive Cognitive Symptoms.","authors":"Kathleen F Pagulayan, Holly K Rau, David P Sheppard, Orli M Shulein, Emma Onstad-Hawes, Jeanne M Hoffman, Rhonda M Williams","doi":"10.1097/HTR.0000000000001014","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001014","url":null,"abstract":"<p><strong>Objective: </strong>To present the results of a pilot study of On-TRACC (Tools for Recovery and Clinical Care), a novel intervention for individuals experiencing persistent cognitive difficulties after mild traumatic brain injury (mTBI). On-TRACC is a 5-session, 1:1 manualized treatment that integrates psychoeducation, cognitive rehabilitation strategies, and self-management skills to target symptoms and increase understanding of the interaction between cognitive difficulties, injury history, and comorbid medical and psychological conditions. The primary study goals were to evaluate the feasibility, acceptability, and preliminary effectiveness of On-TRACC.</p><p><strong>Setting: </strong>Veterans Affairs medical center and an academic medical center.</p><p><strong>Participants: </strong>Veterans and civilian adults (n = 28) >3 months post-mTBI with current self-reported cognitive difficulties.</p><p><strong>Design: </strong>In this single-group, open-label pilot study, all participants received On-TRACC (5 sessions) via video-based telehealth.</p><p><strong>Main measures: </strong>Primary measures were feasibility (eg, session attendance and homework completion rate, dropout rate, and treatment fidelity) and acceptability (treatment satisfaction/helpfulness ratings). Preliminary effectiveness was explored by measuring pre- to post-intervention change in cognitive symptom level and attribution, perceived self-efficacy, use of compensatory strategies, daily functioning, quality of life, and planned future engagement in health care.</p><p><strong>Results: </strong>The On-TRACC completion rate for all enrolled participants was 79% (with 88% treatment completion rate for participants who started On-TRACC); homework was fully or partially completed for 98% of attended sessions. Treatment satisfaction ratings were high, with 95% satisfied with the information and skills learned. There were no adverse events. Positive pre- to posttreatment changes were seen in cognitive self-efficacy, symptom attribution, functional status, quality of life, and planned engagement in care for comorbid conditions.</p><p><strong>Conclusion: </strong>On-TRACC was a feasible and acceptable intervention for individuals with chronic cognitive difficulties following mTBI. Additional research, including a randomized clinical trial, is needed to evaluate the efficacy of this intervention and its long-term impact on outcomes in this clinical population.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health and Health Care Utilization Outcomes for Individuals With Traumatic Brain Injury: A 1-Year Longitudinal Study.","authors":"Dana Waltzman, Gabrielle F Miller, Likang Xu, Juliet Haarbauer-Krupa, Flora M Hammond","doi":"10.1097/HTR.0000000000001008","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001008","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic brain injury (TBI) can result in new onset of comorbidities and limited studies suggest health care utilization following TBI may be high. Setting, Participants, Mean Measures, and Design: This study used 2018 and 2019 MarketScan Commercial Claims and Encounters data to examine differences in longitudinal health outcomes (health care utilization and new diagnoses) by various demographic factors (age, sex, U.S. region, intent/mechanism of injury, urbanicity, and insurance status) among individuals with and without a TBI in the year following an index health care encounter.</p><p><strong>Results: </strong>Results show that within 1 year of the initial encounter, a higher percentage of patients with TBI versus without TBI had at least one outpatient visit (96.7% vs 86.1%), emergency department (ED) visit (28.5% vs 13.1%), or hospital admission (6.4% vs 2.6%). Both children (33.8% vs 23.4%) and adults (43.8% vs 31.4%) who sustained a TBI had a higher percentage of new diagnoses within 1 year compared to the non-TBI group. Additionally, individuals with a TBI had greater health care utilization across all types of health care settings (outpatient and inpatient), visits (ED visits and hospital admissions), and across all demographic factors (P < .001).</p><p><strong>Conclusion: </strong>These results may inform future research around the development of systems of care to improve longer-term outcomes in individuals with TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2024 NABIS Conference on Brain Injury Abstracts.","authors":"","doi":"10.1097/HTR.0000000000001029","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001029","url":null,"abstract":"","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Defense Military Treatment Facility and Community Care Costs After Traumatic Brain Injury in Service Members and Veterans Treated in Veterans Affairs Polytrauma Rehabilitation Centers: A VA TBI Model Systems Study.","authors":"Clara E Dismuke-Greer, Emily Almeida, Jessica L Ryan, Risa Nakase-Richardson","doi":"10.1097/HTR.0000000000001028","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001028","url":null,"abstract":"<p><strong>Objective: </strong>To estimate cost models of military traumatic brain injury (TBI) that can provide evidence for future cost-effectiveness analyses highlighted as a gap in the recent National Academies of Sciences, Engineering, and Medicine (NASEM) report on accelerating progress in TBI.</p><p><strong>Setting: </strong>Military Treatment Facilities (MTFs) and community care facilities within the Military Health System (MHS).</p><p><strong>Participants: </strong>1,101 service members/veterans (SMV) diagnosed with a TBI and treated at a Veterans Administration (VA) Polytrauma Rehabilitation Center (PRC).</p><p><strong>Design: </strong>This retrospective study analyzed healthcare costs in MTFs and community care facilities among SMVs diagnosed with TBI and treated at 1 of 5 VA PRCs. MTF and community care records were assessed.</p><p><strong>Main measures: </strong>Annual MTF and community care inpatient and outpatient costs. TBI disability was measured by the Disability Rating Scale (DRS).</p><p><strong>Results: </strong>Mean age was 31, with 9.8 years of service, and time in MHS post-TBI was 7.18 years. The mean annual inpatient cost was $22,126 in MTFs and $112,218 in community. The mean annual outpatient cost was $17,983 in MTFs and $9,141 in community. Each year of age was associated with $8,276 (95% CI 4,068-12,483), each day of acute care length of stay (LOS) before rehabilitation with $1,024 (95% CI 8-2039), and each additional point on the DRS with $10,858 (95% CI 4,273-17,442) higher costs.</p><p><strong>Conclusion: </strong>Findings describe MHS annualized costs across acute and chronic stages in MTFs and the community and their association with SMVs' TBI disability measured by the DRS. These foundational cost data are critical for informing future hybrid design trials in TBI that examine the economic impact of TBI interventions being studied in future research.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}