Journal of Head Trauma Rehabilitation最新文献

筛选
英文 中文
Factors Associated With Cardiovascular Mortality After Complicated Mild to Severe Traumatic Brain Injury (TBI): A TBI Model Systems Study. 复杂的轻至重度创伤性脑损伤(TBI)后心血管死亡率相关因素:一项TBI模型系统研究。
IF 3.3 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-30 DOI: 10.1097/HTR.0000000000001087
Shanti M Pinto, Bhaskar Thakur, Raj G Kumar, Umesh M Venkatesan, Amelia J Hicks, Simon Driver, Kan Ding, Thomas K Watanabe, Kathleen Bell, William C Walker, Sheryl Katta-Charles, Ross Zafonte, Amanda Rabinowitz, Flora M Hammond
{"title":"Factors Associated With Cardiovascular Mortality After Complicated Mild to Severe Traumatic Brain Injury (TBI): A TBI Model Systems Study.","authors":"Shanti M Pinto, Bhaskar Thakur, Raj G Kumar, Umesh M Venkatesan, Amelia J Hicks, Simon Driver, Kan Ding, Thomas K Watanabe, Kathleen Bell, William C Walker, Sheryl Katta-Charles, Ross Zafonte, Amanda Rabinowitz, Flora M Hammond","doi":"10.1097/HTR.0000000000001087","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001087","url":null,"abstract":"<p><strong>Objective: </strong>To characterize factors associated with death due to cardiovascular causes following complicated mild to severe traumatic brain injury (TBI).</p><p><strong>Setting: </strong>Chart review or telephonic interviews.</p><p><strong>Participants: </strong>Participants enrolled in the TBI Model Systems database.</p><p><strong>Design: </strong>Retrospective.</p><p><strong>Main measures: </strong>Primary cause of death due to cardiovascular causes coded with ICD-9 codes 390-459 or ICD-10 codes 100-199 (diseases of the circulatory system) on death certificates. A competing risk cause-specific Cox proportional hazards regression analysis was completed to identify demographic and injury-related factors associated with increased risk of cardiovascular-related mortality.</p><p><strong>Results: </strong>Overall, 15,370 participants were included. Overall, 2,770 (18.0%) individuals died, of which 595 (21.5%) died due to cardiovascular-related causes. Those who died due to cardiovascular causes were older (hazard ratio [HR] 1.08, 95% 1.07-1.09, P <.001), more likely to be male (HR 1.84, 95% CI 1.50-2.26, P <.001), divorced (HR 1.63, 95% CI 1.20-2.23, P = .002), and had lower functional independence measure motor scores (HR 0.99, 95% CI 0.98-0.99, P <.001). Individuals who identified as Asian/Pacific Islander (HR 0.21, 95% CI 0.08-0.55, P = .002), were employed (HR 0.65, 95% CI 0.46-0.90, P = .010), had private insurance (HR 0.77, 95% CI 0.60-0.99, P = .043), and had post-traumatic amnesia (PTA) duration >30 days (HR 0.71, 95% CI 0.55-0.92, P = .010) were less likely to die due to cardiovascular causes. Alcohol or drug use and education level were not significantly associated with death due to cardiovascular causes.</p><p><strong>Conclusion: </strong>Over 1 in 5 deaths following TBI were due to cardiovascular causes. Older age, male sex, being divorced, and having lower FIM motor scores are risk factors, whereas being employed, having private health insurance, and PTA >30 days are protective factors for cardiovascular mortality.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742260","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}
引用次数: 0
Traumatic Brain Injury in Those With Preexisting Disability: Prevalence, Characteristics, and Psychosocial Function. 创伤性脑损伤在那些先前存在的残疾:患病率,特点,和社会心理功能。
IF 3.3 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-29 DOI: 10.1097/HTR.0000000000001080
Amelia J Hicks, Nicola L de Souza, Jill Del Pozzo, Noelle K Kurth, Jean P Hall, Kristen Dams-O'Connor
{"title":"Traumatic Brain Injury in Those With Preexisting Disability: Prevalence, Characteristics, and Psychosocial Function.","authors":"Amelia J Hicks, Nicola L de Souza, Jill Del Pozzo, Noelle K Kurth, Jean P Hall, Kristen Dams-O'Connor","doi":"10.1097/HTR.0000000000001080","DOIUrl":"10.1097/HTR.0000000000001080","url":null,"abstract":"<p><strong>Objective: </strong>To identify the prevalence of incident traumatic brain injury with loss of consciousness (traumatic brain injury [TBI] with loss of consciousness [LOC]) among a cohort of individuals with preexisting disabilities. To examine age at first TBI with LOC and number of TBI with LOC. To identify whether TBI with LOC was associated with type of preexisting primary disability and age of disability onset. We also compared psychosocial function between those with and without TBI with LOC.</p><p><strong>Setting: </strong>2023/2024 National Survey on Health and Disability (NSHD).</p><p><strong>Participants: </strong>Adults aged ≥18 years, living in the US, with self-reported preexisting disabilities. Our analyses included 235 participants who reported TBI with LOC after the onset of their primary disability, and 1211 participants who did not experience TBI with LOC.</p><p><strong>Design: </strong>Cross-sectional observational online survey.</p><p><strong>Main measures: </strong>NSHD survey and abbreviated Brain Injury Screening Questionnaire.</p><p><strong>Results: </strong>A total of 235 individuals sustained TBI after disability onset. The average age of first TBI with LOC was 20.3 years, and 34.1% of participants incurred multiple TBIs with LOC. In fully adjusted models, relative to a primary physical/mobility disability, having a primary mental illness/psychiatric disability was associated with higher odds of incident TBI with LOC. Younger age at disability onset was associated with a 5% greater odds of reporting incident TBI with LOC. Finally, those with TBI with LOC were more likely to report poor physical and mental health days, and greater levels of loneliness, but did not have higher odds of unemployment compared to those without TBI.</p><p><strong>Conclusion: </strong>TBI with LOC in those living with preexisting disability is common, associated with younger age at disability onset, greater likelihood of poor physical and mental health days, and greater loneliness. Screening for TBI in those living with all-cause disability is warranted, alongside care coordination to meet care needs of this vulnerable but historically overlooked group.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707732","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}
引用次数: 0
Length of Stay as a Predictor of Long-Term Mortality in Patients Surviving a Traumatic Brain Injury: A Nationwide TBI Cohort Study of 153 177 Adults. 住院时间作为外伤性脑损伤存活患者长期死亡率的预测指标:一项包含153177名成人的全国性TBI队列研究
IF 3.3 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-22 DOI: 10.1097/HTR.0000000000001086
Christian Mirian, Therese Ovesen, Lasse Rehné Jensen, Thomas Scheike, Jacob Bertram Springborg
{"title":"Length of Stay as a Predictor of Long-Term Mortality in Patients Surviving a Traumatic Brain Injury: A Nationwide TBI Cohort Study of 153 177 Adults.","authors":"Christian Mirian, Therese Ovesen, Lasse Rehné Jensen, Thomas Scheike, Jacob Bertram Springborg","doi":"10.1097/HTR.0000000000001086","DOIUrl":"10.1097/HTR.0000000000001086","url":null,"abstract":"<p><strong>Objective: </strong>Our aim was to explore the length of stay (LOS) as a predictor of long-term mortality in patients surviving a traumatic brain injury (TBI). The objectives were to (1) establish TBI length of stay (LOS)-based groups empirically, (2) assess their accuracy in predicting death, and (3) compare the long-term risk of death between the LOS-based groups and non-TBI controls (Controls).</p><p><strong>Participants: </strong>Patients (≥18.0) with TBIs in Denmark between 1994 and 2018 that survived beyond discharge were (1:5) age-matched with Controls.</p><p><strong>Design: </strong>Nationwide cohort study. TBI patients and Controls were stratified according to age: 18.0-39.9, 40.0-69.9, and ≥70.0.</p><p><strong>Main measures: </strong>Adjusted binomial regression was used to estimate odd ratios for mortality, and predictive accuracy was assessed using cross-validated area under the receiver operation curve (AUC) values. The Kaplan-Meier method and the adjusted binomial regression models were used to compare the all-cause mortality between LOS-based groups and Controls.</p><p><strong>Results: </strong>Among 153 177 TBI survivors, LOS-based groupings showed modest stratification of mortality risk, particularly in those under 70.0 years. However, based on the AUC, they did not improve individual-level prediction of death once adjusted for key confounders. Compared with Controls, TBI survivors had persistently excess mortality risk of up to 20 years post-index across all age groups. In older adults, LOS was positively correlated with the number of new comorbidities detected during hospitalization, which likely contributed to the observation that TBI patients with short LOS had better survival than Controls in this age population (surveillance bias).</p><p><strong>Conclusions: </strong>LOS-based groups did not predict individual-level risk of death in TBI survivors but offered some short-term risk stratification at a group-level. Its application to group-level mortality outcomes in older adults is complicated by surveillance bias. Persistent excess mortality across all age groups supports the need for long-term follow-up after TBI.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707731","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}
引用次数: 0
Course of Fatigue and Sleep After Moderate to Severe Traumatic Brain Injury. 中重度颅脑外伤后的疲劳和睡眠过程。
IF 2.4 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-22 DOI: 10.1097/HTR.0000000000001078
Jessica Bruijel, Sven Stapert, Annemiek Vermeeren, Julie Staals, Jennie Ponsford, Caroline van Heugten
{"title":"Course of Fatigue and Sleep After Moderate to Severe Traumatic Brain Injury.","authors":"Jessica Bruijel, Sven Stapert, Annemiek Vermeeren, Julie Staals, Jennie Ponsford, Caroline van Heugten","doi":"10.1097/HTR.0000000000001078","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001078","url":null,"abstract":"<p><strong>Objective: </strong>To examine the development of different dimensions of fatigue and subjective and objective measures of sleep in the first 18 months post moderate to severe traumatic brain injury (TBI), and explore the association with biological (processing speed), psychological (mood), and social (restrictions in participation) factors across time.</p><p><strong>Participants: </strong>Forty-two participants with moderate-severe TBI (45 ± 16 years old, 33% female).</p><p><strong>Design: </strong>Longitudinal multicenter observational cohort study with 4 measurements (3, 6, 12, and 18 months post-injury).</p><p><strong>Main measures: </strong>Dimensions of fatigue (Fatigue Severity Scale, FSS; Dutch Multifactor Fatigue Scale, DMFS), subjective (Pittsburgh Sleep Quality Index, PSQI) and objective sleep (actigraphy), processing speed (Symbol Digit Modalities Task, SDMT), mood (Hospital Anxiety and Depression Scale, HADS), and restrictions in participation (Utrecht Scale for Evaluation and Rehabilitation-Participation, USER-P).</p><p><strong>Results: </strong>Results showed reduced sleep quality (PSQI: poor sleep quality at 3 months 41%; 6 months 43%; 12 months 56%; 18 months 43%) and high levels of fatigue (FSS: severe fatigue at 3 months 41%; 6 months 38%; 12 months 33%; 18 months 34%) with no significant changes over time. Physical fatigue (DMFS: β = -0.11, P = .007) and total sleep time (β = -0.14, P = .015) decreased over time. More mood problems were associated with worse sleep quality (PSQI; β = 0.35, P = .021), shorter total sleep time (β = 0.14, P = .046), and higher levels of fatigue (FSS: β = 0.20, P = .036; DMFS-mental: β = 0.36, P = .028; DMFS-physical: β = 0.36, P = .029). Restrictions in participation were associated with fatigue but not with sleep.</p><p><strong>Conclusions: </strong>High and stable levels of fatigue and poor sleep quality in the first 18 months following moderate-severe TBI were found. These symptoms were associated with mood problems. Assessment and treatment of fatigue and sleep problems should be included in clinical practice. In line with other studies, we suggest that mood interventions might aid the treatment for fatigue and sleep quality.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707729","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}
引用次数: 0
Gender Differences in Seeking and Receiving Healthcare After Mild Traumatic Brain Injury. 轻度创伤性脑损伤后寻求和接受医疗保健的性别差异。
IF 2.4 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-21 DOI: 10.1097/HTR.0000000000001085
Isha Kashyap, Noah D Silverberg, Ana Mikolić
{"title":"Gender Differences in Seeking and Receiving Healthcare After Mild Traumatic Brain Injury.","authors":"Isha Kashyap, Noah D Silverberg, Ana Mikolić","doi":"10.1097/HTR.0000000000001085","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001085","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate gender differences in seeking and receiving healthcare following mild traumatic brain injury (mTBI).</p><p><strong>Setting: </strong>Participants were recruited from 6 emergency departments and 2 urgent care facilities in the Greater Vancouver Area, Canada.</p><p><strong>Participants: </strong>254 adults (56% women, 2% gender-diverse; aged 18-69 years) who presented to emergency department/urgent care within 72 hours after mTBI and were randomized to usual care in the parent study.</p><p><strong>Design: </strong>Secondary analysis of a clinical trial evaluating the effectiveness of a guideline implementation tool for managing mental health complications after mTBI (ClinicalTrials.gov Registry: NCT04704037).</p><p><strong>Main measures: </strong>Self-reported use of rehabilitation and health services were assessed with questionnaires at 3- and 6-months post-injury. Chief symptoms, prescribed interventions and referrals to specialists within 6 months post-injury were extracted from general practitioner (GP) charts. Post-concussion symptoms were assessed using the Rivermead Post-Concussion Symptoms Questionnaire, and mental health symptoms using the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, and the Primary Care Post-Traumatic Stress Disorder (PTSD) for DSM-5 at 6 months post-injury. Perceived need for mental health care was assessed with an adapted interview version of the Perceived Need for Care Questionnaire.</p><p><strong>Results: </strong>Approximately 62% of men and 74% of women reported visiting their GP within 6 months after mTBI. They received similar interventions and referrals from GPs. Besides GP visits, no substantial differences were found in use of allied health and rehabilitation services. Women reported more severe post-concussion and mental health symptoms and more frequently having unmet mental health care needs (32% vs 19%).</p><p><strong>Conclusions: </strong>Women reported worse symptoms but did not receive more specialty clinical care. Women are more likely to report having under-treated mental health problems. Future studies are needed to confirm whether women have a greater mismatch between their need for and receipt of rehabilitation services and explore mechanisms contributing to this gap.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707730","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}
引用次数: 0
Instrumented Dual-Task Tests Help for Concussion Assessment in Ice Hockey. 仪器双任务测试有助于冰球脑震荡评估。
IF 2.4 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-10 DOI: 10.1097/HTR.0000000000001082
Frederic Meyer, Nicolas Baehler, Dario Sciacca, Lea Chabrowski, Mathieu Falbriard, Anisoara Ionescu
{"title":"Instrumented Dual-Task Tests Help for Concussion Assessment in Ice Hockey.","authors":"Frederic Meyer, Nicolas Baehler, Dario Sciacca, Lea Chabrowski, Mathieu Falbriard, Anisoara Ionescu","doi":"10.1097/HTR.0000000000001082","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001082","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to validate an instrumented dual-task (DT) assessment procedure based on smartphone-embedded sensors. Data processing algorithms were developed to extract relevant features, and ice hockey players were evaluated.</p><p><strong>Participants: </strong>In total, 114 Swiss elite ice hockey players.</p><p><strong>Design: </strong>Experimental study.</p><p><strong>Main measures: </strong>Participants performed DT tests regularly during the season and within the days following a diagnosed concussion. The DT test consisted of static balance and self-paced walking, combined with counting backward by 3. In total, 265 DT tests were performed, including 38 tests between 1 day and 2 weeks after the 13 diagnosed concussions.</p><p><strong>Results: </strong>Cognitive abilities during gait were mainly affected after a concussion. A DT performance metric was defined based on features significantly associated with worsening DT performance after the concussion (P < .001, effect size d = 1.50). Finally, a model was proposed to estimate the risk of concussion based on a DT test outcome.</p><p><strong>Conclusion: </strong>DT assessments can detect residual cognitive impairments even after other clinical symptoms have resolved. These tests offer medical staff objective insights, facilitating informed decision-making during the return-to-play process.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659316","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}
引用次数: 0
Objective Versus Subjective Cognitive Status Following Mild Traumatic Brain Injury: The Role of Psychological Factors. 轻度创伤性脑损伤后客观与主观认知状态:心理因素的作用。
IF 2.4 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-08 DOI: 10.1097/HTR.0000000000001075
Gabrielle A Hromas, Marlina A Novoa, Jeremy J Davis
{"title":"Objective Versus Subjective Cognitive Status Following Mild Traumatic Brain Injury: The Role of Psychological Factors.","authors":"Gabrielle A Hromas, Marlina A Novoa, Jeremy J Davis","doi":"10.1097/HTR.0000000000001075","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001075","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether there is a relationship between objective cognitive performance and self-reported cognitive status after mild traumatic brain injury (mTBI) and whether mental health symptoms influence this relationship.</p><p><strong>Participants and design: </strong>Secondary analysis of the Federal Interagency Traumatic Brain Injury Research Informatics System database included an initial sample of 2657 participants. Cases with missing data, questionable validity, age over 65, or mild-complicated, moderate, or severe TBI were excluded resulting in a final sample of 614 individuals (n = 138 controls and n = 476 mTBI).</p><p><strong>Main measures: </strong>Z-scores were derived using the Brief Test of Cognition by Telephone (BTACT) cognitive screener and the composite of the cognitive complaint items (CC) on the Rivermead Postconcussion Symptoms Questionnaire to represent objective and subjective cognitive status, respectively. The cognitive discrepancy was calculated by regressing BTACT on CC scores and retaining standardized residuals which produced a different score. A linear regression model was fitted using continuous cognitive discrepancy scores as the outcome and age, gender, time since injury, education, and mental health status (obtained via several self-report questionnaires) as predictors.</p><p><strong>Results: </strong>Individuals with mTBI had higher affective symptoms and cognitive complaints but did not differ from controls based on objective cognitive abilities. Affective symptoms were significantly higher in individuals with mTBI who reported higher subjective complaints than expected based on cognitive scores. Older age, female gender, and increased emotional distress were associated with greater cognitive discrepancy in the whole sample.</p><p><strong>Conclusions: </strong>Consistent with prior research, elevated psychological symptoms burden was associated with higher subjective cognitive complaints in relation to objective cognitive abilities. These results highlight the continued need for psychological intervention in post-mTBI recovery.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659317","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}
引用次数: 0
Influence of Neighborhood Disadvantage on All-Cause Mortality Following Moderate-to-Severe Traumatic Brain Injury: A TBI Model Systems Cohort Study. 社区劣势对中重度创伤性脑损伤后全因死亡率的影响:一项TBI模型系统队列研究。
IF 2.4 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-08 DOI: 10.1097/HTR.0000000000001081
Brennan Hickson, Felipe Figueiredo, Raj G Kumar, Flora M Hammond, Umesh Venkatesan, C B Eagye, Amanda R Rabinowitz
{"title":"Influence of Neighborhood Disadvantage on All-Cause Mortality Following Moderate-to-Severe Traumatic Brain Injury: A TBI Model Systems Cohort Study.","authors":"Brennan Hickson, Felipe Figueiredo, Raj G Kumar, Flora M Hammond, Umesh Venkatesan, C B Eagye, Amanda R Rabinowitz","doi":"10.1097/HTR.0000000000001081","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001081","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations between neighborhood disadvantage and all-cause mortality among patients receiving inpatient rehabilitation for moderate-to-severe traumatic brain injury (msTBI).</p><p><strong>Setting: </strong>Participants who were discharged from inpatient rehabilitation at a Traumatic Brain Injury Model Systems (TBIMS) center.</p><p><strong>Participants: </strong>A total of 6634 individuals enrolled in the TBI Model Systems National Database, who were discharged from inpatient rehabilitation for msTBI between January 1, 2010, and December 31, 2018.</p><p><strong>Design: </strong>Secondary analysis of longitudinal data.</p><p><strong>Main measures: </strong>All-cause mortality served as the primary outcome variable, measured in years from the date of discharge to the date of either expiration or censorship, with follow-up through December 31, 2019. Due to proportional hazards violations, we fit separate models for early deaths (within 4 months post-discharge) and late deaths (after 4 months post-discharge). Neighborhood disadvantage was indicated by the Distressed Communities Index (DCI), a validated measure that compares the socioeconomic conditions of United States ZIP codes.</p><p><strong>Results: </strong>Neighborhood distress level did not significantly influence early mortality risk in either univariate or multivariable Cox proportional hazards models. However, when examining deaths occurring 4 months to 10 years post-discharge, a significant association emerged. Residing in Distressed neighborhoods was linked to an increased mortality risk. In the model adjusted for sociodemographic factors, urban-rural classification, and baseline health and injury characteristics, individuals in Distressed neighborhoods experienced a 28% higher risk of death compared to those in Prosperous neighborhoods (HR: 1.28; 95% CI: 1.01-1.62). This association was somewhat attenuated and no longer significant (P = .09) after further adjusting for functional independence at discharge (Cognitive and Motor FIM) (HR: 1.22; 95% CI: 0.96-1.55).</p><p><strong>Conclusions: </strong>This study contributes to the literature by examining the role of neighborhood socioeconomic conditions on mortality risk following TBI, while controlling for established person-level risk factors. Our findings suggest that discharge to a distressed neighborhood is significantly associated with increased mortality risk among individuals who receive inpatient rehabilitation for msTBI and survive to at least 4 months post-injury. This heightened risk appears to be partly explained by reduced functional independence at discharge among those returning to disadvantaged neighborhoods. These results suggest that enhancing patients' functional independence during inpatient rehabilitation may help mitigate some of the excess mortality risk associated with adverse neighborhood conditions.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659315","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}
引用次数: 0
Research Letter: Interview Versus Self-Administration of Retrospective Brain Injury Identification. 研究报告:访谈与自我管理的回顾性脑损伤鉴定。
IF 2.4 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-08 DOI: 10.1097/HTR.0000000000001083
John D Corrigan, Kathryn A Hyzak, Jennifer Bogner
{"title":"Research Letter: Interview Versus Self-Administration of Retrospective Brain Injury Identification.","authors":"John D Corrigan, Kathryn A Hyzak, Jennifer Bogner","doi":"10.1097/HTR.0000000000001083","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001083","url":null,"abstract":"<p><strong>Objectives: </strong>(1) Determine concordance between retrospective identification of a prior history of brain injury exposure when the method of administration is either interview or self-administered; and (2) Determine the test/retest reliability of self-administered identification.</p><p><strong>Setting: </strong>American Population Panel.</p><p><strong>Participants: </strong>In total, 391 (54% female; 70% white, non-Hispanic) self-selected from 54 000 panel participants aged 18 years or older living in the United States.</p><p><strong>Design: </strong>Descriptive measures of concordance and test/retest reliability. The concordance sample was randomized for order of administration.</p><p><strong>Main measures: </strong>Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) with additional questions on anoxic/hypoxic events and prior diagnosis of other acquired brain injuries.</p><p><strong>Results: </strong>Substantial concordance was found for summary indices comparing OSU TBI-ID self-administered to interview results. High test/retest reliability was observed for most indices derived from the self-administered OSU TBI-ID. For both concordance and test/retest reliability, perfect agreement ranged from 85% to 90% for both the presence or absence of a history of any TBI, the presence or absence of a TBI that resulted in loss of consciousness, and the occurrence of repeated head impacts. Some indices of hypoxic/anoxic events could not be tested due to low frequency, but perfect agreement exceeded 90% for ever losing consciousness due to a drug overdose, or ever due to being choked or strangled. There was also very high perfect agreement for ever having been diagnosed with another acquired brain injury (91% for concordance; 89% for reliability).</p><p><strong>Conclusion: </strong>These findings suggest that the psychometric properties of the self-administered OSU TBI-ID are comparable to those in the interview version. High concordance and test/retest reliability were also observed for identification of other sources of acquired brain injury. Findings for items used to capture certain anoxic/hypoxic events were also supported though low endorsement rates limited some analyses.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659318","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}
引用次数: 0
The Prevalence, Chronology, and Clinical Correlates of Traumatic Brain Injury Among Individuals Seeking Treatment for Opioid Use Disorder. 寻求阿片类药物使用障碍治疗的个体中创伤性脑损伤的患病率、年表和临床相关性
IF 2.4 3区 医学
Journal of Head Trauma Rehabilitation Pub Date : 2025-07-08 DOI: 10.1097/HTR.0000000000001084
Hannah Truitt, Ryan Hjelle, Meredith K Ginley
{"title":"The Prevalence, Chronology, and Clinical Correlates of Traumatic Brain Injury Among Individuals Seeking Treatment for Opioid Use Disorder.","authors":"Hannah Truitt, Ryan Hjelle, Meredith K Ginley","doi":"10.1097/HTR.0000000000001084","DOIUrl":"https://doi.org/10.1097/HTR.0000000000001084","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the prevalence and characteristics of traumatic brain injuries (TBI) among persons with opioid use disorder (OUD), establish the chronology of comorbid TBI and first opioid use, and evaluate the relation between TBI and factors associated with greater harm potential of OUD.</p><p><strong>Setting: </strong>Outpatient OUD treatment clinics.</p><p><strong>Participants: </strong>Adults undergoing outpatient treatment for OUD (N = 158).</p><p><strong>Design: </strong>Observational.</p><p><strong>Main measures: </strong>The Ohio State University Traumatic Brain Injury Identification Method; Alcohol Use Disorders Identification Test.</p><p><strong>Results: </strong>A history of at least 1 TBI was reported by 48.7% of the sample. Of persons with a history of TBI, 44.2% reported multiple TBI. The odds of incurring TBI before ever using opioids were 1.5 times higher than the reverse progression. Approximately 90% of participants with TBI had been prescribed an opioid medication by a healthcare professional, which was significantly higher than for persons without TBI. Participants with TBI were at elevated risk of overdose, use of certain substances (eg, amphetamines, cocaine, sedatives, fentanyl), and riskier routes of opioid administration, as compared to patients without TBI. Use of certain substances (eg, alcohol, marijuana) and most psychosocial/demographic characteristics did not differ by TBI history.</p><p><strong>Discussion: </strong>TBI is a relatively frequent comorbidity for patients enrolled in OUD treatment. Among individuals with a history of TBI, 55.8% incurred their injury before ever using opioids. Individuals with TBI may be more likely to experience greater harm from OUD. These findings support the routine assessment of substance use and TBI in medical settings and the consideration of these factors for treatment planning.</p>","PeriodicalId":15901,"journal":{"name":"Journal of Head Trauma Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659319","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信