Article

OBJECTIVE: To determine the association between demographic, psychosocial, and
injury-related characteristics and traumatic brain injury (TBI) occurring prior
to a moderate or severe TBI requiring rehabilitation. DESIGN: Secondary data
analysis. SETTING: TBI Model System inpatient rehabilitation facilities.
PARTICIPANTS: Persons (N=4464) 1, 2, 5, 10, 15, or 20 years after TBI resulting
in participation in the TBI Model System National Database. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURES: History of TBI prior to the TBI Model System
Index injury, pre-Index injury demographic and behavioral characteristics, Index
injury characteristics, post-Index injury behavioral health and global outcome.
RESULTS: Twenty percent of the cohort experienced TBIs preceding the TBI Model
System Index injury-80% of these were mild and 40% occurred before age 16. Pre-
and post-Index injury behavioral issues, especially substance abuse, were highly
associated with having had a prior TBI. Greater severity of the pre-Index injury
as well as occurrence before age 6 often showed stronger associations.
Unexpectedly, pre-Index TBI was associated with less severe Index injuries and
better functioning on admission and discharge from rehabilitation. CONCLUSIONS:
Findings suggest that earlier life TBI may have important implications for
rehabilitation after subsequent TBI, especially for anticipating behavioral
health issues in the chronic stage of recovery. Results provide additional
evidence for the potential consequences of early life TBI, even if mild.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS