Article

OBJECTIVE: To estimate the overall and by age-group characteristics at admission
and discharge from rehabilitation between 2001 and 2010 of all late-teens and
adults undergoing inpatient rehabilitation for a primary diagnosis of traumatic
brain injury (TBI) in the United States. DESIGN: Secondary data analysis.
SETTING: Acute inpatient rehabilitation facilities. PARTICIPANTS: Patients aged
16 years and older receiving inpatient rehabilitation for a primary diagnosis of
TBI between 2001 and 2010. MAIN OUTCOME MEASURES: Functional independence, level
of disability, and living situation. RESULTS: The incidence of TBI by age group
found the largest proportion of cases to be aged 80 years and older, with a
gradual decline in incidence in the age group of 30 years, at which point there
was a slight increase. Injuries resulted predominantly from falls (49.8%) and
motor vehicle crashes (40.8%); however, injuries to the youngest individuals were
largely from motor vehicle crashes with decreasing rates as age increased, while
injuries due to falls rose as age increased, with the oldest age groups most
likely to incur a TBI. Preinjury alcohol misuse and substance use were found to
occur in 22.9% and 12.2% of the total population, respectively; however, age
distributions demonstrated high preinjury use among individuals younger than 50
years (eg, 46.4% and 30.6% for those aged 20 and 29 years, respectively) with
decreasing misuse as age increased. Of the total population, 49.2% were retired,
31.1% employed, 14.1% not working, and 5.6% students. Trends by age showed that
younger individuals were more likely to be students or employed (eg, 14.5% and
62.0% for those aged 20 and 29 years, respectively), with employment status
peaking for those aged 30 to 39 years, and declining to 3.2% for the oldest age
group (80 years and older). The trend of person(s) living alone between pre- and
postrehabilitation showed the least amount of change for those aged 16 to 19
years with steadily increasing changes as age increased. Similar trends were seen
for residence changes pre- and postrehabilitation, with the youngest most likely
to return to living at a private residence, and a gradual decrease in return to
living at a private residence as age increased. FIM instrument ("FIM") Motor and
Cognitive subscale scores demonstrated that younger individuals had lower scores
at admission to rehabilitation and higher scores at rehabilitation discharge.
CONCLUSION: This study provides population estimates for all patients 16 years of
age and older receiving inpatient rehabilitation for a primary diagnosis of TBI
in the United States between 2001 and 2010. A recent trend shows the aging of the
inpatient TBI rehabilitation population. Many characteristics important to
rehabilitation outcomes are influenced by age, with older individuals trending
toward being female, having less severe TBIs, incurring TBIs as a result of
falls, but showing less improvement during rehabilitation, greater resulting
disability, and more changes in their living situation postrehabilitation. These
findings are of particular interest, as the oldest age groups considered in these
analyses did not include the baby boom population.

Langue : ANGLAIS