Comorbid Conditions Among Adults 50 Years and Older with Traumatic Brain Injury: Examining Associations with Demographics, Health Care Utilization, Institutionalization and 1-year Outcomes

Details

• Alternative Title:
  J Head Trauma Rehabil
• Personal Author:
  Kumar, RG ; Olsen, J ; Juengst, SB ; Dams-O’Connor, K ; O’Neil-Pirozzi, TM ; Hammond, FM ; Wagner, AK
• Description:
  Objectives:
  
  To assess the relationship of acute complications, pre-existing chronic diseases, and substance abuse with clinical and functional outcomes among adults ≥50 years with moderate-to-severe traumatic brain injury (TBI).
  
  Design:
  
  Prospective cohort study.
  
  Participants:
  
  Adults age≥50 with moderate-to-severe TBI (n=2,134).
  
  Measures:
  
  Clusters of comorbid health conditions empirically derived from non-injury International Classification of Disease 9th codes, demographic/injury variables, and outcome [acute and rehabilitation length of stay (LOS), FIM efficiency, post-traumatic amnesia (PTA) duration, institutionalization, rehospitalization and Glasgow Outcome Scale-Extended (GOS-E) at 1 year].
  
  Results:
  
  Individuals with greater acute hospital complication burden were more often middle-aged men, injured in motor vehicle accidents, and had longer LOS and PTA. These same individuals experienced higher rates of 1-year rehospitalization and greater odds of unfavorable GOS-E scores at 1 year. Those with greater chronic disease burden were more likely to be rehospitalized at 1 year. Individuals with more substance abuse burden were most often younger (e.g. middle adulthood), black race, less educated, injured via motor vehicle accidents, and had an increased risk for institutionalization.
  
  Conclusion:
  
  Pre-existing health conditions and acute complications contribute to TBI outcomes. This work provides a foundation to explore effects of comorbidity prevention and management on TBI recovery in older adults.
  
  
• Subjects:
  Aged Aged, 80 And Over Article Brain Injuries, Traumatic Chronic Disease Combined Modality Therapy Comorbidity Correlation Of Data Demography Female Glasgow Outcome Scale Humans Independent Living Institutionalization Male Middle Aged Patient Acceptance Of Health Care Patient Readmission Risk Factors Survival Rate Treatment Outcome

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• Source:
  J Head Trauma Rehabil. 34(4):224-232
• Pubmed ID:
  30829819
• Pubmed Central ID:
  PMC10234605
• Document Type:
  Journal Article
• Funding:
  K01 HD074651/HD/NICHD NIH HHSUnited States/ ; TL1 TR001858/TR/NCATS NIH HHSUnited States/ ; U48 DP000039/DP/NCCDPHP CDC HHSUnited States/ ; U48 DP000041/DP/NCCDPHP CDC HHSUnited States/
• Volume:
  34
• Issue:
  4
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:a027d15e2deeeb1a7202711ccbbeb3c5ea727f733d36bbc31cd79edeb9da8d5c
• Download URL:
  https://stacks.cdc.gov/view/cdc/129433/cdc_129433_DS1.pdf
• File Type:
  [PDF - 373.41 KB ]