Journal:Journal of Head Trauma Rehabilitation
Year, Volume, Issue, Page(s):12, 27, 6, E69-E80
Study assessed mortality, life expectancy, risk factors, and causes of death among individuals who received inpatient traumatic brain injury (TBI) rehabilitation. Data were analyzed for 8,573 individuals who were injured between 1988 and 2009 and received inpatient rehabilitation at TBI Model Systems sites, with survival status determined as of December 31, 2009. Standardized mortality ratio (SMR), life expectancy, and cause of death were determined. Results indicated that the SMR was 2.25 overall and was significantly elevated for all age groups, both sexes, all race/ethnic groups (except Native Americans), and all injury severity groups. SMR decreased as survival time increased but remained elevated even 10 years after injury. SMR was elevated for all cause-of-death categories but especially so for seizures, aspiration pneumonia, sepsis, accidental poisonings, and falls. Life expectancy was shortened an average of 6.7 years. Multivariate Cox regression showed age at injury, sex, race/ethnic group, marital status and employment status at the time of injury year of injury, preinjury drug use, days unconscious, functional independence and disability on rehabilitation discharge, and comorbid spinal cord injury to be independent risk factors for death. Findings suggest that there is an increased risk of death after moderate or severe TBI. Risk factors and causes of death were identified that may be amenable to intervention.