Mortality Over Four Decades Following Traumatic Brain Injury Rehabilitation: A Retrospective Cohort Study

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Objective: To investigate mortality, life expectancy, risk factors for death. and causes of death in persons with traumatic brain injury (TBI) Design: Retrospective Cohort study. Setting: Used data from an inpatient rehabilitation facility,the Social Security Death Index, death certificates, and the u.s. population age-race-sex-specific and cause-specific mortality rates. Part!cipants: Persons with TBI (N= 1678) surviving to their first anniversary of injury admitted to rehabilitation from an acute care hospital within 1 year of injury between 1961 and 2002. Interventions: Not applicable, Main Outcome Measures: Vital status. standardized mortality ratio. life expectancy, cause of death. . Results: Persons with TBI were 1 .5 times more likely to dIe than persons in the general population of similar age, sex, and race, resulting in an estimated average life expectancy reduction of 4 years. Within tbe TBI population. the strongest independent risk factors for death after I year post injury were being older. being male, having less education. baving a longer
hospitalization, having an earlier year of injury) and being in a vegetative state at rehabilitation ctischarge. After 1 year postinjury persons with TBI were 49 times more likely to die of aspiration pneumonia, 22 times more likely to die of seizures,
4 times more likely to die ofpneulTIonia, 3 times more likely to commit suicide. and 2.5 times more likely to die of digestive conditions than persons in the general population of similar age, sex, and race. Conclusions: This study demonstrated life expectancy after TBf rehabilitation is reduced and associated with specific risk factors and causes of death. Key Words: Brain injuries; Cause of death; Life expectancy; Mortality: Rehabilitation.
© 2009 by the American Congress of Rehabilitation Medicine

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