233478 Re-injury among veterans with traumatic brain injury discharged from VA Polytrauma Rehabilitation Centers

Wednesday, November 10, 2010 : 1:10 PM - 1:30 PM

Kathleen F. Carlson, MS, PhD , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Agnes Jensen, BS , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Alisha Baines Simon, MPH , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Amy A. Gravely, MS , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Brent C. Taylor, PhD , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Ann K. Bangerter, BS , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Laura A. Meis, PhD , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
Katy Wilder Schaaf, PhD , Psychology, Minneapolis VA Medical Center, Minneapolis, MN
Joan M. Griffin, PhD , Center for Chronic Disease Outcomes Research, Minneapolis VA Medical Center, Minneapolis, MN
     
Background: Trauma survivors have high rates of fatal injury for at least 20 years after their initial trauma. Little is known about rates of nonfatal injury. We examined nonfatal re-injury among military service members and veterans treated in Veterans' Affairs (VA) Polytrauma Rehabilitation Centers (PRCs).

Methods: We surveyed family caregivers of 1,046 PRC patients who: 1) had military service from 2001-2009; 2) sustained polytrauma including traumatic brain injury (TBI); 3) received PRC care from 2001-2009; 4) were discharged at least three months before the study; and 5) were alive during the study. Caregivers completed a 35-page questionnaire asking about the caregiver and patient, including whether the patient had sought medical attention for any “accidents/new injuries” since discharge. We conducted descriptive analyses on prevalence and source(s) of re-injury. We then estimated patients' risk of re-injury in reference to hypothesized risk factors. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression.

Results: There were 564 (54%) surveys returned. Caregivers reported re-injuries among 161 patients (29%); falls (n=79) and motor vehicles (n=59) were most frequent. Increased odds of re-injury were associated with being female (OR=4.1; CI=1.7-10.0), National Guard versus Active Duty status (OR=2.2; CI=1.1-4.3), severe versus mild TBI (OR=1.8; CI=1.0-3.2), and low versus high caregiver health status (OR=2.0; CI=1.2-3.4).

Discussion: Our study identifies a need for injury prevention programs for service members and veterans who have been treated for polytrauma in VA PRCs. Further research that could serve as the basis for development of prevention programs is warranted.

Learning Objectives:
1. Describe the population of US military service members and veterans who have incurred polytraumatic injuries, including traumatic brain injury, and have been treated in Veterans' Affairs (VA) Polytrauma Rehabilitation Centers (PRCs); 2. Identify the prevalence of VA PRC patients who have been non-fatally re-injured subsequent to being discharged from a PRC; and 3. Discuss potential risk factors for non-fatal re-injury among VA PRC patients.

Keywords: Injury Control, Veterans' Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am trained in injury prevention and control and work as an epidemiologist and health services researcher for the US Veterans Health Administration.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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