Etiology of traumatic brain injury: characterization of differential outcomes up to 1 year postinjury.

OBJECTIVE

To characterize outcomes after traumatic brain injury (TBI) resulting from vehicular crashes, violence, falls, or other causes.

DESIGN

Prospective, multicenter, longitudinal.

SETTING

Seventeen Traumatic Brain Injury Model Systems.

PARTICIPANTS

A total of 1,170 individuals with moderate to severe TBI with data from initial medical and rehabilitation stays and 1-year follow-up.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

At rehabilitation discharge, FIM instrument, Disability Rating Scale (DRS), and Rancho Los Amigo Levels of Cognitive Functioning Scale. At 1 year postinjury, FIM, DRS, Community Integration Questionnaire (CIQ), employment, residence, marital status, and seizure occurrence.

RESULTS

The 4 etiology groups could be distinguished based on premorbid characteristics. Severity of injury indices indicated that individuals in vehicular crashes showed a trend toward incurring more severe injuries than the other 3 groups. At rehabilitation discharge, there were no functional differences between groups. At 1 year postinjury, the groups could be differentiated: individuals in violence-related TBI had higher unemployment rates and lower CIQ scores; persons in vehicular crashes reported the best functional and psychosocial outcomes; and individuals in the falls and other groups had outcomes lying between the vehicular and violence groups.

CONCLUSION

This study elucidated important differences between persons with violence-related TBI and those with non-violence-related TBI. Further research is needed to find effective interventions to address these differences.