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VA 创伤性脑损伤模型系统多部位创伤康复中心的描述性研究结果。

Descriptive Findings of the VA Polytrauma Rehabilitation Centers TBI Model Systems National Database.

机构信息

VA Palo Alto Health Care System, Polytrauma System of Care, Palo Alto, California, USA.

James A. Haley Veterans Hospital, Department of Medicine, University of South Florida, Tampa, Florida, USA.

出版信息

Arch Phys Med Rehabil. 2018 May;99(5):952-959. doi: 10.1016/j.apmr.2017.12.035. Epub 2018 Feb 7.

Abstract

OBJECTIVES

To present initial descriptive findings from the Veterans Affairs (VA) Polytrauma Rehabilitation Centers (PRC) Traumatic Brain Injury (TBI) Model Systems (MS) National Database.

DESIGN

Prospective cohort study.

SETTING

VA PRC TBIMS National Database.

PARTICIPANTS

712 service members and veterans with TBI who consented to participate between January 2010 and June 2015.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Demographics, preinjury characteristics, injury characteristics, rehabilitation course, functional outcomes, and discharge disposition by TBI severity level.

RESULTS

The study cohort was predominantly male with moderate to severe TBI secondary to vehicular accident or blast injury. Sixty-five percent were active duty service members; one-third had been injured during deployment. One-third reported mental health treatment and/or alcohol use problems in the year predating the index TBI. The median number of days between injury and PRC admission was 42.5. Nearly 25% reported clinical levels of posttraumatic stress disorder; 75% reported mild to moderate neurobehavioral symptomatology. The median length of stay in the PRC was 36 days; those with severe TBI had the longest lengths of stay. Functional independence ratings improved from admission to discharge across all TBI severity levels. A majority were discharged to urban areas to reside with spouses or other residents in private residences or adult homes, with some variability by injury severity.

CONCLUSIONS

The VA PRC TBIMS national database is a rich source of information on a unique group of individuals with TBI and promises to complement existing knowledge on TBI in the civilian population.

摘要

目的

呈现退伍军人事务部(VA)创伤性脑损伤(TBI)多模式康复中心(PRC)TBI 模型系统(MS)国家数据库的初步描述性研究结果。

设计

前瞻性队列研究。

地点

VA PRC TBIMS 国家数据库。

参与者

712 名患有 TBI 的现役军人和退伍军人,他们在 2010 年 1 月至 2015 年 6 月期间同意参与。

干预措施

不适用。

主要观察指标

TBI 严重程度的人口统计学、受伤前特征、受伤特征、康复过程、功能结果和出院处置。

结果

研究队列主要为男性,TBI 程度为中度至重度,继发于车辆事故或爆炸伤。65%为现役军人;三分之一的人在部署期间受伤。三分之一的人报告在指数 TBI 前一年有心理健康治疗和/或酒精使用问题。从受伤到 PRC 入院的中位数天数为 42.5 天。近 25%的人报告有创伤后应激障碍的临床水平;75%的人报告有轻度至中度神经行为症状。PRC 的中位住院时间为 36 天;TBI 严重程度较高的患者住院时间最长。所有 TBI 严重程度的功能独立性评分均从入院到出院有所改善。大多数人被送往城市,与配偶或其他居民居住在私人住宅或成人家庭中,根据受伤严重程度有所不同。

结论

VA PRC TBIMS 国家数据库是一个关于 TBI 独特群体的丰富信息来源,有望补充关于平民 TBI 的现有知识。

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