Brain Injury Rehabilitation Service, Department of Rehabilitation Medicine, Brooke Army Medical Center (Mss Nix and Cummings and Drs Lu and Bowles), and Traumatic Brain Injury Center of Excellence, Defense Health Agency (Dr Lu), JBSA Fort Sam Houston, San Antonio, Texas; The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, Maryland (Ms Nix); and General Dynamic Information Technology, Falls Church, Virginia (Dr Lu).
J Head Trauma Rehabil. 2022;37(6):E458-E466. doi: 10.1097/HTR.0000000000000792. Epub 2022 May 26.
To characterize treatment responders and nonresponders as measured by the Neurobehavioral Symptom Inventory (NSI) in order to understand whether certain traits in our patient population would characterize favorable response.
Brain Injury Rehabilitation Service at Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas.
In total, 655 active duty military patients with a diagnosis of mild traumatic brain injury (mTBI) who received treatment between 2007 and 2020 and completed self-report measures as part of routine care.
Observational retrospective analysis of outpatient clinical outcomes data.
The primary outcome measure was the NSI, divided into the responder and nonresponder groups. Responders were defined by reliable change in NSI total score (decrease of ≥8 points from intake to discharge).
Responders ( n = 395) reported a higher level of symptom burden at intake on the NSI. Women responded proportionally more (70%) than men (58%). After treatment, responders reported improvements on all measures evaluated while nonresponders reported no change or slightly worse symptoms. Logistic regression analysis showed that posttraumatic stress symptoms at intake decreased odds of favorable treatment response while satisfaction with social relationships increased odds of favorable treatment response.
The results from this process improvement project suggested that posttraumatic symptoms warrant programmatic attention in TBI clinics while social relationships may be a protective factor that can be capitalized to enhance troop readiness. Systematic examination of these characteristics should be conducted on a larger population within the military health system.
通过神经行为症状量表（NSI）来描述治疗有反应者和无反应者，以便了解患者群体中的某些特征是否能反映出良好的反应。
德克萨斯州圣安东尼奥市萨姆休斯顿堡的陆军医疗中心脑损伤康复服务处。
共有 655 名现役军人患有轻度创伤性脑损伤（mTBI），他们在 2007 年至 2020 年间接受了治疗，并作为常规护理的一部分完成了自我报告的测量。
对门诊临床结果数据的观察性回顾性分析。
主要结果测量指标是 NSI，分为有反应者和无反应者两组。有反应者的定义是 NSI 总分可靠变化（从入院到出院时总分下降≥8 分）。
有反应者（n=395）报告 NSI 入院时的症状负担水平更高。女性的反应比例（70%）高于男性（58%）。治疗后，有反应者报告所有评估的指标都有所改善，而无反应者报告症状没有变化或略有恶化。逻辑回归分析表明，入院时的创伤后应激症状降低了治疗反应良好的可能性，而对社会关系的满意度则增加了治疗反应良好的可能性。
这个过程改进项目的结果表明，创伤后症状需要在 TBI 诊所得到有计划的关注，而社会关系可能是一个保护因素，可以利用它来提高部队的准备状态。应在更大的军事卫生系统人群中对这些特征进行系统检查。
