Trajectories of Global Functioning Over the 10 Years After Traumatic Brain Injury in Black Individuals: A Model System Study.

OBJECTIVE

This study examined longitudinal global functioning trajectories over the 10 years after traumatic brain injury (TBI) in a group of Black individuals, and demographic and injury-related predictors of those trajectories.

DESIGN

Participants completed follow-up data collections at 1, 2, 5, and 10 years after TBI and being discharged from acute rehabilitation.

SETTING

TBI Model System (TBIMS) hospitals.

PARTICIPANTS

This study included a subsample of Black individuals (N=2523) in the TBIMS National Database who had a completed global functioning scores at 1 or more follow-up time points.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURE

Glasgow Outcome Scale-Extended (GOS-E).

RESULTS

GOS-E scores across the full sample tended to increase slightly between years 1 and 2 and then plateaued for the successive years such that a quadratic, or U-shaped, trend best fit the data. Younger age (P<.001), higher level of education (P<.001), private insurance (P=.007), and shorter posttraumatic amnesia (PTA) duration (P<.001) were significant predictors of higher GOS-E trajectories. There was also a significant time × age effect (P<.001), such that younger adults improved slightly over the first 5 years and plateaued between years 5 and 10 relative to a general decline for older adults.

CONCLUSIONS

These findings suggest that age, education, insurance status, and PTA are important predictors of long-term global functional outcomes for Black individuals with TBI. Identifying baseline risk factors for Black individuals who may experience lower global functioning trajectories can inform development of targeted interventions and be a first step in working to reduce health disparities in functional outcomes in this group.