Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury: Examining Associations with Demographics, Healthcare Utilization, Institutionalization, and 1-Year Outcomes

Raj G. Kumar, Jennifer Olsen, Shannon B. Juengst, Kristen Dams-O'Connor, Therese M. O'Neil-Pirozzi, Flora Hammond, Amy K. Wagner

Research output: Contribution to journalArticle

Abstract

Objectives: To assess the relationship of acute complications, preexisting chronic diseases, and substance abuse with clinical and functional outcomes among adults 50 years and older with moderate-to-severe traumatic brain injury (TBI). Design: Prospective cohort study. Participants: Adults 50 years and older with moderate-to-severe TBI (n = 2134). Measures: Clusters of comorbid health conditions empirically derived from non-injury International Classification of Diseases, Ninth Revision codes, demographic/injury variables, and outcome (acute and rehabilitation length of stay [LOS], Functional Independence Measure efficiency, posttraumatic amnesia [PTA] duration, institutionalization, rehospitalization, and Glasgow Outcome Scale-Extended (GOS-E) at 1 year). Results: Individuals with greater acute hospital complication burden were more often middle-aged men, injured in motor vehicle accidents, and had longer LOS and PTA. These same individuals experienced higher rates of 1-year rehospitalization and greater odds of unfavorable GOS-E scores at 1 year. Those with greater chronic disease burden were more likely to be rehospitalized at 1 year. Individuals with more substance abuse burden were most often younger (eg, middle adulthood), black race, less educated, injured via motor vehicle accidents, and had an increased risk for institutionalization. Conclusion: Preexisting health conditions and acute complications contribute to TBI outcomes. This work provides a foundation to explore effects of comorbidity prevention and management on TBI recovery in older adults.

Original languageEnglish (US)
JournalJournal of Head Trauma Rehabilitation
DOIs
StatePublished - Jan 1 2019

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Institutionalization
Demography
Glasgow Outcome Scale
Delivery of Health Care
Preexisting Condition Coverage
Amnesia
Motor Vehicles
Substance-Related Disorders
Accidents
Length of Stay
Chronic Disease
Health
International Classification of Diseases
Comorbidity
Cohort Studies
Prospective Studies
Traumatic Brain Injury
Wounds and Injuries

Keywords

  • aging
  • brain injuries
  • comorbidity
  • epidemiology

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

Cite this

Comorbid Conditions among Adults 50 Years and Older with Traumatic Brain Injury : Examining Associations with Demographics, Healthcare Utilization, Institutionalization, and 1-Year Outcomes. / Kumar, Raj G.; Olsen, Jennifer; Juengst, Shannon B.; Dams-O'Connor, Kristen; O'Neil-Pirozzi, Therese M.; Hammond, Flora; Wagner, Amy K.

In: Journal of Head Trauma Rehabilitation, 01.01.2019.

Research output: Contribution to journalArticle

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