Mortality following rehabilitation in the Traumatic Brain Injury Model Systems of Care

While many outcomes after traumatic brain injury (TBI) have been systematically investigated, the most basic of all outcomes--survival--has been neglected. The purpose of this study was to investigate mortality in a cohort of 2,178 individuals with TBI completing inpatient rehabilitation in one of 15 National Institute on Disability and Rehabilitation Research-funded TBI Model Systems of care. The study hypotheses were: (1) relative to the general population, TBI increases mortality and decreases life expectancy in individuals with TBI completing inpatient rehabilitation and surviving to one-year post-injury; and (2) within the TBI population, the risk of death is greater in certain TBI subgroups. Results indicate that individuals with TBI were twice as likely to die compared to individuals in the general population of similar age, gender and race, resulting in an estimated average life expectancy reduction of seven years for individuals with TBI. Within the TBI population, the strongest independent risk factors for death after one-year post-injury were older age and not being employed at injury, and greater disability at rehabilitation discharge. This information is important to guide decision-making for treatment, utilization of limited medical resources, and planning for ongoing health care needs and lifetime planning.