Causes of Death Following 1 Year Postinjury Among Individuals With Traumatic Brain Injury

OBJECTIVE: To investigate causes of death in individuals with traumatic brain injury (TBI). DESIGN: Retrospective cohort study. SETTING: Utilized data from the TBI Model Systems National Database, the Social Security Death Index, death certificates, and the US population age-race-gender-cause-specific mortality rates for 1994. PATIENTS: Two thousand one hundred forty individuals with TBI completing inpatient rehabilitation in 1 of 15 National Institute on Disability and Rehabilitation Research-funded TBI Model Systems of Care between 1988 and 2001, and surviving past 1 year postinjury. MAIN OUTCOME MEASURES: Primary cause of death based on the International Classification of Diseases--9th Revision--Clinical Modification-coded death certificates. RESULTS: Individuals with TBI were about 37 times more likely to die of seizures, 12 times more likely to die of septicemia, 4 times more likely to die of pneumonia, and about 3 times more likely to die of other respiratory conditions (excluding pneumonia), digestive conditions, and all external causes of injury/poisoning than were individuals in the general population of similar age, gender, and race. CONCLUSION: Long-term follow-up of individuals with TBI should increase vigilance for, and prevention of, diagnoses frequently causing death (circulatory disorders) and diagnoses with a high relative risk of causing death in this population (seizures, septicemia, respiratory and digestive conditions, and external causes of injury).