Violent traumatic brain injury: Occurrence, patient characteristics, and risk factors from the traumatic brain injury model systems project

Hanks RA, Wood DL, Millis S, Harrison-Felix C, Pierce CA, Rosenthal M, Bushnik T, High WM Jr, Kreutzer J. Violent traumatic brain injury: occurrence, patient characteristics, and risk factors from the Traumatic Brain Injury Model Systems project. Arch Phys Med Rehabil 2003;84:249-54. Objectives: To examine the occurrence of and characteristics associated with violent traumatic brain injury (TBI) in the Traumatic Brain Injury Model Systems (TBIMS) project for 4 of the 5 original Model Systems centers and to determine the patient characteristics of this group, as well as the risk factors for sustaining such an injury. Design: Prospective evaluation of individuals with violent TBI over a 10-year period. Setting: Four TBIMS centers. Participants: A total of 1229 individuals who received acute hospitalization and inpatient rehabilitation care for TBI. Interventions: Not applicable. Main Outcome Measure: The occurrence of a violent TBI. Results: Twenty-six percent of the participants in the TBIMS project sustained a violent TBI. This type of injury was more common in African-American men who were single and slightly older than the average TBI patient, were unemployed before injury, and had had a previous TBI. A higher injury rate was noted in the earlier part of the evaluation period. Those who sustained a violent TBI had higher levels of caregiver burden and disability, as well as decreased productivity and community reintegration at rehabilitation discharge and at 1 and 2 years postinjury. Conclusions: The occurrence of violent TBI in the TBIMS project is consistent with national trends of decreasing incidence of violent injuries in the 1990s. These results present a profile of those who have been injured through violence. The relative risks for sustaining such an injury appear to be well defined when considering demographic and temporal factors. [copy ] 2003 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation