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Disability after Traumatic Brain Injury: A Population-Based Study

PI: Gale Whiteneck, PhD, FACRM
Funded by: CDC through the Colorado Injury Control Research Center
Dates: 2007 – 2012
Contact: Gale Whiteneck 303 789 8304

Traumatic brain injury (TBI) is well recognized as a major public health concern based on the Centers for Disease Control and Prevention (CDC) estimates of 50,000 TBI deaths and 235,000 TBI hospitalizations in the United States annually and at least 5.3 million people currently living in the US with long-term disability resulting from TBI. Unfortunately there is no mechanism for capturing the full incidence of TBI including those people not hospitalized and not seen in emergency departments. The specific aim of this project is to design, implement, and evaluate, on a statewide basis, a methodology that can be used on a national level, to determine the population-based prevalence of TBI outcomes (including functional limitations, disabilities, and persistent symptoms) attributable to all severities of TBI (MTBI as well as more severe TBI), and following all care paths (whether hospitalized, treated and released from a hospital Emergency Department, seen in a physicians’ office or clinic, or did not seek medical care).

Using a general population survey in Colorado and BRFSS methodology, the project will attempt to screen 5,000 individuals age 18 and over to identify 1,000 individuals with a history of traumatic brain injury, up to 1,000 people with a history of long bone fracture, and a random sample of 1,000 people with neither injury, to participate in an outcomes interview. The outcomes of people with TBI will be compared with people in the two control conditions. A subset of participants – 100 reporting TBI in the last five years and 50 reporting no injuries – will be asked to respond to a more in-depth clinical interview designed to identify TBI to test the sensitivity of the initial brief screening interview to solicit TBI incidence. Medical records of people in the subset who report TBI on one or both interviews will be reviewed to corroborate a TBI diagnosis. By determining the prevalence of TBI-related outcomes and understanding the risk factors for those problematic outcomes (including the risk factors of severity of injury, treatment pathways, and demographics), planning of effective interventions to improve the lives of people with TBI will be enhanced.

This proposal is specifically designed to assess the outcome disparities between people reporting TBI and those not reporting TBI in Colorado. This will clearly help meet the goals of the NCIPC Injury Research Agenda, Healthy People 2010, and address the priority areas identified in the CDC Acute Injury Care Research Agenda.