Citation

Hammond F, Ketchum J, Dams-O'connor K, Corrigan JD, Miller AC, Haarbauer-Krupa J, Faul M, Trexler LE, Harrison-Felix CL. J. Neurotrauma 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2020.7038

PMID

unavailable

Abstract

Studies have shown reduced life expectancy following moderate-severe traumatic brain injury (TBI) with death due to unintentional poisoning (UP) 11x higher following TBI than in the general population. The characteristics of those who die of unintentional poisoning are compared to those who die of other causes (OC) in a retrospective cohort who received inpatient rehabilitation following traumatic brain injury (TBI) and enrolled in the TBI Model Systems National Database between 1989 and 2017 (n = 15,835 cases with 2,238 deaths recorded). Seventy-eight cases (3.5%) of deaths were due to UP, 76% were due to OC, and 20.5% died of unknown cause. Among the UP deaths, 90% involved drugs (of these 67% involved narcotic drugs and 14% psychostimulants) and 8% involved alcohol. Age- adjusted risk for UP death was associated with: White/Non-Hispanic race/ethnicity, living alone, non-institutionalization, pre- and post-injury illicit drug use and alcohol/drug problem use, any alcohol use at last follow up, better Functional Independence Measure TM (FIM) scores, history of arrest, moderate disability (vs severe disability or good recovery), less supervision needed, and greater anxiety. Adults who receive inpatient rehabilitation for TBI who die due to UP are distinguishable from those who die of OC. Factors such as pre-injury substance use in the context of functional independence may be regarded as targets for prevention and/or intervention to reduce substance use and substance-related mortality among survivors of moderate-severe TBI. The current findings may have implications for medical care, surveillance, prevention, and health promotion.

Language: en

Keywords

ADULT BRAIN INJURY; ALCOHOL AND DRUG ABUSE; REHABILITATION; TRAUMATIC BRAIN INJURY