@article{ref1,
title="Long-term disability and survival in traumatic brain injury: Results from the NIDRR Model Systems",
journal="Archives of physical medicine and rehabilitation",
year="2013",
author="Brooks, Jordan C. and Strauss, David J. and Shavelle, Robert M. and Paculdo, David R. and Hammond, Flora M. and Harrison-Felix, Cynthia L.",
volume="94",
number="11",
pages="2203-2209",
abstract="OBJECTIVE: To document long-term survival in one-year survivors of traumatic brain injury (TBI); to compare the use of the Disability Rating Scale (DRS) and Functional Independence Measure (FIM) as factors in the estimation of survival probabilities; and to investigate the effect of time since injury and secular trends in mortality. DESIGN: Cohort study of one-year survivors of TBI; followed up to 20 years post-injury. Statistical methods include standardized mortality ratios (SMRs), Kaplan-Meier survival curve, proportional hazard regression, and &quot;person-year&quot; logistic regression. SETTING: Post-discharge from National Institute on Disability and Rehabilitation Research-funded TBI Model Systems rehabilitation units. PARTICIPANTS: Population-based sample of 7,228 persons who were admitted to a TBI Model Systems facility and survived at least 1 year post-injury. These persons contributed 32,505 person-years, with 537 deaths, over the 1989 to 2011 study period. INTERVENTIONS: Not Applicable. MAIN OUTCOME MEASURES: Survival. RESULTS: Survival was poorer than that of the general population (SMR=2.1; 95% CI 1.9-2.3). Age, sex, and functional disability were significant risk factors for mortality (p < 0.0001). FIM- and DRS-based proportional hazard survival models had comparable predictive performance (C-index 0.80 vs. 0.80, AIC 11,005 vs 11,015). Time since injury and current calendar year were not significant predictors of long-term survival (both p > 0.05). CONCLUSION: Long-term survival prognosis in TBI depends on age, sex, and disability. FIM and DRS are useful prognostic measures with comparable statistical performance. Age- and disability-specific mortality rates in TBI have not declined over the last 20 years. A survival prognosis calculator is available at http://www.LifeExpectancy.org/tbims.shtml.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2013.07.005",
url="http://dx.doi.org/10.1016/j.apmr.2013.07.005"
}