TY  - JOUR
PY  - 2019//
TI  - Comorbid conditions among adults 50 years and older with traumatic brain injury: examining associations with demographics, healthcare utilization, institutionalization, and 1-year outcomes
JO  - Journal of head trauma rehabilitation
A1  - Kumar, Raj G.
A1  - Olsen, Jennifer
A1  - Juengst, Shannon B.
A1  - Dams-Oʼconnor, Kristen
A1  - Oʼneil-Pirozzi, Therese M.
A1  - Hammond, Flora M.
A1  - Wagner, Amy K.
SP  - 224
EP  - 232
VL  - 34
IS  - 4
N2  - OBJECTIVES: To assess the relationship of acute complications, preexisting chronic diseases, and substance abuse with clinical and functional outcomes among adults 50 years and older with moderate-to-severe traumatic brain injury (TBI). <br><br>DESIGN: Prospective cohort study. PARTICIPANTS: Adults 50 years and older with moderate-to-severe TBI (n = 2134). MEASURES: Clusters of comorbid health conditions empirically derived from non-injury International Classification of Diseases, Ninth Revision codes, demographic/injury variables, and outcome (acute and rehabilitation length of stay [LOS], Functional Independence Measure efficiency, posttraumatic amnesia [PTA] duration, institutionalization, rehospitalization, and Glasgow Outcome Scale-Extended (GOS-E) at 1 year). <br><br>RESULTS: Individuals with greater acute hospital complication burden were more often middle-aged men, injured in motor vehicle accidents, and had longer LOS and PTA. These same individuals experienced higher rates of 1-year rehospitalization and greater odds of unfavorable GOS-E scores at 1 year. Those with greater chronic disease burden were more likely to be rehospitalized at 1 year. Individuals with more substance abuse burden were most often younger (eg, middle adulthood), black race, less educated, injured via motor vehicle accidents, and had an increased risk for institutionalization. <br><br>CONCLUSION: Preexisting health conditions and acute complications contribute to TBI outcomes. This work provides a foundation to explore effects of comorbidity prevention and management on TBI recovery in older adults.<p />  <p>Language: en</p>
LA  - en
SN  - 0885-9701
UR  - http://dx.doi.org/10.1097/HTR.0000000000000470
ID  - ref1
ER  -