Traumatic brain injury in veterans—differences from civilians may affect long-term care

July 6, 2017, Wolters Kluwer Health

Veterans with traumatic brain injury (TBI) differ from civilians with TBI in some key ways—with potentially important implications for long-term care and support of injured service members and their families. New research from the Veterans Administration TBI Model System is assembled in the July/August special issue of the Journal of Head Trauma Rehabilitation (JHTR).

"The VA TBI Model System is uniquely positioned to inform policy about the health, mental health, socioeconomic, rehabilitation, and caregiver needs following TBI," write Guest Editors Risa Nakase-Richardson, PhD, of James A. Haley Veterans' Hospital, Tampa, Fla., and Lillian Stevens, PhD, of Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Va.

The special issue presents initial reports from a Department of Veterans Affairs (VA)-specific database of patients representing all (TBI) severity levels. The findings will play a critical role in VA's efforts to meet the long-term needs of veterans with TBI.

VA TBI Model System Will Guide Care for Veterans and Families Affected by TBI

The initial TBI Model System was developed by the National Institute on Disability and Rehabilitation Research— now the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)-in 1987. Over the years, 16 civilian hospitals have contributed data on the course of recovery and outcomes for more than 16,000 patients who received inpatient rehabilitation after TBI.

The VA TBI Model System, created in response to a Congressional mandate, collects similar data on rehabilitation outcomes of military TBI. Since 2010, over 1,000 patients with TBI hospitalized at five regional VA Polytrauma Rehabilitation Centers have been added to the database. The five premiere VA Polytrauma Rehabilitation Centers offer inpatient rehabilitation with specialized capacity to treat the more severely injured veterans and active duty service members.

Dr. Nakase-Richardson is the lead author of a study comparing the characteristics of 550 patients from the VA TBI Model System versus 5,270 patients from the original NIDILRR . The results suggested that military and civilian cases of TBI differ in most characteristics/outcomes compared. For example, the data showed that violent causes of TBI were more common in the VA group, while falls were more common in civilian cases. Most violence-related TBI cases in veterans were related to deployment.

At least 13 percent of the civilian TBI patients had previously served in the military. Dr. Nakase-Richardson and co-authors highlight the need for a complementary sample to broaden research findings to veterans and service members who seek primarily civilian health care.

The differences between databases make it difficult to directly compare outcomes between the military and civilian TBI groups. The researchers emphasize the need for further studies to clarify the differences and their implications for treatment and outcomes.

Other topics in the special issue include the critical long-term impact on families and caregivers; and new insights for promoting health, quality of life, and community re-entry (i.e., employment) for veterans and service members with TBI.

These and future studies will have a major impact on VA's efforts to plan for ongoing care and support for the large numbers of veterans and families affected by TBI, according to Joel Scholten, MD, Director of Physical Medicine and Rehabilitation at the Veterans Health Administration.

"Participation in the TBI Model System allows VA to continue to define the unique needs of Veterans following TBI and translate these findings into policy, essentially creating a of continuous quality improvement for TBI within VA," said Scholten.

Explore further: Suicide in veterans – study finds mixed picture

More information: Risa Nakase-Richardson et al. Comparison of the VA and NIDILRR TBI Model System Cohorts, Journal of Head Trauma Rehabilitation (2017). DOI: 10.1097/HTR.0000000000000334

Related Stories

Suicide in veterans – study finds mixed picture

May 12, 2017
People who have served in the armed forces do not have a greater risk of suicide overall than people who have never served in the military, but there is an increased risk in certain groups, according to a study by the University ...

Survey finds civilian physicians feel underprepared to treat veterans

June 1, 2015
A survey of nearly 150 U.S. physicians who frequently treat veterans found civilian doctors aren't adequately trained in health issues related to military service, according to research published today in The Journal of the ...

Veterans with traumatic brain injuries and combat-related challenges

February 3, 2014
Virginia Commonwealth University researchers have found that among traumatic brain injury-diagnosed veterans treated by the Veterans Health Administration between 2009 and 2011, the majority had a clinician-diagnosed mental ...

Symptoms and quality of life after military brain injury

January 5, 2016
New research shows four distinct patterns of symptoms after mild traumatic brain injury (TBI) in military service members, and validates a new tool for assessing the quality-of-life impact of TBI. The studies appear in the ...

VA commission on care: Eliminate VA medical centers

April 11, 2016
(HealthDay)—A radical proposal has been suggested for eliminating all Veterans Affairs (VA) medical centers and outpatient facilities in the next 20 years, floated by seven of 15 members of the VA Commission on Care, according ...

Health care's familiarity with military culture critical to improving care for veterans

January 29, 2016
Health care systems and providers need to understand the unique realities of military culture in order to work effectively with veterans and military families, according to the findings of a study by a University at Buffalo ...

Recommended for you

Suicide risk in abused teen girls linked to mother-daughter conflict

October 18, 2018
Teenage girls who were maltreated as children are more likely to entertain suicidal thoughts if the relationship with their mother is poor and the degree of conflict between the two of them high.

Study shows how bias can influence people estimating the ages of other people

October 17, 2018
A trio of researchers from the University of New South Wales and Western Sydney University has discovered some of the factors involved when people make errors in estimating the ages of other people. In their paper published ...

Infants are more likely to learn when with a peer

October 16, 2018
Infants are more likely to learn from on-screen instruction when paired with another infant as opposed to viewing the lesson alone, according to a new study.

Researchers use brain cells in a dish to study genetic origins of schizophrenia

October 16, 2018
A study in Biological Psychiatry has established a new analytical method for investigating the complex genetic origins of mental illnesses using brain cells that are grown in a dish from human embryonic stem cells. Researchers ...

Income and wealth affect the mental health of Australians, study shows

October 16, 2018
Australians who have higher incomes and greater wealth are more likely to experience better mental health throughout their lives, new research led by the Bankwest Curtin Economics Centre has found.

Study suggests biological basis for depression, anxiety, sleep disturbances in older adults

October 15, 2018
UC San Francisco researchers, in collaboration with the unique Brazilian Biobank for Aging Studies (BBAS) at the University of São Paulo, have shown that the earliest stages of the brain degeneration associated with Alzheimer's ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.