Literature DB >> 12601659

Ethnographic analysis of traumatic brain injury patients in the national Model Systems database.

Derek M Burnett1, Stephanie A Kolakowsky-Hayner, Dan Slater, Anthony Stringer, Tamara Bushnik, Ross Zafonte, David X Cifu.   

Abstract

OBJECTIVE: To compare demographics, injury characteristics, therapy service and intensity, and outcome in minority versus nonminority patients with traumatic brain injury (TBI).
DESIGN: Retrospective analysis.
SETTING: Twenty medical centers. PARTICIPANTS: Two thousand twenty patients (men, n=1,518; women, n=502; nonminority, n=1,168; minority, n=852) with TBI enrolled in the Traumatic Brain Injury Model Systems database.
INTERVENTIONS: Not applicable. MAIN OUTCOMES MEASURES: Age, gender, marital status, education, employment status, injury severity (based on Glasgow Coma Scale [GCS] admission score, length of posttraumatic amnesia, duration of unconsciousness), intensity (hours) of therapy rendered, rehabilitation length of stay (LOS), rehabilitation charges, discharge disposition, postinjury employment status, FIM instrument change scores, and FIM efficiency scores. Independent sample t tests were used to analyze continuous variables; chi-square analyses were used to evaluate categorical data. DEMOGRAPHICS: overall, minorities were found to be mostly young men who were single, unemployed, and less well educated, with a longer work week if employed when injured. ETIOLOGY: motor vehicle crashes (MVCs) predominated as the cause of injury for both groups; however, minorities were more likely to sustain injury from acts of violence and auto-versus-pedestrian crashes. Minorities also had higher GCS scores on admission and shorter LOS. Rehabilitation services: significant differences were found in the types and intensity of rehabilitation services provided; these included physical therapy, occupational therapy, and speech-language pathology, but not psychology.
CONCLUSION: Minority patients who sustain TBI generally tend to be young men with less social responsibility. Although MVCs predominate as the primary etiology, acts of violence and auto-versus-pedestrian incidents are more common in the minority population. Minorities tend to have higher GCS scores at admission. Also, the type and intensity of rehabilitation services provided differed significantly for the various interdisciplinary subspecialties. Rehabilitation charges, discharge disposition, and postinjury employment status were similar for the 2 groups, even though LOS is typically 3 to 4 days shorter for the minority group. A more detailed investigation is warranted to explain these findings.

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Year:  2003        PMID: 12601659     DOI: 10.1053/apmr.2003.50091

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


  12 in total

1.  Disparities in disability after traumatic brain injury among Hispanic children and adolescents.

Authors:  Nathalia Jimenez; Beth E Ebel; Jin Wang; Thomas D Koepsell; Kenneth M Jaffe; Andrea Dorsch; Dennis Durbin; Monica S Vavilala; Nancy Temkin; Frederick P Rivara
Journal:  Pediatrics       Date:  2013-05-06       Impact factor: 7.124

2.  Minority status and the risk of serious childhood injury and death.

Authors:  John R Hayes; Jonathan I Groner
Journal:  J Natl Med Assoc       Date:  2005-03       Impact factor: 1.798

3.  Trajectories of Functional Change After Inpatient Rehabilitation for Traumatic Brain Injury.

Authors:  Bret T Howrey; James E Graham; Monique R Pappadis; Carl V Granger; Kenneth J Ottenbacher
Journal:  Arch Phys Med Rehabil       Date:  2017-04-07       Impact factor: 3.966

4.  Efficiency of specialist rehabilitation in reducing dependency and costs of continuing care for adults with complex acquired brain injuries.

Authors:  L Turner-Stokes; S Paul; H Williams
Journal:  J Neurol Neurosurg Psychiatry       Date:  2006-05       Impact factor: 10.154

5.  Availability of Outpatient Rehabilitation Services for Children After Traumatic Brain Injury: Differences by Language and Insurance Status.

Authors:  Megan Moore; Nathalia Jimenez; Ali Rowhani-Rahbar; Margaret Willis; Kate Baron; Jessica Giordano; Deborah Crawley; Frederick P Rivara; Kenneth M Jaffe; Beth E Ebel
Journal:  Am J Phys Med Rehabil       Date:  2016-03       Impact factor: 2.159

6.  Impact of racial-ethnic minority status and systemic vulnerabilities on time to acute TBI rehabilitation admission in an urban public hospital setting.

Authors:  Armando Fuentes; Chelsea Schoen; Rebecca R Kulzer; Coralynn Long; Tamara Bushnik; Joseph F Rath
Journal:  Rehabil Psychol       Date:  2019-01-28

7.  Ethnic differences in discharge destination among older patients with traumatic brain injury.

Authors:  Pei-Fen J Chang; Glenn V Ostir; Yong-Fang Kuo; Carl V Granger; Kenneth J Ottenbacher
Journal:  Arch Phys Med Rehabil       Date:  2008-02       Impact factor: 3.966

8.  Functional outcomes during inpatient rehabilitation for American Indian and Alaska Native children with traumatic brain injury.

Authors:  Molly M Fuentes; Nathalia Jimenez; Susan D Apkon; Frederick P Rivara
Journal:  J Pediatr Rehabil Med       Date:  2016-05-31

Review 9.  Racial and Ethnic Disparities Associated with Traumatic Brain Injury Across the Continuum of Care: a Narrative Review and Directions for Future Research.

Authors:  Altaf Saadi; Sarah Bannon; Eric Watson; Ana-Maria Vranceanu
Journal:  J Racial Ethn Health Disparities       Date:  2021-03-17

10.  Early Life Stress Exacerbates Outcome after Traumatic Brain Injury.

Authors:  Chantal M Sanchez; David J Titus; Nicole M Wilson; Julie E Freund; Coleen M Atkins
Journal:  J Neurotrauma       Date:  2020-09-16       Impact factor: 5.269

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