Age Moderates the Effect of Injury Severity on Functional Trajectories in Traumatic Brain Injury: A Study Using the NIDILRR Traumatic Brain Injury Model Systems National Dataset.

Authors

Laraine Winter, Nursing Service, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104, USA; M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA
Janell L Mensinger, Department of Clinical and School Psychology, College of Psychology, Nova Southeastern University, Fort Lauderdale, FL 33314, USA
Helene J Moriarty, Nursing Service, Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA 19104, USA; M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA
Keith M Robinson, Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
Michelle McKay, M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, PA 19085, USA
Benjamin E Leiby, Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA

Document Type

Article

Publication Date

4-28-2022

Comments

This article is the author's final published version in Journal of Clinical Medicine, Volume 11, Issue 9, April 2022, Article number 2477.

The published version is available at https://doi.org/10.3390/jcm11092477.

Copyright © 2022 by the authors. Licensee MDPI, Basel, Switzerland

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

Abstract

Age is a risk factor for a host of poor outcomes following traumatic brain injury (TBI), with some evidence suggesting that age is also a source of excess disability. We tested the extent to which age moderates the effect of injury severity on functional trajectories over 15 years post injury. Data from 11,442 participants from the 2020 National Institute of Disability and Independent Living Rehabiitation Research (NIDILRR) Traumatic Brain Injury Model Systems (TBIMS) National Dataset were analyzed using linear mixed effects models. Injury severity was operationally defined using a composite of Glasgow Coma Scale scores, structural imaging findings, and the number of days with post-trauma amnesia. Functioning was measured using the Glasgow Outcomes Scale-Extended. Age at injury was the hypothesized moderator. Race, ethnicity, sex, education, and marital status served as covariates. The results showed a significant confounder-adjusted effect of injury severity and age of injury on the linear slope in functioning. The age effect was strongest for those with mild TBI. Thus, the effects of injury severity on functional trajectory were found to be moderated by age. To optimize outcomes, TBI rehabilitation should be developed specifically for older patients. Age should also be a major focus in TBI research.

Recommended Citation

Winter, Laraine; Mensinger, Janell L; Moriarty, Helene J; Robinson, Keith M; McKay, Michelle; and Leiby, Benjamin E, "Age Moderates the Effect of Injury Severity on Functional Trajectories in Traumatic Brain Injury: A Study Using the NIDILRR Traumatic Brain Injury Model Systems National Dataset." (2022). Department of Pharmacology and Experimental Therapeutics Faculty Papers. Paper 144.
https://jdc.jefferson.edu/petfp/144

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.

PubMed ID

35566607

Language

English