Causes of mortality among veterans previously hospitalized after traumatic brain injury

Research Objectives: To examine mortality rates and causes among Veterans with traumatic brain injury (TBI) following discharge from inpatient rehabilitation

Design: Secondary analysis; Cohort study

Setting: Five Veterans Affairs (VA) Polytrauma Rehabilitation Centers

Participants: Persons enrolled in the VA Traumatic Brain Injury Model Systems (TBIMS) who were admitted to rehabilitation within one year of TBI and discharged (alive) from rehabilitation between 01/01/2009 and 03/31/2020, and who died after rehabilitation discharge (N=82).

Interventions: N/A

Main Outcome Measures: Mortality

Results: The mortality rate was 8.3% for participants within this study’s time frame. Most deaths (46.9%) occurred between 2 and 5 years from discharge. Reasons for death (among the known causes: 74%) were as follows: external causes of injury (30%), circulatory (20%), respiratory (16%), digestive (11%), neoplasm (11%), nervous system (10%), and infectious disease (2%).

Conclusions: Overall mortality rate was comparable to research in the civilian TBIMS (9-10%). Prior research implicated circulatory conditions as the most common cause of death, but in this study, the primary reasons were external causes (e.g., late effects of intracranial trauma; suicide). Digestive conditions (e.g., alcoholic liver disease) were the fourth most common cause of death yet a negligible cause in the general TBI population. Implications of the current findings include targeted clinical interventions for prevention or treatment of causes of mortality among veterans following discharge.

Author(s) Disclosures: Supported in part by NIDILRR [grant #90DPTB0002] (Hammond). Conducted with resources and use of facilities at the following: Hunter Holmes McGuire VA, Richmond, VA; James A. Haley VA, Tampa, FL; Minneapolis VA, Palo Alto VA, and South Texas VA. The authors declare no conflicts of interest. The views expressed here are the authors’ and do not necessarily represent official policy/position of any federal government agency. This work was prepared under Contract HT0014-21-C-0012 [DHA Contracting Office (CO-NCR) HT0014] and defined as U.S. Government work under Title 17 U.S.C.§101. Per Title 17 U.S.C.§105, copyright protection is not available. For more information, contact TBICOEinfo@mail.mil. UNCLASSIFIED