Adverse Outcomes among Veterans who Screen Positive for TBI/do not Complete a TBI Evaluation

Thursday, November 10, 2022

3:15 PM – 3:31 PM

Presenting Author(s)

Terri K. Pogoda, PhD

Research Health Scientist
VA Boston Healthcare System
Boston, Massachusetts, United States

Slides Slides and Audio

Non-presenting Author(s)

MA

Megan Amuan, MPH

Health Statistician
VA Salt Lake City Health Care System, Informatics Decision Enhancement and Analytic Sciences Center of Innovation, Salt Lake City UT
North Andover, Massachusetts, United States
Kathleen Carlson, PhD

Investigator
VA Portland Healthcare System
Portland, Oregon, United States
Rachel S. Adams, PhD, MPH

Senior Scientist
Brandeis University
Waltham, Massachusetts, United States
Clara E. Dismuke-Greer, PhD (she/her/hers)

Research Health Science Specialist
Health Economics Resource Center (HERC), Ci2i, VA Palo Alto Healthcare System
Brunswick, Georgia, United States
Mary Jo Pugh, PhD, RN

Research Career Scientist/Professor
VA Salt Lake City/University of Utah
Salt Lake City, Utah, United States

We reviewed Department of Defense (FY00-FY19) and Department of Veterans Affairs (VA) (FY01-FY19) data to examine whether Veterans who screened positive for mild traumatic brain injury (mTBI), but did not complete a Veterans Health Administration (VHA) Comprehensive TBI Evaluation (CTBIE), were at higher hazard for adverse outcomes compared to Veterans who screened negative for TBI. The adverse outcomes were incident diagnoses of substance use disorder (SUD), alcohol use disorder (AUD), opioid use disorder (OUD), overdose, and homelessness within 3 years of TBI screening. All Veterans had at least 1 VHA visit each year following their TBI screen or an indication of death during this time. Compared to Veterans who screened negative for TBI, Veterans who screened positive for mTBI but never completed a CTBIE were at increased hazard for incident SUD, AUD, OUD, overdose, and homelessness following their TBI screening, after controlling for demographic, military, and regional covariates.

Learning Objectives:

Describe the screening and evaluation process for determining deployment-related mTBI history among Post-9/11 Veterans.
Identify adverse outcomes that different groups of Post-9/11 Veterans screened for mTBI may be at risk for.
Discuss policy initiatives that can be undertaken to ensure that Post-9/11 Veterans with mTBI are adequately identified, evaluated, and treated.