Characteristics of Firearm Brain Injury Survivors in the Traumatic Brain Injury Model Systems (Tbims) National Database: A Comparison of Assault and Self-Inflicted Injury Survivors

Publication date: Available online 4 May 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Hilary Bertisch, Jason Krellman, Thomas Bergquist, Laura E. Dreer, Valerie Ellois, Tamara Bushnik
ObjectiveTo characterize and compare subgroups of survivors with assault-related versus self-inflicted traumatic brain injuries (TBI) via firearms at time of inpatient rehabilitation, 1, 2, and 5 year follow-up.DesignSecondary analysis of data from the Traumatic Brain Injury Model Systems National Database (TBIMS NDB), a multicenter longitudinal cohort study.SettingRetrospective analyses of a subset of individuals enrolled in the TBIMS NDB.ParticipantsIndividuals 16 years and older (N=399; 310 via assault and 89 via self-inflicted injury) with a primary diagnosis of TBI due to firearm injury enrolled in the TBIMS NDB.Main Outcome MeasuresDisability Rating Scale (DRS), Glasgow Outcome Scale-Extended (GOS-E), socio-demographic variables (sex, age, race, marital status), injury-related/acute care information (posttraumatic amnesia, loss of consciousness, time from injury to acute hospital discharge) and mental health variables (i.e., substance use history, psychiatric hospitalizations, suicide history, incarcerations).ResultsIndividuals who survived TBI secondary to a firearm injury differed by injury mechanism (assault versus self-inflicted) on critical demographic, injury-related/acute care, and mental health variables at inpatient rehabilitation and across long-term recovery. Groups differed in terms of geographic area, age, ethnicity, education, marital status, admission GCS, and alcohol abuse, suicide attempts, and psychiatric hospitalizations at various time points.ConclusionThese findings have implications for prevention, for example mental health programming and access to firearms in targeted areas, and for rehabilitation planning, for instance by incorporating training with coping strategies and implementation of addictions-related services for firearm-related TBI, based upon subtype of injury.



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