Long-term physical and mental health outcomes associated with traumatic brain injury severity in post-9/11 veterans: A retrospective cohort study

ABSTRACT

Objectives: To examine long-term outcomes of self-reported physical and mental health among Post-9/11 Veterans stratified by traumatic brain injury (TBI) severity, we hypothesized that more severe TBI would be associated with significantly poorer outcomes.

Methods: A prospective longitudinal survey of physical and mental health status was conducted with a national cohort of Post-9/11 Veterans. We then used generalized linear models (GLM) to assess the unique contribution of TBI severity on long-term outcomes after controlling for socio-demographic characteristics, comorbidity phenotypes, and deployment experiences.

Results: TBI of any severity was associated with significantly poorer outcomes relative to the No TBI group. However, the manifestation of these outcomes identified in our study differed meaningfully by TBI severity level.

Conclusions: Veterans with any TBI exposure experience poorer long-term outcomes than those with no TBI even when covariates are considered. In particular, measures of somatization, PTSD symptom distress, and depression indicate pervasive and long-term health concerns among individuals with TBI. Additional research is required to fully explicate what appear to be complex relationships among TBI severity, physical and mental well-being, combat exposures, and socioeconomic resources in this population.

KEYWORDS:

• Comorbidity
• mental health
• stress disorders
• health status
• self report

Acknowledgements

The authors thank the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, VA Health Services Research and Development Service, South Texas Veterans Healthcare System/Audie L. Murphy Division, the Edith Nourse Rogers VA Memorial Hospital, and the Joint Trauma System for their support. The authors also acknowledge assistance with data collection and manuscript preparation by Natalie Rohde, Margaret Wells, Barbara Elizondo and Kathleen Franklin. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs or the Department of Defense.

Additional information

Funding

This work was supported by the Health Services Research and Development [grant number DHI 09-237], [grant number IK6 HX002608-01].