These results affirm the external validity of the PCSS 4-factor model, showing comparable symptom subscale measurements amongst diverse racial, gender, and competitive groups. The PCSS and 4-factor model's continued use to evaluate concussed athletes across a variety of populations is validated by these findings.
The PCSS 4-factor model is supported by external evidence, with these results demonstrating equivalent symptom subscale measurements across different racial and gender demographics, along with varied competitive levels. In evaluating a varied group of concussed athletes, the findings support the sustained applicability of the PCSS and 4-factor model.
Predictive utility of the Glasgow Coma Scale (GCS), time to follow commands (TFC), length of post-traumatic amnesia (PTA), duration of impaired consciousness (TFC+PTA), and Cognitive and Linguistic Scale (CALS) scores, in predicting long-term Glasgow Outcome Scale-Extended, Pediatric Revision (GOS-E Peds) outcomes for children with traumatic brain injury (TBI), two months and one year after their rehabilitation discharge.
Inpatient rehabilitation, a crucial component of this large urban pediatric medical center.
The sample consisted of sixty youth, averaging 137 years of age at the time of moderate to severe TBI occurrence (range = 5-20).
A study of past patient charts.
The lowest Glasgow Coma Scale (GCS) score post-resuscitation, along with Total Functional Capacity (TFC), Performance Task Assessment (PTA), the sum of TFC and PTA, and inpatient rehabilitation admission and discharge Clinical Assessment of Language Skills (CALS) scores, were evaluated at 2-month and 1-year follow-ups, as were the Glasgow Outcome Scale-Extended (GOS-E Peds) scores.
Both admission and discharge CALS scores demonstrated a statistically significant correlation with GOS-E Peds scores. The initial correlation was weak to moderate, and the correlation at discharge was moderate. Gos-E Peds scores at two months were correlated with both TFC and TFC+PTA measures; TFC demonstrated predictive ability at the one-year point. A correlation analysis between the GCS and PTA, and the GOS-E Peds, revealed no relationship. The stepwise linear regression model revealed that, of all variables, only the CALS score at discharge was a statistically significant predictor for GOS-E Peds scores at both the 2-month and 1-year follow-up assessments.
The CALS exhibited a correlational relationship with long-term disability, with better performance associated with less long-term disability. Conversely, the TFC showed a correlation with long-term disability, with longer times associated with more long-term disability, as measured by the GOS-E Peds. The CALS value at discharge was the sole significant predictor of GOS-E Peds scores at 2 and 12 months post-discharge, explaining approximately 25% of the observed variance in GOS-E scores in this sample. Variables linked to the rate of recuperation are potentially better indicators of the outcome, as suggested by prior research, in comparison to the variables associated with the initial severity of the injury (e.g., GCS). For the benefit of both clinical practice and research initiatives, subsequent multi-location studies are imperative to improve sample size and standardize data collection techniques.
Our correlational analysis revealed an association between higher CALS scores and reduced long-term disability, while longer TFC durations were linked to increased long-term disability, as assessed by the GOS-E Peds. Among this sample, the CALS score at discharge was the only persistent and substantial predictor of GOS-E Peds scores at the two-month and one-year follow-ups, explaining about 25% of the variance. Studies conducted previously suggest that factors associated with the rate of recovery might be better indicators of the final result than variables reflecting the immediate degree of injury severity, such as the Glasgow Coma Scale (GCS). Future multi-site studies should be conducted to increase the sample size and standardize data collection protocols for both clinical practice and research.
People of color (POC) facing multiple social disadvantages, such as non-English language speakers, women, senior citizens, or those from lower socioeconomic strata, continue to experience inadequate healthcare provision, contributing to inferior health outcomes and elevated health risks. While traumatic brain injury (TBI) disparity research may emphasize individual factors, it frequently fails to capture the compounding effects of belonging to multiple historically marginalized groups.
To assess the intersectional influence of multiple vulnerable social identities impacted by traumatic brain injury (TBI) on mortality, opioid use during the acute phase of hospitalization, and the location of discharge.
A retrospective observational study design used combined data from electronic health records and local trauma registries. Patient cohorts were segmented based on racial and ethnic identification (people of color or non-Hispanic white), age, sex, insurance status, and spoken language (English or non-English). Systemic disadvantage clusters were identified through the application of latent class analysis (LCA). GS-5734 Outcome measures across latent classes were then analyzed, looking for differences between them.
Across an eight-year timeframe, 10,809 patients requiring admission due to traumatic brain injury (TBI) were documented, with 37% belonging to minority groups. Following the LCA procedure, a four-class model was identified. GS-5734 Mortality rates correlated with the degree of systemic disadvantage within specific groups. Acute care facilities serving older patient groups saw lower opioid use rates and a decreased likelihood of referral to inpatient rehabilitation. Sensitivity analyses, focused on supplementary indicators of TBI severity, displayed that the younger demographic, burdened by greater systemic disadvantage, experienced more severe TBI. Statistical significance regarding mortality among younger individuals was affected by the incorporation of additional indicators reflecting TBI severity.
Study results underscore substantial health inequities in mortality and access to inpatient rehabilitation services after a traumatic brain injury (TBI), and more severely injured younger patients often have greater social disadvantage. While numerous inequities might be connected to systemic racism, our study suggested an additional, detrimental impact for patients who identified with multiple historically marginalized groups. GS-5734 The role of systemic disadvantage in shaping the healthcare journey of individuals with traumatic brain injury requires further study and analysis.
Significant health inequities manifest in TBI mortality and inpatient rehabilitation access, alongside higher severe injury rates observed in younger patients with more pronounced social disadvantages. Given the potential link between systemic racism and various inequities, our research indicated a compounded, detrimental effect for patients who belonged to multiple marginalized groups historically. A deeper understanding of systemic disadvantage's impact on individuals with TBI within the healthcare framework requires further study.
Pain severity, its impact on daily life, and prior pain management are to be compared across non-Hispanic White, non-Hispanic Black, and Hispanic individuals with both traumatic brain injury (TBI) and ongoing chronic pain, to determine if there are disparities.
Community-based care following a stay in inpatient rehabilitation.
Following acute trauma care and inpatient rehabilitation, a total of 621 individuals, with moderate to severe TBI medically documented, were analyzed, which included 440 non-Hispanic Whites, 111 non-Hispanic Blacks, and 70 Hispanics.
A research study, employing a cross-sectional survey methodology, involved multiple centers.
The receipt of opioid prescriptions, the Brief Pain Inventory, the receipt of nonpharmacologic pain treatments, and receipt of comprehensive interdisciplinary pain rehabilitation are all noteworthy components.
Following the control of relevant sociodemographic factors, non-Hispanic Black individuals demonstrated a greater level of pain severity and experienced a greater degree of pain interference compared to non-Hispanic White individuals. The interplay of race/ethnicity and age revealed larger differences in severity and interference between White and Black individuals, especially among the older participants and those with less than a high school diploma. There was no difference in the likelihood of having received pain treatment when comparing across racial and ethnic demographics.
Non-Hispanic Black individuals with both TBI and chronic pain may experience a higher degree of vulnerability in terms of controlling the severity of their pain and its impact on their daily activities, encompassing mood disturbance. Chronic pain in individuals with TBI requires a holistic assessment and treatment plan that acknowledges the systemic biases impacting Black individuals' social determinants of health.
Among individuals with TBI experiencing chronic pain, non-Hispanic Black individuals may be more prone to experiencing issues controlling pain intensity and its impact on activities and mood. In evaluating and treating chronic pain in individuals with TBI, a holistic perspective must include the crucial consideration of systemic biases impacting Black communities regarding their social determinants of health.
A study exploring racial and ethnic variations in suicide and drug/opioid overdose mortality among a population-based cohort of military service members with a diagnosis of mild traumatic brain injury (mTBI) sustained during their military service.
A cohort study, conducted retrospectively, was reviewed.
Military personnel who sought care within the Military Health System from 1999 to 2019.
Across the period spanning 1999 to 2019, the military personnel records documented 356,514 members aged 18 to 64, whose first TBI diagnosis was mTBI while actively serving or activated.
The National Death Index employed ICD-10 codes to determine fatalities attributed to suicide, drug overdose, and opioid overdose. Race and ethnicity characteristics were documented in the Military Health System Data Repository.