Cross-sectional Analysis of Demographics and Injury Characteristics of Persons Hospitalized for Psychiatric Reasons Following Discharge From Traumatic Brain Injury Rehabilitation

Research Objectives: Most studies of rehospitalization following traumatic brain injury (TBI) examine all-cause, with scant research on hospitalization for psychiatric reasons. This is despite research showing that psychiatric disorders are common following TBI, with rates of psychiatric hospitalization ranging from 5-10% during the chronic recovery phase. In this study, persons with and without psychiatric hospitalization within the first 5 years of TBI were compared on demographic and injury-related characteristics.

Design: Secondary analysis of the TBI Model Systems longitudinal multicenter study. Follow up interviews occurred at 1-, 2-, and/or 5-years post-TBI.

Setting: Five Veterans Affairs Polytrauma Rehabilitation Centers.

Participants: In this observational study, Veterans who completed a 1 year (N=1006), 2-year (N=985), or 5-year (N=772) post-TBI follow up. Lost to follow up rate was 7.8-14.5% depending on follow up year. Retention rate at each year was 79%, 77%, and 72%, respectively.

Interventions: N/A

Main Outcome Measures: Psychiatric rehospitalization.

Results: Per univariable analyses, predictors of psychiatric rehospitalization at 1-, 2-, and 5-year follow-up were pre-TBI psychiatric hospitalization (OR=4.48, p<.01; OR=4.49, p<.01; OR=3.74, p<.01) and pre-TBI mental health treatment (OR=2.20, p=.01;OR=2.46, p<.01; OR=2.97, p<.01). At years 1 and 2 follow up only, pre-TBI suicide attempts predicted psychiatric rehospitalization (OR=3.68, p<.01; OR=2.61, p=.01), while active duty status (versus veteran) at time of TBI were less likely to be psychiatrically rehospitalized. Duration of posttraumatic amnesia did not predict psychiatric rehospitalization at 1, 2, or 5-years post-TBI.

Conclusions: Analysis revealed that pre-TBI psychiatric hospitalization and mental health treatment predicted post-TBI psychiatric rehospitalization consistently during the first 5 years post-TBI. Follow up multivariable analysis is needed to better account for shared variance and shed light on unique predictors.

Author(s) Disclosures: The authors declare no conflicts of interest. The views expressed are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. This work was prepared under Contract HT0014-22-C-0016 with DHA Contracting Office (CO-NCR) HT0014 and, therefore, is defined as U.S. Government work under Title 17 U.S.C.§101.