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The VA Polytrauma Rehabilitation Center(PRC) Traumatic Brain Injury (TBI)Model SystemsA project funded by the U.S. Department of Veterans Affairs in collaborationwith the National Institute on Disability, Independent Living, and RehabilitationResearch (NIDILRR) and the Defense and Veterans Brain Injury Center (DVBIC)Data represents database as of 12/31/2019
Congressional Mandate As part of Public Law 110-181– Jan 28 2008, congressestablished means for the VAto specifically coordinateresearch focusing onTraumatic Brain Injury withboth the National Institute onDisability, Independent Living,and Rehabilitation Research(formerly NIDIRR) and theDefense and Veterans BrainInjury Center of theDepartment of Defense.
Collaboration: NIDILRR and VA PRC TBI Model SystemsNIDILRR TBI Model SystemsEstablished 1987Goal: Prospective, longitudinal, multi-center study.Examines TBI recovery and outcomes followingcoordinated acute medical care and inpatientrehabilitation. 16 Funded Centers1 National Data and Statistical Center (Craig Hospital)1 Knowledge Translation Center 18,000 participants enrolledConducting follow-up at years 1, 2, 5, and every 5years thereafter Special Interest Groups, Committees, & ModulesVA PRC TBI Model SystemsEstablished 2009. Parallel to the civiliancenters.Goal: To establish a longitudinal databaseof rehabilitation outcomes in servicemembers and veterans who receiveinpatient rehabilitation for TBI and are inthe acute and/or chronic stages ofrecovery. 5 Funded Centers 1 National Data and Statistical Center(Craig Hospital) 1,300 participants enrolled
Collaboration: NIDILRR and VA PRC TBI Model Systems
VA PRC TBI Model Systems SitesPalo Alto, CAMinneapolis, MNRichmond, VASan Antonio, TXTampa, FL
VA PRC TBIMS Database Inclusion CriteriaVeteran or Service Member sustained a TBI using the VA/DoDconsensus definition; includes all severity levels (mild to severe TBI)Age 16 or older at time of index TBI, but age 18 or older at time ofconsentAdmitted to a VA PRC or Polytrauma Transitional RehabilitationProgram (PTRP) units
Departments of Defense and VA ConsensusDefinition of Traumatic Brain Injury (TBI)A traumatically induced structural injury and/or physiological disruption of brainfunction as a result of an external force (e.g., object strikes head, head strikesobject, acceleration/deceleration movement) that is indicated by new onset orworsening of at least one of the following clinical signs, immediately following theevent Any period of loss of or a decreased level of consciousness; Any loss of memory for events immediately before or after the injury; Any alteration in mental state at the time of the injury (confusion, disorientation, slowedthinking, etc.); Neurological deficits (weakness, loss of balance, change in vision, praxis, paresis/plegia,sensory loss, aphasia, etc.) that may or may not be transient; Intracranial /rehab/mtbi/)
VA PRC TBIMS Data Collection ProcessEnrollFollow-up(Form 1)(Form 2)608 Variables570 VariablesEnrollment datagathered from medicalrecords, patients, andfamily membersFollow-up at year 1, 2, 5and every 5 yearsthereafter. Data from inperson or phone interviewsor mail-out questionnaires
VA PRC TBIMS Data CategoriesDemographic characteristics Examples include age, gender, race/ethnicity, height, weight, primary language,country of birth, military historyInjury-related information Examples include date of injury, cause of injury, spinal cord injury, amputationfrom injury, neuroimagingCharacteristics of treatment/rehabilitation services Examples include pathways of care, length of stay, neurosurgery, rehospitalization
VA PRC TBIMS Data CategoriesImpairment and Disability Examples include mortality, lifetime history of TBI, clinician-rated functioning,level of supervision neededMental and Behavioral Health Measurements Examples include PTSD, depression, anxiety, substance use, legal problems,learning problems, satisfaction with life, post-concussive symptomsSocial Participation and Community Reintegration Examples include clinician-rated social engagement, residential status, maritalstatus, employment, education, transportation
Collaboration: DVBIC and VA PRC TBI Model SystemsI-MAP: Improved Understanding of Medical andPsychological Needs in Veterans and ServiceMembers with TBIIn 2015, Dr. RisaNakase-Richardson(Tampa PRC) wasawarded a grantfrom DVBIC.Goal: Identify comorbidchronic health conditions;describe health care needs;identify factors impactingongoing needs post-TBIAdded to Form 1:Added to Form 2s:Comorbidity DataComorbidity DataVeteran NeedsFamily Needs
Current VA PRC TBIMS National DatabaseForm 1Form 21,362 individuals enrolled as ofDecember 31, 20193,956 follow-ups (72% followed)83 individuals enrolled into PTRP onlyYear 1: 1,403 (72% followed)Year 2: 1,281 (73% followed)Year 5: 922 (73% followed)
Current VA PRC TBIMS National DatabaseAge RangeGenderRaceCause of TBIEducation 17-91 Years 95% Male 81% Caucasian Vehicular (44%) Violence/Blasts (18%) Falls (17%) Penetrating (4%) At least some college (59%)Emerging Consciousness Program 8%
Current VA PRC TBIMS National DatabaseAt Injury At Year 1 At Year 2 97% Private Residence74% Private Residence83% Private Residence49% Married38% Married39% Married18% Living Alone15% Living Alone17% Living Alone82% Employed22% Employed23% Employed64% Active Duty68% Independent71% Independent
Dissemination/Implementation of TBIMS Findings
Dissemination/Implementation of TBIMS FindingsInternalImplementation The VA PRC TBIMS researchers collaboratewith the clinical teams at each of the PRCs toshare recent findings and to discusstranslating those findings to best practices.ExternalDissemination The VA PRC TBIMS researchers haveproduced 183 presentations at national andlocal research conferences and 58publications in peer-reviewed journals.
VA PRC TBI Model Systems terDatabase/index.aspOnline VA PRC TBI ModelSystems Database SyllabusNational and InternationalPresentationsDisseminating VA PRCTBIMS Findings
Veteran Knowledge TranslationNewsletters can be found onthe VA Polytrauma nterDatabase/
The VA Polytrauma Rehabilitation Center (PRC) Traumatic Brain Injury (TBI) Model Systems A project funded by t
