An evaluation of the Veterans Affairs traumatic brain injury screening process among Operation Enduring Freedom and/or Operation Iraqi Freedom veterans

PM R. 2013 Mar;5(3):210-20; quiz 220. doi: 10.1016/j.pmrj.2012.12.004. Epub 2013 Jan 29.

Abstract

Objective: To describe the early results of the U.S. Department of Veterans Affairs (VA) screening program for traumatic brain injury (TBI) and to identify patient and facility characteristics associated with receiving a TBI screen and results of the screening.

Design: National retrospective cohort study.

Setting: VA Medical facilities.

Patients: A total of 170,681 Operation Enduring Freedom and/or Operation Iraqi Freedom (OEF/OIF) Veterans who sought care at VA medical facilities from April 2007 to September 30, 2008.

Methods: Data were abstracted from VA administrative and operational databases, including patient demographics, facility characteristics, and outcomes.

Main outcome measurements: The main outcomes were receipt of and results of the TBI screen.

Results: The majority of veterans eligible received the TBI screen (91.6%). Screening rates varied by patient and facility characteristics. In all, 25% of screened veterans had probable TBI exposure, in which the majority of the exposures were blasts (85.0%). The rate of a positive TBI screen was 20.5% for the screened cohort. Male gender, service in the army, multiple deployments, and mental health diagnoses in the previous year were associated with a positive screen.

Conclusions: TBI screening rates are high in VA; concomitant mental health diagnoses were highly prevalent in individuals with positive TBI screens. These data indicate that there will be a significant need for long-term health care services for veterans with TBI symptomatology.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Afghan Campaign 2001-
  • Black People / statistics & numerical data
  • Black or African American
  • Blast Injuries / epidemiology
  • Brain Injuries / diagnosis*
  • Brain Injuries / epidemiology*
  • Cohort Studies
  • Depression / epidemiology
  • Headache / epidemiology
  • Hospitals, Veterans
  • Humans
  • Iraq War, 2003-2011
  • Irritable Mood
  • Logistic Models
  • Male
  • Marital Status / statistics & numerical data
  • Mass Screening / statistics & numerical data*
  • Retrospective Studies
  • Sex Factors
  • Sleep Wake Disorders / epidemiology
  • Stress Disorders, Post-Traumatic / epidemiology
  • United States / epidemiology
  • Veterans / statistics & numerical data*
  • White People / statistics & numerical data