Violent traumatic brain injury: occurrence, patient characteristics, and risk factors from the Traumatic Brain Injury Model Systems project

Arch Phys Med Rehabil. 2003 Feb;84(2):249-54. doi: 10.1053/apmr.2003.50096.


Objectives: To examine the occurrence of and characteristics associated with violent traumatic brain injury (TBI) in the Traumatic Brain Injury Model Systems (TBIMS) project for 4 of the 5 original Model Systems centers and to determine the patient characteristics of this group, as well as the risk factors for sustaining such an injury.

Design: Prospective evaluation of individuals with violent TBI over a 10-year period.

Setting: Four TBIMS centers.

Participants: A total of 1,229 individuals who received acute hospitalization and inpatient rehabilitation care for TBI.

Interventions: Not applicable.

Main outcome measure: The occurrence of a violent TBI.

Results: Twenty-six percent of the participants in the TBIMS project sustained a violent TBI. This type of injury was more common in African-American men who were single and slightly older than the average TBI patient, were unemployed before injury, and had had a previous TBI. A higher injury rate was noted in the earlier part of the evaluation period. Those who sustained a violent TBI had higher levels of caregiver burden and disability, as well as decreased productivity and community reintegration at rehabilitation discharge and at 1 and 2 years postinjury.

Conclusions: The occurrence of violent TBI in the TBIMS project is consistent with national trends of decreasing incidence of violent injuries in the 1990s. These results present a profile of those who have been injured through violence. The relative risks for sustaining such an injury appear to be well defined when considering demographic and temporal factors.

Publication types

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

MeSH terms

  • Adult
  • Alcohol Drinking
  • Brain Injuries / epidemiology*
  • Brain Injuries / rehabilitation
  • Female
  • Health Status Indicators
  • Humans
  • Incidence
  • Logistic Models
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • United States / epidemiology