Brain Injury

John Muir Traumatic Brain Injury Research Project Supports Current Research

Recognition that head injury is a major public health problem has led to several studies over the past decade to produce epidemiological data in order to devise effective preventive measures, and to plan the most appropriate health care provision both for acute care and the rehabilitation of disabled survivors." (Jennet, 1996, p.362)

John Muir's NSI TBI Research Group recently completed a study on Mild Traumatic Brain Injury to determine whether patients likely to have a more problematic outcome could be identified during the acute state of their hospitalization for an MTBI, and if so, what instruments (psychodiagnostic measures and/or clinical assessments) would be most effective in identifying those patients who would have a more complicated/problematic outcome after their hospitalization.

The TBI Research Group, comprised of Geoffrey Adey, M.D.; Terence Chen, M.D.; Susan Colligan, Ph.D.; Kristy G aub, R.N.; Howarrd Taekman, M.D.; Jen T el,lier, Psy.D Cheryl Wolcott, Ph.D. and Randall Yee, Ph.D. studied two hundred fifty-five hospitalized patients who sustained an MTBI and were admitted to the Trauma Service at John Muir Medical Center, Walnut Creek Campus. The patients were diagnosed with a concussion upon admittance.

Approximately 10 percent of the subjects (probably a low estimate) reported less favorable functional outcome, as measured by a Community integration questionnaire. There were several individually statistically significant correlates of outcome. Results indicated that subjects who scored higher on Major Depression and Post Traumatic Stress Disorder Scales on the MCMI-III (Millon, 1994) and endorsed significant symptomatology at baseline assessment such as problems with finances and relationships reported a less favorable outcome in terms of their re-integration into the community.

In addition, subjects who reported more difficulty maintaining activities of daily living at baseline assessment, had a blood alcohol content level above the legal limit in California (BAC ³ .08) at the time of injury, or were involved in litigation at follow-up reported a significantly less favorable outcome.

Conclusions

The majority of individuals who have suffered an MTBI recover to premorbid levels of functioning without any major difficulty. However, based on a rowing body of research and John Muir's own experience we not know that long term cognitive, emotional and behavioral consequences affect a significant proportion of these MTBI patients. Psychosocial dysfunction and secondary psychological symptoms such as personality style, substance abuse, financial concerns, and litigation can impact functional outcome and can occur later in recovery when the person attempts to resume pre-injury activities.

Predictors of Functional Outcome in Mild Traumatic Brain Injury

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