Factors associated with completing comprehensive traumatic brain injury evaluation.

Area of Science:

• Neuroscience
• Public Health
• Military Medicine

Background:

• Traumatic Brain Injury (TBI) is a common injury among Iraq and Afghanistan Veterans.
• Early identification and comprehensive evaluation are crucial for managing TBI and preventing long-term disability.
• The Department of Veterans Affairs (VA) implemented a TBI screening protocol to identify at-risk Veterans.

Purpose of the Study:

• To identify factors associated with the completion of a comprehensive TBI evaluation among Iraq and Afghanistan Veterans following a positive initial VA TBI screen.
• To understand barriers and facilitators to TBI evaluation uptake in a veteran population.

Main Methods:

• Retrospective cohort study of 465 Iraq and Afghanistan Veterans with a positive initial TBI screen at a VA Medical Center and affiliated clinics.
• Data collected on demographics, clinical factors, and completion of the comprehensive TBI evaluation.
• Statistical analysis to determine factors associated with evaluation completion.

Main Results:

• 75% of Veterans completed the comprehensive TBI evaluation.
• Women were less likely to complete the evaluation compared to men (OR=0.33).
• Post-traumatic stress disorder (PTSD) avoidance symptoms were associated with lower completion rates (OR=0.52).
• Headaches, Hispanic ethnicity, and summer screening season were positively associated with completion.
• A significant minority of eligible Veterans did not complete the comprehensive evaluation.

Conclusions:

• Factors such as gender, PTSD symptomology, and referral timing influence TBI evaluation completion.
• Targeted interventions addressing gender-specific needs and PTSD avoidance may improve engagement.
• Optimizing referral processes and considering seasonal variations could enhance TBI care access for veterans.
• Improving follow-up rates is essential for early TBI management and preventing chronic disability.