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Disruptive Dizziness Among Post-9/11 Veterans With Deployment-Related Traumatic Brain Injury.

Alicia A Swan¹, Faith W Akin, Megan E Amuan

¹Department of Psychology, The University of Texas at San Antonio, San Antonio (Dr Swan and Ms Crowsey); South Texas Veterans Health Care System, San Antonio (Dr Swan); James H Quillen VA Medical Center, Mountain Home, Tennessee (Drs Akin and Hall); Departments of Audiology and Speech Language Pathology (Dr Akin) and Rehabilitative Sciences (Dr Hall), East Tennessee State University, Johnson City; Informatics, Decision-Enhancement and Analytic Sciences Center (IDEAS 2.0), VA Salt Lake City Health Care System, Salt Lake City, Utah (Mss Amuan and Padilla and Drs Kalvesmaki and Pugh); Department of Internal Medicine, University of Utah, Salt Lake City (Mss Amuan and Padilla and Drs Kalvesmaki and Pugh); Department of Head and Neck Surgery & Communication Sciences, Duke University, Durham, North Carolina (Dr Riska); and Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina (Dr Riska).

The Journal of Head Trauma Rehabilitation

|July 28, 2021

Summary

This summary is machine-generated.

Veterans with traumatic brain injury (TBI) are more likely to receive dizziness diagnoses when they access specialty care. Black veterans and those with substance use disorders were less likely to be diagnosed, highlighting care gaps.

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Area of Science:

Neuroscience and neurology
Military health and veteran affairs
Audiology and vestibular science

Background:

Traumatic brain injury (TBI) is common in post-deployment veterans.
Dizziness and vestibular dysfunction are frequent, disruptive symptoms following TBI.
Understanding diagnostic patterns for these symptoms is crucial for veteran care.

Purpose of the Study:

To identify factors associated with receiving diagnoses for dizziness symptoms after deployment-related TBI.
To investigate disparities in dizziness and vestibular dysfunction diagnoses among veterans.

Main Methods:

Retrospective observational study using administrative data from the Department of Veterans Affairs (VA).
Included post-9/11 veterans with TBI-related dizziness symptoms and at least 3 years of VA care.
Analyzed International Classification of Diseases (ICD-9-CM) codes for dizziness, vestibular dysfunction, and postconcussive conditions.

Main Results:

Increased access to or utilization of VA specialty care significantly predicted dizziness and/or vestibular dysfunction diagnoses.
Black non-Hispanic veterans and those with substance use disorder diagnoses were less likely to receive these diagnoses.
Specialty care access was the strongest predictor for receiving a dizziness diagnosis.

Conclusions:

Facilitating access to specialized care is vital for veterans experiencing dizziness post-TBI.
Disparities in diagnosis exist, particularly for Black veterans and those in rural areas.
Enhanced cultural competency, telemedicine, and patient education may address care gaps.