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Brain Inj ; 33(13-14): 1602-1614, 2019.
Article in English | MEDLINE | ID: mdl-31476880

ABSTRACT

Background: Research has shown that number of and blast-related Traumatic Brain Injuries (TBI) are associated with higher levels of service-connected disability (SCD) among US veterans. This study builds and tests a prediction model of SCD based on combat and training exposures experienced during active military service.Methods: Based on 492 US service member and veteran data collected at four Department of Veterans Affairs (VA) sites, traditional and Machine Learning algorithms were used to identify a best set of predictors and model type for predicting %SCD ≥50, the cut-point that allows for veteran access to 0% co-pay for VA health-care services.Results: The final model of predicting %SCD ≥50 in veterans revealed that the best blast/injury exposure-related predictors while deployed or non-deployed were: 1) number of controlled detonations experienced, 2) total number of blast exposures (including controlled and uncontrolled), and 3) the total number of uncontrolled blast and impact exposures.Conclusions and Relevance: We found that the highest blast/injury exposure predictor of %SCD ≥50 was number of controlled detonations, followed by total blasts, controlled or uncontrolled, and occurring in deployment or non-deployment settings. Further research confirming repetitive controlled blast exposure as a mechanism of chronic brain insult should be considered.


Subject(s)
Brain Injuries, Traumatic/epidemiology , Combat Disorders/epidemiology , Disabled Persons , Military Personnel , United States Department of Veterans Affairs/trends , Veterans , Adult , Aged , Blast Injuries/diagnosis , Blast Injuries/epidemiology , Blast Injuries/psychology , Brain Injuries, Traumatic/diagnosis , Brain Injuries, Traumatic/psychology , Cohort Studies , Combat Disorders/diagnosis , Combat Disorders/psychology , Disabled Persons/psychology , Female , Forecasting , Humans , Longitudinal Studies , Male , Middle Aged , Military Personnel/psychology , Models, Theoretical , United States/epidemiology , Veterans/psychology , Young Adult
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