Long-term medical and psychosocial vulnerability after home return following severe traumatic brain injury.

Overview

1. IRCCS Centro Neurolesi Bonino-Pulejo, Messina
2. Golgi Redaelli Institute, Milan
3. Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy

Abstract

Objective: To identify a 5-year medical and psychosocial vulnerability profile among adults living at home 1 year after severe TBI and examine associated early characteristics.

Design: Retrospective secondary analysis of a multicentre longitudinal cohort.

Subjects/Patients: Adults aged 16 years or older with operationally defined severe traumatic brain injury, private residence at 1 year, linked 5-year follow-up, and complete data for 4 profile indicators.

Methods: Latent class analysis used 5-year rehospitalization, PHQ-9, GAD-7, and Satisfaction With Life Scale scores dichotomized with prespecified clinically interpretable thresholds. External rehabilitation outcomes and early associated factors were examined descriptively and with multivariable logistic regression.

Results: Among 2,835 participants, a 2-class solution identified a lower-vulnerability profile (n = 2,361) and a multidomain vulnerability profile (n = 474). The latter showed more depressive symptoms, anxiety symptoms, low life satisfaction, and rehospitalization, with poorer 5-year functioning, participation, health, productive status, and higher frequency of non-private residence. Better 1-year global outcome was protective; female sex, preinjury illicit drug use, and living alone at 1 year were associated with assignment to this profile.

Conclusion: Home return after severe traumatic brain injury should be treated as a transition point for longitudinal rehabilitation surveillance.

Reproduced under the paper's license (CC BY), from the paper cited above.

Code

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Data

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Data, code, and materials availability

The data that support the findings of this study are available from the Traumatic Brain Injury Model Systems (TBIMS) National Data and Statistical Center. De-identified data can be accessed by qualified investigators after completion of a Data Use Agreement through the TBIMS National Data and Statistical Center. The authors are not permitted to redistribute the dataset directly. Analytic code used for the present secondary analysis is available from the corresponding author on reasonable request to qualified investigators with authorized access to the relevant TBIMS dataset.

Reproduced under the paper's license (CC BY), from the paper cited above.

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Version 2, 28 September 2026

• Funding: added U.S. Department of Health and Human Services; Traumatic Brain Injury Model Systems National Data and Statistical Center; North Dakota Soybean Council; Ministero della Salute; Administration for Community Living

Version 1, 27 September 2026: the first record

Recorded: type, language, journal, volume, pages, dates, 9 authors, 7 keywords, 16 MeSH terms, 36 references.

Cite

This paper

CALDERONE, A., RIFICI, C., BONAIUTI, D., MANULI, A., BRUSCHETTA, D., PICCIONE, M., BALLETTA, T., QUARTARONE, A., & CALABRÒ, R. S. (2026). Long-term medical and psychosocial vulnerability after home return following severe traumatic brain injury. Journal of rehabilitation medicine, 58, 46093. https://doi.org/10.2340/jrm.v58.46093

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