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Disruptive Dizziness among Post-9/11 Veterans with Deployment-Related Traumatic Brain Injury
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In: ETSU Faculty Works (2021)
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Abstract:
Objective: To identify disruption due to dizziness symptoms following deployment-related traumatic brain injury (TBI) and factors associated with receiving diagnoses for these symptoms. Setting: Administrative medical record data from the Department of Veterans Affairs (VA). Participants: Post-9/11 veterans with at least 3 years of VA care who reported at least occasional disruption due to dizziness symptoms on the comprehensive TBI evaluation. Design: A cross-sectional, retrospective, observational study. Main Measures: International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes of dizziness, vestibular dysfunction, and other postconcussive conditions; neurobehavioral Symptom Inventory. Results: Increased access to or utilization of specialty care at the VA was significant predictors of dizziness and/or vestibular dysfunction diagnoses in the fully adjusted model. Veterans who identified as Black non-Hispanic and those with substance use disorder diagnoses or care were substantially less likely to receive dizziness and vestibular dysfunction diagnoses. Conclusions: Access to specialty care was the single best predictor of dizziness and vestibular dysfunction diagnoses, underscoring the importance of facilitating referrals to and utilization of specialized, comprehensive clinical facilities or experts for veterans who report disruptive dizziness following deployment-related TBI. There is a clear need for an evidence-based pathway to address disruptive symptoms of dizziness, given the substantial variation in audiovestibular tests utilized by US providers by region and clinical specialty. Further, the dearth of diagnoses among Black veterans and those in more rural areas underscores the potential for enhanced cultural competency among providers, telemedicine, and patient education to bridge existing gaps in the care of dizziness.
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Keyword:
Audiology and Speech-Language Pathology; brain injuries; dizziness; health services; traumatic; vestibular diseases; veterans
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URL: https://doi.org/10.1097/HTR.0000000000000714 https://dc.etsu.edu/etsu-works/9700
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2 |
Association of Traumatic Brain Injury with Vestibular Dysfunction and Dizziness in Post-9/11 Veterans
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In: ETSU Faculty Works (2020)
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3 |
Effects of Noise Exposure on the Vestibular System: A Systematic Review
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In: ETSU Faculty Works (2020)
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Impact of Otolith Dysfunction on Postural Stability and Quality of Life: a Chronic Effects of Neurotrauma Consortium Study
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In: ETSU Faculty Works (2019)
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5 |
The Development of the Benign Paroxysmal Positional Vertigo Symptom Impact Questionnaire (BSIQ)
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In: ETSU Faculty Works (2019)
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6 |
Noise and Blast-related Effects on Vestibular and Balance Function
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In: ETSU Faculty Works (2018)
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7 |
Sensory Dysfunction and Traumatic Brain Injury Severity Among Deployed Post-9/11 Veterans: A Chronic Effects of Neurotrauma Consortium Study
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In: ETSU Faculty Works (2018)
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8 |
Longitudinal consequences of mTBI and blast exposure on vestibular and balance function: preliminary observations
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In: ETSU Faculty Works (2018)
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9 |
Impact of Otolith Dysfunction on Postural Stability and Quality of Life
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In: ETSU Faculty Works (2018)
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10 |
Vestibular Consequences of Noise Exposure in Humans
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In: ETSU Faculty Works (2018)
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11 |
A Benign Paroxysmal Positional Vertigo Triage Clinic
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In: ETSU Faculty Works (2017)
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12 |
Efficacy of Gaze Stability Exercises in Older Adults with Non-vestibular Dizziness
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In: ETSU Faculty Works (2017)
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13 |
Vestibular Consequences of Mild Traumatic Brain Injury and Blast Exposure: A Review
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In: ETSU Faculty Works (2017)
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14 |
War-related Vestibular Dysfunction
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In: ETSU Faculty Works (2017)
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15 |
Reliability and Validity of Bertec Computerized Dynamic Posturography
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In: ETSU Faculty Works (2017)
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16 |
Characteristics and Treatment Outcomes of Benign Paroxysmal Positional Vertigo in a Cohort of Veterans
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In: ETSU Faculty Works (2017)
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17 |
Contemporary Issues in Vestibular Assessment
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In: ETSU Faculty Works (2016)
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18 |
Vestibular, Balance, Microvascular and White Matter Neuroimaging Characteristics of Blast Injuries and Mild Traumatic Brain Injury: Four Case Reports
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In: ETSU Faculty Works (2016)
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19 |
Reliability of Regression Gain Versus Instantaneous Gain During Video Head Impulse Testing
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In: ETSU Faculty Works (2016)
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20 |
Intra- and Inter-Examiner Reliability of the Binocular Video Head Impulse Test
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In: ETSU Faculty Works (2016)
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