Saurabha Bhatnagar, MD

Objective: To compare Veterans Health Administration (VHA) diagnoses, health services utilization, and costs by mild traumatic brain injury (mTBI) group (blast-related [BR] mTBI vs non-blast-related [NBR] mTBI vs no mTBI) among Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans in the Chronic Effects of Neurotrauma Consortium multicenter observational study.

The time it takes for clinical innovation and evidence-based practices to reach patients remains a major challenge for the health care sector. In 2015, the Veterans Health Administration (VHA) launched the Diffusion of Excellence Initiative aimed at aligning organizational resources with early-stage to midstage promising practices and innovations to replicate, scale, and eventually spread those with greatest potential for impact and positive outcomes. This initiative serves as a promising model… Show more

The time it takes for clinical innovation and evidence-based practices to reach patients remains a major challenge for the health care sector. In 2015, the Veterans Health Administration (VHA) launched the Diffusion of Excellence Initiative aimed at aligning organizational resources with early-stage to midstage promising practices and innovations to replicate, scale, and eventually spread those with greatest potential for impact and positive outcomes. This initiative serves as a promising model for other health care systems seeking to accelerate the spread and adoption of clinical innovation and evidence-based practices. Show less

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.

Conclusions and Relevance Although wait times in the VA and PS appeared to be similar in 2014, there have been interval improvements in VA wait times since then, while wait times in the PS appear to be static. These findings suggest that access to care within the VA has improved over time.

Each year, approximately 1.7 million Americans have a traumatic brain injury (TBI); more than 5 million of those hospitalized for a TBI are currently living with a disability.1 Some have postulated this figure to be underestimated, as some patients with mild TBIs (mTBIs) do not seek medical care.1 TBIs can be caused by a variety mechanisms, including motor vehicle accidents, falls, assaults, strikes or blows to the head, biking or sporting accidents, and blast injuries from military conflicts.2… Show more

Each year, approximately 1.7 million Americans have a traumatic brain injury (TBI); more than 5 million of those hospitalized for a TBI are currently living with a disability.1 Some have postulated this figure to be underestimated, as some patients with mild TBIs (mTBIs) do not seek medical care.1 TBIs can be caused by a variety mechanisms, including motor vehicle accidents, falls, assaults, strikes or blows to the head, biking or sporting accidents, and blast injuries from military conflicts.2 More than 650,000 annual cases of TBI are attributed to falls and motor vehicle accidents3; more than 250,000 service members have been diagnosed with a TBI from the Afghanistan and Iraq conflicts.4

TBI is a serious problem that can lead to long-term disabilities. Show less

There are nearly 1.8 million annual emergency room visits and over 289,000 annual hospitalizations related to traumatic brain injury (TBI). The goal of this review article is to highlight pharmacotherapies that we often use in the clinic that have been shown to benefit various sequelae of TBI. We have decided to focus on sequelae that we commonly encounter in our practice in the post-acute phase after a TBI. These symptoms are hyper-arousal, agitation, hypo-arousal, inattention, slow processing… Show more

There are nearly 1.8 million annual emergency room visits and over 289,000 annual hospitalizations related to traumatic brain injury (TBI). The goal of this review article is to highlight pharmacotherapies that we often use in the clinic that have been shown to benefit various sequelae of TBI. We have decided to focus on sequelae that we commonly encounter in our practice in the post-acute phase after a TBI. These symptoms are hyper-arousal, agitation, hypo-arousal, inattention, slow processing speed, memory impairment, sleep disturbance, depression, headaches, spasticity, and paroxysmal sympathetic hyperactivity. In this review article, the current literature for the pharmacological management of these symptoms are mentioned, including medications that have not had success and some ongoing trials. It is clear that the pharmacological management specific to those with TBI is often based on small studies and that often treatment is based on assumptions of how similar conditions are managed when not relating to TBI. As the body of the literature expands and targeted treatments start to emerge for TBI, the function of pharmacological management will need to be further defined. Show less