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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 |
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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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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5 |
A Benign Paroxysmal Positional Vertigo Triage Clinic
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In: ETSU Faculty Works (2017)
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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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Reliability and Validity of Bertec Computerized Dynamic Posturography
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In: ETSU Faculty Works (2017)
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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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9 |
Contemporary Issues in Vestibular Assessment
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In: ETSU Faculty Works (2016)
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10 |
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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Vestibular Assessment and Rehabilitation: Ten-year Survey Trends of Audiologists' Opinions and Practice
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In: ETSU Faculty Works (2016)
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Contemporary Issues in Vestibular Assessment
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In: ETSU Faculty Works (2016)
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Vestibular Consequences of mTBI and Blast Exposure
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In: ETSU Faculty Works (2016)
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14 |
Reliability and Normative Data for the Dynamic Visual Acuity Test for Vestibular Screening
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In: ETSU Faculty Works (2016)
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Intra- and Inter-Examiner Reliability of the Video Head Impulse Test
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In: ETSU Faculty Works (2015)
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Survey of Audiologists’ Opinions and Practices regarding Vestibular Assessment and Rehabilitation
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In: ETSU Faculty Works (2015)
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17 |
Inter-ocular Gain Differences of The Horizontal Vestibulo-ocular Reflex During the Video Head Impulse Test
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In: ETSU Faculty Works (2015)
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18 |
Video Head Impulse Testing (vHIT) and the Assessment of Horizontal Semicircular Canal Function
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In: ETSU Faculty Works (2015)
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19 |
Vestibular Consequences of mTBI and Blast Exposure
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In: ETSU Faculty Works (2015)
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20 |
Effects of Age on Vestibular and Balance Systems
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In: ETSU Faculty Works (2015)
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