Predictors of High School and College Graduation After Sustaining a Moderate-to-Severe Traumatic Brain Injury.

Abstract

To identify early predictors of US high school and college graduation after moderate-to-severe traumatic brain injury (TBI). Inpatient rehabilitation and community. TBI Model Systems participants, aged 16 to 24 years, enrolled as high school or college students at time of injury. Prospective cohort study. Successful graduation was defined as having a diploma (high school) or an associate/bachelor's degree (college) at 1-, 2-, or 5-year follow-up. Predictors were sex, race/ethnicity, urbanicity, preinjury substance abuse, primary rehabilitation payer, and functional independence at inpatient rehabilitation discharge. We descriptively characterized differences between those who did and did not graduate high school and college within the first 5 years postinjury and identified early predictors of successful high school and college graduation using 2 binomial logistic regressions. Of those with known graduation status, 81.2% of high school and 41.8% of college students successfully graduated. Graduates in both groups were more often White than Black and had more functional independence at discharge. Among high school students, preinjury substance abuse was also a risk factor for not graduating, as was identifying as Hispanic or "other" race. Sociodemographic factors and disability influence graduation outcomes, requiring structural, institutional, and personal interventions for success.