Syllabus

Please select which Form Variables you would like to see. Form I variables are the variables asked about the initial rehabiliation stay. Form II variables are questions asked to an individual at follow-up. Once you select Form I or Form II you have a choice of viewing either the actual fields that the variable group has ("Show Fields"), or you can view the data dictionary page ("Select") for the selected variable group.

Select which form you want to see Form IForm II

Group ID	Title	Form
01	VERSION OF FORM I BEING ENTERED	1
100	SYSTEM/SUBJECT ID	1
101a	DATES (AND TIMES)	1
102	SHORT TERM REHABILITATION INTERRUPTION	1
103	PATIENT BIRTHDATE	1
104	SEX	1
105	RACE	1
106	PRIMARY LANGUAGE	1
107	MARITAL STATUS	1
108	PRIMARY PERSON LIVING WITH	1
109	RESIDENCE	1
109a	ZIP CODE	1
110a	YEARS OF EDUCATION	1
110b	GED	1
111a	EMPLOYMENT STATUS	1
111b	HOURS OF PAID COMPETITIVE EMPLOYMENT	1
111d	JOB STABILITY: WEEKS EMPLOYED	1
111i	ANNUAL EARNINGS	1
112	CENSUS OCCUPATIONAL CATEGORY	1
121	HISTORY OF TBI	1
122	PREMORBID CONDITIONS	1
123	PREMORBID LIMITATIONS	1
130a	DATE ABLE TO FOLLOW COMMANDS	1
131h	ASSOCIATED INJURY - Spinal Cord Injury	1
133a	CAUSE OF INJURY	1
133b	ICD-9-CM EXTERNAL CAUSE OF INJURY CODE	1
134	ETOH BLOOD LEVEL AT INJURY	1
135	INTRACRANIAL CT DIAGNOSIS	1
137	ICD-9-CM Diagnosis codes	1
139	GLASGOW COMA SCALE	1
140	REVISED TRAUMA SCORE	1
144a	DATE EMERGED FROM PTA	1
144b	METHOD OF PTA DETERMINATION	1
146	CAUSE(S) OF DEATH	1
148h	CRANIAL COMPLICATIONS - Intracranial Hypertension	1
150	NEUROPSYCHOLOGICAL BATTERY	1
150q	ORIENTATION LOG (O-LOG)	1
150r	CALIFORNIA VERBAL LEARNING TEST (CVLT-II)	1
150s	REITAN TRAIL MAKING TEST	1
151	DISABILITY RATING SCALE	1
152	FUNCTIONAL INDEPENDENCE MEASURE (FIM)	1
170m1	CRANIAL SURGERY - CRANIOTOMY/CRANIECTOMY	1
176	CHARGES	1
178	PAYOR SOURCE	1
192a1	PREMORBID DRUG USE	1
192a2	PREMORBID ALCOHOL USE	1
192g	PREMORBID PSYCHIATRIC HISTORY	1
192h	PREMORBID HISTORY OF PENAL INCARCERATIONS WITH CONVICTION FOR FELONY	1
192i	PREMORBID HISTORY OF LEARNING AND/OR BEHAVIOR PROBLEMS IN SCHOOL	1

National Data and Statistical Center

Traumatic Brain Injury Model Systems