Objectives: To investigate mortality, life expectancy, causes, and risk factors for death in individuals with traumatic brain injury (TBI). Hypotheses: TBI increases mortality and decreases life expectancy. Causes of death after TBI do not match the causes in the general population. The risk of death is greater in certain TBI subgroups. Risk of death decreases with each newly injured cohort over 4 decades. Participants: One thousand four hundred ninety-four individuals with TBI surviving to their first anniversary of injury admitted to inpatient rehabilitation from an acute care hospital within 1 year of injury between 1961 and 2002. Methods: A retrospective cohort study using data from an inpatient rehabilitation facility, the Social Security Death Index, and the US population age-race-gender specific mortality rates for 1992 and 2002. Results: Individuals with TBI were 1.7 times more likely to die, with a shortened life expectancy of 5 years. Causes of death exceeding those in the general population were aspiration pneumonia, other pneumonias, seizure, digestive conditions, and suicide. Risk factors for death were age, gender, education, length of stay, injury year, and Glasgow Outcome Scale score. Conclusions: Four decades of follow-up has demonstrated that life expectancy after TBI rehabilitation is reduced with several factors influencing mortality and causes of death.

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