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Return to productive activity after traumatic brain injury: relationship with measures of disability, handicap, and
Amy K Wagner1, Flora M Hammond, Howell C Sasser
1Charlotte Institute of Rehabilitation, Department of Physical Medicine and Rehabilitation, Charlotte, NC, USA. wagnerak@msx.upmc.edu
Objectives:
To identify which factors are associated with successful return to productive activity (RTPA) 1 year after hospitalization with traumatic brain injury (TBI) and to examine the relations between successful RTPA and other measures of impairment, disability, handicap, and integration into the community.
Design:
Prospective study with 1-year follow-up.
Setting:
Level I trauma center.
Participants:
One hundred five respondents from a cohort of 378 adults hospitalized with TBI admitted between September 1997 and May 1998.
Interventions:
Not applicable.
Main Outcome Measures:
Return to productive work 1 year after injury; Disability Rating Scale (DRS); and Community Integration Scale (CIQ).
Results:
Of the 105 participants, 72% achieved RTPA. Logistic regression showed an association between RPTA and the following factors: premorbid educational level, premorbid psychiatric history, violent mechanism of injury, discharge status after acute hospitalization, prior alcohol and drug use, and injury severity. Handicap and community integration at 1-year postinjury, as measured by subscales of the DRS and the CIQ, were also associated with RTPA.
Conclusion:
Premorbid and injury-related variables and measures of handicap and community integration were associated with RTPA at 1 year. To understand and effectively support vocational pursuits in the TBI population, future studies are needed to define further causality and origin of these relationships.