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Published on: January 20, 2023
Race and productivity outcome after traumatic brain injury: influence of confounding factors
Mark Sherer1, Todd G Nick, Angelle M Sander
1Neuropsychology Department, Methodist Rehabilitation Center, University of Mississippi Medical Center, Jackson, MS 39216, USA. marks@mmrcrehab.org
Objective:
Investigate the impact of race on productivity outcome after traumatic brain injury (TBI) and evaluate the influence of confounding factors on this relationship.
Design:
Inception cohort of 1083 adults with TBI for whom 1-year productivity follow-up data were available.
Results:
Univariable logistic regression indicated that race was a significant predictor of productivity outcome after TBI. African Americans were 2.76 times more likely to be nonproductive than whites and other racial minorities were 1.92 times more likely to be nonproductive than whites. Multivariable logistic regression analyses revealed that the effect of race on employability was influenced by confounds with preinjury productivity, education level, and cause of injury. After adjustment for other predictors, African Americans were 2.00 times more likely to be nonproductive than whites and other racial minorities were 2.08 times more likely to be nonproductive than whites. The multivariable logistic regression model with all predictors except race accounted for 39% of the variability in productivity outcome (R2-Nagelkerke=0.39), whereas the full logistic regression model including race accounted for 41% of the variability in productivity outcome (R2-Nagelkerke=0.41); a difference of only 2%.
Conclusion:
Any effect of race on productivity is significantly influenced by confounding with preinjury productivity, education level, and cause of injury.
