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Predicting return to work in traumatic brain injury using assessment scales.
1Marianjoy Rehabilitation Center, Wheaton, IL.
Archives of Physical Medicine and Rehabilitation
|October 1, 1992
Summary
The Patient Evaluation and Conference System (PECS) accurately predicts return to work after traumatic brain injury. Tracking social factors like substance abuse and support systems can further improve these predictions.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Occupational Health
Background:
- Traumatic brain injury (TBI) significantly impacts an individual's ability to return to work.
- Accurate prediction of return to work is crucial for effective rehabilitation planning and support.
- Existing assessment scales vary in their predictive capabilities for vocational outcomes post-TBI.
Purpose of the Study:
- To compare the predictive accuracy of two common brain injury assessment scales against a comprehensive functional scale for return to work in TBI patients.
- To identify which scales are most effective in forecasting vocational outcomes after inpatient rehabilitation.
Main Methods:
- Fifty-seven TBI patients were assessed at admission and discharge using the Patient Evaluation and Conference System (PECS), Disability Rating Scale, and Levels of Cognitive Functioning Scale.
- Hierarchical logistic regression analysis was employed to evaluate the scales' accuracy in predicting return to work or school up to 26 months post-injury.
- Initial and discharge status on each scale served as independent variables, with return to work/school as the dependent variable.
Main Results:
- The assessed scales demonstrated a predictive accuracy ranging from 73.5% to 84.4% for return to work.
- The total PECS score and PECS Cognition sub-score emerged as the most accurate predictors of vocational outcome.
- Inaccurate predictions highlighted the need to consider social factors such as substance abuse, family support, and financial needs.
Conclusions:
- The Patient Evaluation and Conference System (PECS) shows strong potential for predicting return to work in individuals with traumatic brain injury.
- Integrating assessments of social determinants, including substance abuse history and support systems, is vital for refining return-to-work predictions.
- Further research should explore incorporating these social factors into TBI assessment protocols to enhance rehabilitation strategies.