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Vocational Outcomes After Traumatic Brain Injury; Prevalence and Risk Factors After 1 Year in a Multivariable Model.

Rajiv Singh1, Jeremy Dawson, Subhashis Basu

  • 1School of Health and Related Research (ScHARR), Faculty of Medicine, Dentistry and Health, University of Sheffield, Sheffield, United Kingdom (Drs Singh, Humphries, Mason, and Lecky); Osborn Neurorehabilitation Unit, Department of Rehabilitation Medicine (Drs Singh and Humphries), and Occupational Health Department, Northern General Hospital (Dr Basu), Sheffield Teaching Hospitals, Sheffield, United Kingdom; and Institute of Work Psychology, Sheffield University Management School, Sheffield, United Kingdom (Dr Dawson).

The Journal of Head Trauma Rehabilitation
|May 3, 2021
PubMed
Summary
This summary is machine-generated.

Return to work after traumatic brain injury (TBI) is poor, with only 44.9% achieving full-time employment or study at one year. Injury severity and psychological factors predict employment status, but much remains unexplained.

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Area of Science:

  • Neuroscience
  • Public Health
  • Rehabilitation Medicine

Background:

  • Traumatic brain injury (TBI) significantly impacts individuals of working age.
  • Understanding long-term employment and study outcomes after TBI is crucial for rehabilitation and societal reintegration.

Purpose of the Study:

  • To determine the prevalence of employment status (ES) or full-time study after TBI in a representative population.
  • To identify predictive factors for employment and study outcomes following TBI.

Main Methods:

  • Prospective cohort study involving 1734 working-age individuals admitted with TBI.
  • Follow-up at 8 weeks and 1 year using face-to-face interviews.
  • Employment or study status analyzed as an ordinal variable (complete, partial/modified, or no return).

Main Results:

  • At 1 year post-TBI, only 44.9% returned to full-time work/study; 28.7% had a partial/modified return, and 26.4% had no return.
  • Lower employment status was associated with greater injury severity, CT scan abnormalities, older age, assault as the mechanism of injury, and presence of depression, alcohol intoxication, or psychiatric history.
  • A multivariable model explained 35.3% of the variance in employment status (P < .001).

Conclusions:

  • Employment outcomes one year after TBI are suboptimal, with frequent changes in work status observed.
  • While certain factors can help identify vulnerable individuals, a significant portion of the variance in employment outcomes remains unexplained, necessitating further research.