Citation

Grauwmeijer E, Heijenbrok-Kal M, Haitsma I, Ribbers G. J. Neurotrauma 2017; 34(17): 2575-2581.

Affiliation

Rijndam rehabilitation Center, Rotterdam Neurorehabilitation Research - RoNeRes, Rotterdam, Netherlands ; gribbers@rijndam.nl.

Copyright

(Copyright © 2017, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2016.4846

PMID

28447873

Abstract

The objective of this prospective cohort study was to evaluate the probability of employment and predictors of employment in patients with moderate to severe Traumatic Brain Injury (TBI) over 10 years follow-up. 113 patients (18-67 years) were included with follow-up measurements 3, 6, 12, 18, 24, 36 months and ten years after TBI. Potential predictors of employment probability included patient characteristics, injury severity factors, functional outcome measured at discharge from the hospital with the Glasgow Outcome Scale (GOS), Barthel Index (BI), Functional Independence Measure (FIM), and the Functional Assessment Measure (FAM). Forty-eight patients (42%) completed the 10-year follow-up. Three months after TBI, 12% was employed, which gradually, but significantly increased to 57% after 2-years follow-up (p<.001), followed by a significant decrease to 43% (p=.041) after ten years. Ten years after TBI, we found that employed persons had less severe TBI, shorter length of hospital stay (LOS), and higher scores on the GOS, BI, FIM, and FAM at hospital discharge than unemployed persons. No significant differences in age, sex, educational level, living with partner/family or not, pre-injury employment, professional category, psychiatric symptoms, or discharge destination were found. Longitudinal multivariable analysis showed that time, pre-injury employment, FAM, and LOS were independent predictors of employment probability. We concluded that employment probability ten years post moderate or severe TBI is related to injury severity and pre-injury employment. Future studies on vocational rehabilitation should focus on modifiable factors and take into consideration the effects of national legislation and national labor market forces.

Language: en

Keywords

OUTCOME MEASURES; PROSPECTIVE STUDY; REHABILITATION; TRAUMATIC BRAIN INJURY