Citation

Chee JN, Hawley C, Charlton JL, Marshall S, Gillespie I, Koppel S, Vrkljan B, Ayotte D, Rapoport MJ. J. Head Trauma Rehabil. 2019; 34(1): E27-E38.

Affiliation

Department of Psychiatry, Sunnybrook Health Sciences Centre, and Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Mr Chee and Dr Rapoport); Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK (Dr Hawley); Monash University Accident Research Centre, Monash University, Clayton, Australia (Drs Charlton and Koppel); Ottawa Hospital Research Institute, Ontario, Canada (Dr Marshall); Canadian Forces Health Services Centre (Pacific), Victoria, British Columbia, Canada (Dr Gillespie); School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada (Dr Vrkljan); and Canadian Medical Association, Ottawa, Ontario, Canada (Ms Ayotte).

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000400

PMID

30045219

Abstract

OBJECTIVE: To synthesize knowledge of the risk of motor vehicle collision (MVC) following a traumatic brain injury (TBI) and the associated risk of driving impairment, as measured by on-road tests, computerized simulators, and self-reported or state-recorded driving records.

METHODS: Our international team searched 7 databases for studies published between 1990 and 2015 of people with TBI, controls, and data concerning either MVC or driving impairment. The included articles examined the risk of MVC among people with TBI; we excluded studies that examined the risk of having a TBI associated with being involved in an MVC.

RESULTS: From 13 578 search results, we included 8 studies involving 1663 participants with TBI and 4796 controls. We found no significant difference in the risk of MVC (odds ratio = 1.24, 95% confidence interval = 0.80-1.91, P =.34). When we restricted the analysis to self-report, the risk of MVC was higher for those without a TBI (odds ratio = 1.63, 95% confidence interval = 1.21-2.22, P =.002). In contrast, participants with TBI consistently performed worse during on-road assessments and had more problems with vehicular control.

CONCLUSION: Limitations of reviewed studies included small sample sizes, failure to specify TBI severity or time postinjury, and absence of objective measures of risk.

FINDINGS concerning the relationship between TBIs from non-MVC causes and crash risk are, therefore, inconclusive and do not provide evidence for major changes to existing clinical guidelines for driving with TBI.

Language: en