TY - JOUR
T1 - Employment Outcome Ten Years after Moderate to Severe Traumatic Brain Injury
T2 - A Prospective Cohort Study
AU - Grauwmeijer, Erik
AU - Heijenbrok-Kal, Majanka H.
AU - Haitsma, Ian K.
AU - Ribbers, Gerard M.
PY - 2017/9
Y1 - 2017/9
N2 - 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-year follow-up. One hundred nine patients (18-67 years) were included with follow-up measurements 3, 6, 12, 18, 24, and 36 months and 10 years post-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 followup. Three months post-TBI, 12% were employed, which gradually, but significantly, increased to 57% after 2-years followup (p < 0.001), followed by a significant decrease to 43% (p = 0.041) after 10 years. Ten years post-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 10 years after 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.
AB - 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-year follow-up. One hundred nine patients (18-67 years) were included with follow-up measurements 3, 6, 12, 18, 24, and 36 months and 10 years post-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 followup. Three months post-TBI, 12% were employed, which gradually, but significantly, increased to 57% after 2-years followup (p < 0.001), followed by a significant decrease to 43% (p = 0.041) after 10 years. Ten years post-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 10 years after 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.
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=eur_pure&SrcAuth=WosAPI&KeyUT=WOS:000408310200011&DestLinkType=FullRecord&DestApp=WOS
U2 - 10.1089/neu.2016.4846
DO - 10.1089/neu.2016.4846
M3 - Article
C2 - 28447873
SN - 0897-7151
VL - 34
SP - 2575
EP - 2581
JO - Journal of Neurotrauma
JF - Journal of Neurotrauma
IS - 17
ER -