Residual impairments and work status 15 years after penetrating head injury: report from the Vietnam Head Injury Study.
We investigated the relationship of neurologic, neuropsychological, and social interaction impairments to the work status of a large sample of penetrating head-injured patients wounded some 15 years earlier during combat in Vietnam. Extensive standardized testing of neurologic, neuropsychological, and social functioning was done at follow-up on each head-injured patient (N = 520), as well as on a sample of uninjured controls (N = 85). Fifty-six percent of the head-injured patients were working at follow-up compared with 82% of the uninjured controls. Seven systematically defined impairments proved to be most correlated with work status. These were post-traumatic epilepsy, paresis, visual field loss, verbal memory loss, visual memory loss, psychological problems, and violent behavior. These disabilities had a cumulative and nearly equipotent effect upon the likelihood of work. We suggest that a simple summed score of the number of these seven disabilities can yield a residual "disability score" which may prove to be a practical tool for assessing the likelihood of return to work for patients in this population and perhaps in other brain-injured populations. These findings may also help to focus rehabilitation efforts on those disabilities most likely to affect return to work.
Schwab
K
K
Head Injury Unit, Uniformed Services University of the Health Sciences, Bethesda, MD.
Grafman
J
J
Salazar
A M
AM
Kraft
J
J
D000328:Adult; D001927:Brain Diseases / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation; D006259:Craniocerebral Trauma / Q000150:complications* / Q000534:rehabilitation; D004651:Employment; D005500:Follow-Up Studies; D006801:Humans; D007361:Intelligence Tests; D008297:Male; D008889:Military Personnel; D009483:Neuropsychological Tests; D012044:Regression Analysis; D012919:Social Behavior; D016896:Treatment Outcome; D014481:United States; D014728:Veterans; D014744:Vietnam; D014950:Wounds, Penetrating / Q000150:complications* / Q000534:rehabilitation