Acute predictors of return to employment after traumatic brain injury: a longitudinal follow-up.
OBJECTIVE
To investigate the relation between selected acute injury and patient characteristics and subsequent return to work 1 to 5 years postinjury.


METHODS
Longitudinal design with prospectively collected data. Data were collected on patients at the time of injury and each year postinjury for up to 5 years.


METHODS
Four medical centers in the federally sponsored Traumatic Brain Injury Model Systems project that provide emergency medical services, intensive and acute medical care, inpatient rehabilitation, and a spectrum of community rehabilitation services.


METHODS
Patients were selected from a national database of 538 rehabilitation inpatients admitted to acute care within 8 hours of traumatic brain injury (TBI) and seen at 1 to 5 years follow-up.


METHODS
Not applicable.


METHODS
Employment status (employed vs not employed) at 1 to 5 years postinjury. Logistic regression analyses were performed to determine the extent to which selected variables predicted employment status at years 1 to 5 postinjury.


RESULTS
At year 1 postinjury, preinjury productivity, age, education, and rehabilitation length of stay were all significantly associated with postinjury employment. Preinjury employment and productivity and age significantly predicted employment at postinjury year 2. At year 3 postinjury, preinjury productivity, age, and FIMtrade mark instrument discharge score significantly predicted employment status. Age was significantly associated with employment status at year 4 postinjury. Preinjury employment and productivity and Disability Rating Scale discharge score were found to be significant predictors of postinjury employment at year 5 follow-up.


CONCLUSIONS
The relationship between certain acute injury and patient variables (eg, age, preinjury productivity, education, discharge FIM) and subsequent return to work may provide rehabilitation professionals with useful information regarding the intensity and types of services needed for individuals in the vocational rehabilitation planning process.
Keyser-Marcus
Lori A
LA
School of Education, Virginia Commonwealth University, Richmond 23284, USA. lakeyser@saturn.vcu.edu
Bricout
John C
JC
Wehman
Paul
P
Campbell
Leanne R
LR
Cifu
David X
DX
Englander
Jeffrey
J
High
Walter
W
Zafonte
Ross D
RD
D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D004651:Employment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D012044:Regression Analysis; D012720:Severity of Illness Index; D013997:Time Factors