title: Vocational outcome indicators in atypically recovering mild TBI: a post-intervention study.
abstract: Beyond issues of MTBI etiology, a key question remains the characterization and early identification of those individuals at risk of poor functional outcome. Using a retrospective analysis, the current study aimed at identifying the specific indicators related to return to work in adults with both symptomatic MTBI and functional impacts, having completed a specialized intervention program. In terms of outcome, 59.1% of the cohort (n=110) returned to some form of work-related activity by the end of intervention whereas the rest had not. Three of the sixteen variables studied were retained (logistic regression) as providing unique and significant (p<0.05) contributions to the prediction outcome model, namely age, number of subjective symptoms and the presence of a public insurance provider. There was also an interaction between the presence of a public insurance provider and referral delay. Overall percentage of cases correctly classified by the model was 70%, positive predictive accuracy was 72.9%, whereas negative predictive accuracy was 65%. Our findings suggest that any studies attempting to assess functional outcome need to take account of the multifactorial nature of MTBI, including not only more objective psychological/physiological variables related to the injury, but also subjective complaints and environmental factors.
authors.affiliation: TBI Program, Centre de réadaptation Lucie-Bruneau, Montréal, Québec, Canada.
authors.forename: Fanny
authors.initials: F
authors.lastname: Guérin
authors.forename: Stephan
authors.initials: S
authors.lastname: Kennepohl
authors.forename: Geneviève
authors.initials: G
authors.lastname: Léveillé
authors.forename: Aysha
authors.initials: A
authors.lastname: Dominique
authors.forename: Michelle
authors.initials: M
authors.lastname: McKerral
mesh_terms: D000328:Adult; D000367:Age Factors; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D015331:Cohort Studies; D004651:Employment; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008483:Medical Assistance; D008875:Middle Aged; D011792:Quebec; D012189:Retrospective Studies; D016896:Treatment Outcome