title: Employment outcomes following resective epilepsy surgery.
abstract: OBJECTIVE
  Analyze determinates of employment changes from before to 2 years after surgery in refractory focal epilepsy patients.
  
  
  METHODS
  Preoperative employment was prospectively assessed in 375 adults with refractory epilepsy. Two-year postsurgical employment status was obtained for 299; factors potentially associated with employment status change among subgroups unemployed and employed at baseline were analyzed.
  
  
  RESULTS
  Presurgical employment status was full-time (n = 148, 39.5%), part-time (n = 26, 6.9%), disabled and unemployed (n = 100, 26.7%), unemployed (n = 44, 11.7%), and other (n = 57, 15.2%). Those with and without 2-year follow-up did not differ on baseline characteristics (all p > 0.10). Two years after surgery, 42.8% were employed full-time and 12.4%, part-time. Among those unemployed before surgery, better seizure outcome was associated with gaining employment at 2 years (p = 0.03).
  
  
  CONCLUSIONS
  Net employment gains were modest 2 years after surgery and higher with better seizure outcomes, reinforcing the need for optimizing surgical candidate selection, long-term follow-up studies, and postsurgical vocational rehabilitation.
authors.affiliation: Robert Wood Johnson Clinical Scholars Program, Department of Medicine, University of California Los Angeles and the Greater Los Angeles VA Health Care System, Los Angeles, California 90095-1769, USA.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Chin
authors.forename: Anne T
authors.initials: AT
authors.lastname: Berg
authors.forename: Susan S
authors.initials: SS
authors.lastname: Spencer
authors.forename: Michael R
authors.initials: MR
authors.lastname: Sperling
authors.forename: Sheryl R
authors.initials: SR
authors.lastname: Haut
authors.forename: John T
authors.initials: JT
authors.lastname: Langfitt
authors.forename: Carl W
authors.initials: CW
authors.lastname: Bazil
authors.forename: Thaddeus S
authors.initials: TS
authors.lastname: Walczak
authors.forename: Steven V
authors.initials: SV
authors.lastname: Pacia
authors.forename: Barbara G
authors.initials: BG
authors.lastname: Vickrey
mesh_terms: D000328:Adult; D018572:Disease-Free Survival; D004651:Employment / Q000706:statistics & numerical data*; D004828:Epilepsies, Partial / Q000453:epidemiology / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D011446:Prospective Studies; D012050:Rehabilitation, Vocational; D014478:Unemployment / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology