Effects of an inpatient rehabilitation program after temporal lobe epilepsy surgery and other factors on employment 2 years after epilepsy surgery.
OBJECTIVE
To evaluate the effects of a postsurgical rehabilitation program on employment status 2 years after temporal lobe epilepsy surgery in relation to other predictors.


METHODS
Employment outcome 2 years after temporal lobe resection in a group of 232 adult patients with the offer of a 3-week inpatient rehabilitation program immediately after surgery ("Reha group") was compared to a group of 119 patients who had surgery before such a rehabilitation program existed. One hundred thirty-nine (59.9%) of the Reha group patients attended the rehabilitation program. Further predictors for employment outcome were analyzed using multivariate logistic regression analysis.


RESULTS
Preoperatively, the groups did not differ significantly in variables relevant for employment, including employment rate. Two years after surgery, the rate of those not being employed had decreased in the Reha group from 38.4% to 27.6% (p < 0.001, McNemar test), and slightly increased in the control group (37.8-42.0%; n.s.), resulting in a difference of 14.4% in favor of the Reha group (p = 0.008). General unemployment rates during the two observation periods were similar. In addition to the offer of rehabilitation support ("Reha group") and preoperative employment, the following other variables were shown as significant predictors of employment post surgery in multivariate regression analysis: seizure outcome, diagnosis of a personality disorder preoperatively, and age at surgery (all, p < 0.01; Nagelkerkes R(2) = 0.59).


CONCLUSIONS
Independently from other factors, a 3-week inpatient rehabilitation program after temporal lobe epilepsy surgery seems to improve employment status 2 years after surgery.
Epilepsy Center Bethel, Clinic Mara, Bielefeld, Germany.
Rupprecht
R
Thorbecke
Epilepsy Center Bethel, Society for Epilepsy Research, Bielefeld, Germany.
Theodor W
TW
May
Epilepsy Center Bethel, Clinic Mara, Bielefeld, Germany.|Center for Psychiatry and Psychotherapy, Bielefeld Protestant Hospital, Bielefeld, Germany.
Steffi
S
Koch-Stoecker
Epilepsy Center Bethel, Clinic Mara, Bielefeld, Germany.
Alois
A
Ebner
Epilepsy Center Bethel, Clinic Mara, Bielefeld, Germany.
Christian G
CG
Bien
Epilepsy Center Bethel, Clinic Mara, Bielefeld, Germany.
Ulrich
U
Specht
D000293:Adolescent; D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000534:rehabilitation*; D003131:Combined Modality Therapy; D003299:Cooperative Behavior; D004833:Epilepsy, Temporal Lobe / Q000534:rehabilitation / Q000601:surgery*; D005260:Female; D006801:Humans; D033183:Interdisciplinary Communication; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission; D010348:Patient Care Team; D011183:Postoperative Complications / Q000534:rehabilitation*; D011379:Prognosis; D012047:Rehabilitation Centers; D012050:Rehabilitation, Vocational; D012189:Retrospective Studies; D055815:Young Adult
Employment; Epilepsy surgery; Outcome; Rehabilitation